Out last few blogs posts we have discussed inflammation. To further build off of this, I wanted to discuss one of the most common chronic conditions- Arthritis. Arthritis is defined as inflammation of the joints of the body, however, this is just a general term. There are actually a number of different types of arthritis that can impact our joints, two of the most common presentations, and two common presentations we see in physiotherapy are osteoarthritis (OA) and rheumatoid arthritis (RA). Although these conditions both impact the joints, it is important to understand the difference between the two, since management strategies can slightly differ.
What is OA?
Osteoarthritis or OA is a degenerative condition which means that it is the overall- wear and tear- that occurs to a joint. With age, activity, lifestyle and some family predispositions, the some cartilage that lines your joints starts to wear down. This results in the two bony surfaces to touch as the joint bends and straightens leading to pain, swelling and stiffness.
What is RA?
Rheumatoid arthritis or RA is an Autoimmune condition which means that the body’s immune system is attacking the cells of the joint/ synovium leading to breakdown and deformities causing pain, inflammation, and stiffness.
What are the key differences?
As we see above, pain, swelling and stiffness are common symptoms in both RA and OA. Additionally, as both are inflammation responses both result in pain that is worse in the morning when compared to the evening, however, morning stiffness in RA lasts longer (more then 30 minutes) then OA (less then 30 minutes usually).
Additionally, as RA is an immune response it can lead to symptoms and impact multiple areas of the body. Some of the common symptoms are fevers, lumps under the skin and fatigue. This whole body impact also causes RA presentations to be symmetrical- often impacting both hands, toes, shoulders or wrists (smaller joints of the body). Differing, OA as it is a degenerative presentation usually impacts the weight bearing joints of the body including the spine, hips and knees.
How can we help?
If you have either OA or RA there are a number of management recommendations including medications, surgical/ specialist reviews, as well as physiotherapy to help manage the symptoms and disease progression as there is no cure. Treatment is focused primarily on maintaining function, minimising further joint damage and maximising quality of life.
Guidelines based on current research promote exercise and physical activity for both forms of arthritis with special focus on increasing flexibility / stretching, strength, aerobic function and reduced weight, activity limitations and pain. The main difference in management is for RA there are periods of flare ups where the joint becomes red. hot, and swollen. During this period rest and joint protection strategies are recommended until the flare up is over.
If you have any questions regarding the management of your osteoarthritis or rheumatoid arthritis, and would like physiotherapy input, call us today at 045-853726 or book online at https://physiotherapyworks.ie/book-online/.
Ottawa Panel Evidence-Based Clinical Practice Guidelines for Therapeutic Exercises in the Management of Rheumatoid Arthritis in Adults. Ottawa Panel. Phys Ther, 2004; 84(10): 934-972.
Walsh & Hurley. 2009. Evidence based guidelines and current practice for physiotherapy management of knee osteoarthritis. Musculoskeletal Care.(1):45-56. doi: 10.1002/msc.144.
Rheumatoid Arthritis Support Network. 2016. Rheumatoid Arthritis vs Osteoarthritis. Retrieved from https://www.rheumatoidarthritis.org/ra/ra-vs-oa/