Rare or Common — What Type of Arthritis Do You Have?

Osteoarthritis, rheumatoid arthritis and unique effects

If you have painful joints, you might wonder if it’s arthritis. Many people don’t realize that this painful disease includes more than 100 different types, which all involve pain and/or swelling in and around the body’s joints. But how do doctors sort out which type you have?

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Each type is unique. Arthritis may affect different joints of the body — only the fingers, or just the knees — or even a dozen different joints in the body. Some types affect more than just the joints, involving organ systems such as the heart, lung, kidney, eyes and skin.

What should you do if you think you have arthritis?

If you have any type of prolonged joint pain, swelling or stiffness, talk to your doctor. They can refer you to a rheumatologist, who will use their special expertise to learn which type you have. Therapy can be tailored to offer the most effective treatment for you.

Sorting out the types of arthritis

Although there are many types of arthritis, many people have one of the following:

  • Osteoarthritis (affecting more than 26 million Americans)
  • Rheumatoid arthritis (affecting an estimated 1.5 million Americans)

While there are many types of arthritis, an uncommon type includes reactive arthritis, which typically affects the knees, ankles and feet. A bacterial infection in another part of your body causes the condition. It also can affect your skin and eyes.

Lupus is another uncommon type of arthritis that is seen in women of child-bearing ages where the body’s immune system may attack the skin, joints, kidneys, and heart. It may cause a classic butterfly shaped rash on the face, as well as arthritis.

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Behçet’s disease  is a rare form that affects your blood vessels, causing inflammation. Symptoms include sores in the mouth and on the genitals, rashes and lesions on the skin, and eye inflammation.

Treatment of the many types of arthritis differs as well, involving medications, exercise or, in some cases, surgery. Doctors treat some types with over-the-counter medications such as acetaminophen or ibuprofen. They treat others with powerful chemotherapy-type drugs.

How the two main types differ

A way to distinguish osteoarthritis from rheumatoid arthritis is to consider the cause of problems with the joints. Osteoarthritis happens over time with continued use of the joints, while RA involves attacks on the joints by the body’s own immune system.

Osteoarthritis affects the cartilage that covers the ends of bones on your body’s joints. Cartilage protects the bones and acts as a shock absorber as your body moves. Sometimes the cartilage wears away. Without that protective layer, the bones rub together and cause pain and swelling. This also limits how much the joint can move.

Rheumatoid arthritis is an autoimmune disease that affects joints on both sides of the body (both hands or both knees, for example). It causes joint pain and swelling, stiffness and fatigue.

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Here are more key differences between osteoarthritis and RA:

  • Osteoarthritis may only occur in one joint, while RA typically affects joints on both sides of the body.
  • For both osteoarthritis and RA, symptoms may include pain, swelling and stiffness.
  • With RA, the symptoms also may include fever, fatigue and loss of appetite. The pain may last for longer than two months, but you may have periods with no symptoms at all.
  • Untreated RA usually has significant morning stiffness that may last more than 30 minutes (and often several hours).
  • Mornings are usually better for people with osteoarthritis.  The pain associated with osteoarthritis generally builds up over time and may increase after activities or in the evening.

Osteoarthritis is typically treated with medications to reduce pain and inflammation, exercise to keep the joints flexible and weight management to help prevent additional strain on the joints.

Treatment for RA depends on your age, overall health and how severe your disease is. It usually involves anti-inflammatory drugs as well as medications that control the immune system, such as methotrexate. Your doctor may suggest physical therapy, occupational therapy or surgery, too.

Other conditions besides arthritis can cause joint pain. If joint stiffness and pain are chronic issues for you, be sure to discuss it with your doctor.

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Howard Smith, MD

Howard Smith, MD, is a Staff Rheumatologist and Director of the Lupus Clinic at Cleveland Clinic.
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