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The two most common subtypes of arthritis are inflammatory and noninflammatory arthritis. This article describes the differences between the two subtypes with regards to causes, risk factors, symptoms and treatment.

Arthritis, which refers to a disease characterized by joint inflammation, is a painful and disabling disorder that is associated with joint stiffness and pain.

While there are several subtypes of arthritis, the two most common forms are inflammatory and non-inflammatory arthritis. The most frequently seen form of inflammatory arthritis is rheumatoid arthritis while the most common form of non-inflammatory arthritis is osteoarthritis. Interestingly, there is a form of osteoarthritis that is also inflammatory, and can be confused with forms of inflammatory arthritis.

It is important to correctly diagnose whether a patient has inflammatory or non-inflammatory arthritis as treatment significantly differs between the two. This article outlines the differences between inflammatory (rheumatoid arthritis) or non-inflammatory arthritis (osteoarthritis) with regards to their causes, risk factors, symptoms, and treatment.

Causes of arthritis

Rheumatoid arthritis is an autoimmune disease, which means that your immune system (which is designed to protect you from foreign organisms) starts to attack itself. In the case of rheumatoid arthritis, your immune system attacks the soft lining around your joints, leading to a build-up of fluid within the joint. This causes the development of characteristic rheumatoid arthritis symptoms such as:

  • Swelling
  • Pain
  • Stiffness
  • Inflammation

Osteoarthritis, on the other hand, develops because patients have a breakdown in cartilage, which is a substance that cushions your joints. Osteoarthritis is thought of as a “wear and tear” disease as it often develops due to repetitive movements. The breakdown of cartilage causes the bones to rub against each other, leading to pain, and sometimes mild inflammation. Pain in osteoarthritis patients is aggravated by movement and weight-bearing and is relieved by rest.

Arthritis: Risk factors

There are several risk factors that are common to both rheumatoid arthritis and osteoarthritis, as well as ones that are specific to each disease.

These are the common risk factors to both diseases:

  • Gender: both types of arthritis are more likely to develop in women compared to men.
  • Age: both arthritis types are common in older adults.

These are the risk factors that are specific to each disease:

  • Rheumatoid arthritis: genetics are a risk factor as you have a higher chance of developing rheumatoid arthritis if your parents, children or siblings have it.
  • Osteoarthritis: being overweight, having prior joint deformities, having diabetes, having gout, conducting repetitive movements every day and having experienced traumatic injuries to joints are all risk factors for the development of osteoarthritis.

Symptoms of arthritis

Similar to risk factors, there are symptoms that are both common and specific to rheumatoid arthritis and osteoarthritis. The symptoms common to both include pain and stiffness in the joints, limited range of motion for joints, warmth in the affected region, and increased severity of symptoms in the morning.

While the basic symptoms are common to both diseases, rheumatoid arthritis and osteoarthritis have their own unique set of symptoms and characteristics and tend to affect affect different joints.

Rheumatoid arthritis: Symptoms

  • Early symptoms of rheumatoid arthritis include a low-grade fever (particularly in children), muscle aches, and severe fatigue.
  • In the advanced stages, patients may develop hard lumps (called rheumatoid nodules) beneath skin near joints that are tender.
  • Joint stiffness lasts longer in rheumatoid arthritis compared to osteoarthritis during a flare-up, and is worse in the morning.
  • At the beginning, rheumatoid arthritis affects smaller joints, such as the finger joints. However, as the disease progresses, rheumatoid arthritis can extend to larger joints including the knees, shoulders and ankles.
  • Rheumatoid arthritis is symmetrical, which means that both sides of your body will experience these symptoms at the same time.
  • Rheumatoid arthritis is a systemic disease, which means that it can affect several systems and organs in your body including lungs, heart and eyes.

Osteoarthritis symptoms

  • As with rheumatoid arthritis, osteoarthritis is most likely to affect the hands and fingers. However, it can also strike the spine, hips and knee, and this is not uncommon.
  • Osteoarthritis is generally limited to joints alone, and doesn’t involve other organs.
  • Patients with osteoarthritis can also develop lumps underneath the skin, but these are different from nodules and are called bone spurs, which refers to excess bone growth at the edges.
  • Unlike rheumatoid arthritis, osteoarthritis is not as symmetrical so you might have pain in both sides of your body, but one joint may feel worse.

Treatment: How is arthritis managed?

There is no cure for arthritis, either inflammatory or non-inflammatory. Therefore, the goal of treatment is to reduce pain, improve functioning and minimize further damage to the joints. Treatment does vary depending on whether you have inflammatory or non-inflammatory arthritis.

Treatment for rheumatoid arthritis includes:

  • Some common treatments include nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen, naproxen and celecoxib, which help reduce pain and inflammation.
  • Disease-modifying antirheumatic drugs (DMARDs), such as methotrexate and leflunomide (Arava), help slow down the progression of the disease and damage to the joints.
  • Corticosteroids can also be used to stop inflammation that affects the joints or internal organs, though this is used rarely.

Treatment for osteoarthritis includes:

  • Analgesics, which are pain relievers such as acetaminophen and opioids.
  • NSAIDs, which are pain relievers as well as fighting inflammation
  • Corticosteroids
  • Hyaluronic acid, which are injections that help lubricate joints.

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