Osteoarthritis Versus Rheumatoid Arthritis

If your joints often feel stiff and achy, there's a good chance you suffer from either osteoarthritis (OA) or rheumatoid arthritis (RA).  Although these two types of arthritis share some similar traits, they are two different conditions that require different types of treatment. The following guidelines briefly explain how to tell the difference between OA and RA to help you better understand your symptoms and treatment options.


The causes of OA and RA are vastly different. Osteoarthritis is caused by years of wear and tear on your joints, whereas rheumatoid arthritis is an autoimmune disease. This means the body's immune system attacks the joints, causing pain, inflammation and possible joint damage.

Source of Pain

With a case of osteoarthritis, the cartilage around the joints slowly wears away over time, causing pain as the bones rub together without a cartilage cushion.

The pain of rheumatoid arthritis comes from the lining of the joints, known as the synovium. The immune system thinks there is an invader within the joints, causing an attack on the synovium.

Age of Onset

Osteoarthritis is the most common form of arthritis, affecting an estimated 27 million Americans age 25 and up. Since OA is the result of lifelong wear and tear of joints, it primarily affects older adults. However, it's not impossible for younger adults to develop OA, especially if they suffer a joint injury or have a genetic joint issue.

On the other hand, rheumatoid arthritis can affect people of all ages and can strike much more abruptly than OA. When children under 16 have RA, it's known as "juvenile RA."  


Joint pain is a telltale symptom of both OA and RA, but the duration of an osteoarthritis flare-up is usually much shorter than a rheumatoid arthritis flare-up. For example, an OA sufferer may awaken in the morning with joint stiffness and pain that lasts for a half hour or so. In contrast, RA pain can last much longer than this.  

Other ways symptoms of OA and RA differ include:

  • Affected Finger Joints: OA commonly affects the joints at the ends of fingers, whereas RA tends to affect the middle finger joints more often.
  • Symmetry of Affected Joints: RA pain is more symmetrical because it often affects the same joints on both sides of the body. With OA, this symmetry doesn't usually occur.
  • Nodules: Roughly 20 to 30 percent of RA sufferers develop painful little nodules (hard lumps) under the skin, but these nodules typically aren't associated with OA.
  • Illness: RA can cause an overall sick feeling with fever and fatigue. OA doesn't cause these feelings of illness.
  • Inflammation: RA sufferers often experience joint redness, swelling and inflammation. OA only affects joint function so these symptoms are not necessarily present.

While your gender isn't normally used as a predictor of either type of arthritis, you should know that RA affects women more than men. This gender discrepancy isn't present with OA.

Treatments for Pain

If you have OA, the pain can often be controlled with OTC medications like naproxen or ibuprofen. In more painful OA cases, a steroid injection into the affected joint can be helpful, too.

RA pain can be treated in the same way, in addition to taking a strong oral steroid. Rheumatology treatments can also include disease-modifying antirheumatic drugs (DMARDs) to slow the progression of the disease.

See your doctor if you experience ongoing symptoms of either osteoarthritis or rheumatoid arthritis. Your doctor can test your blood to determine whether or not you have RA, while x-rays of the affected joint can reveal OA cartilage loss. They can then start you on the appropriate treatment to improve your quality of life.