Around 8.75 million people see their GP about osteoarthritis every year in the UK and one in three people over 45 are affected by the condition. Rheumatoid arthritis is much less common and affects 690,000 people in the UK.
Osteoarthritis is a 'wear and tear’ degenerative disease caused by cartilage which cushions the end of your bones thinning and friction developing, resulting in pain. This aliment can be caused by ageing, but also injuries, overuse and being overweight, so symptoms can start at any age.
Any joint in the body can be affected, but osteoarthritis is most common in the hips, knees, hands and spine.
Rheumatoid arthritis is an autoimmune condition caused by the body producing antibodies that attack joint linings causing inflammation and swelling. Fluid which lubricates the joint becomes inflamed, tissue swells as more fluid is produced and this stretches the capsule which holds the joint in place.
The result is that the joint may become unstable and deformed. Rheumatoid arthritis often attacks the smaller joints first, such as those in the hands or balls of the feet and spreads.
Osteoarthritis symptoms can include joint pain, swelling and stiffness. Joints may also creak and crunch as you move and feel stiff in the morning, but this will ease off by moving around within 30 minutes of getting up.
Rheumatoid arthritis may start with a flu-like illness, symptoms include joint pain, swelling, redness, stiffness, fatigue, depression, irritability and anaemia. Pain is usually symmetrical (e.g. affecting both hands or feet), but rheumatoid arthritis can attack the whole body. Unlike osteoarthritis, morning joint stiffness lasts longer than 30 minutes. Rapid loss of function – being unable to fasten buttons or dropping objects – is also common.
If you’re over 50, overweight and have joint pain that gets worse when you move or at the end of the day, then osteoarthritis may be suspected. Joints can also give way due to muscle weakness or a hard or soft swelling develops around the joints.
Blood tests and x-rays are usually only done if your GP wants to rule out another condition or injury.
There’s no definitive test for rheumatoid arthritis, but your GP can examine your joints and order blood tests to check for markers of inflammation and for rheumatoid factor, a protein produced by the immune system which can attack healthy tissue. These tests offer important clues. X-rays can confirm damage and MRI scans reveal inflammation.
Who gets arthritis?
You’re more at risk of developing osteoarthritis if you're over 50, overweight or obese, and female or have a family history of osteoarthritis.
Rheumatoid arthritis is two to three times more common in women than men and usually starts between the ages of 40 and 60, although it can begin at any age. It’s also more common in smokers and those with a family history of rheumatoid arthritis.
Milder osteoarthritis pain and joint stiffness improves with regular exercise. Losing weight if you’re overweight can also ease symptoms as it takes pressure off the joints.
Some people also need to use painkillers, including paracetamol and non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and/or need physiotherapy to improve joint mobility.
Some research has shown supplements may be beneficial in osteoarthritis, including glucosamine and chondroitin, and cod liver oil, which all have anti-inflammatory effects.
If you have rheumatoid arthritis symptoms see a specialist, ideally within three months as earlier treatment with disease modifying anti-rheumatic drugs (DMARDs) and newer treatments called biologics, can reduce inflammation and prevent joint damage.
In both rheumatoid arthritis and osteoarthritis surgery to repair or replace joints may eventually be needed. Around 160,000 hip and knee replacements are performed every year in England and Wales.