April 22, 2022
Author: Michelle Scott, PA-C
Arthritis. It is one of the most common sources of pain that adults deal with. In fact, in the United States, 24% of all adults, or 58.5 million people, have arthritis (CDC 2021).
Even in light of its prevalence, it is still one of the main questions that I get on a daily basis: what is Arthritis?
In short… arthritis is painful inflammation and stiffness of your joints. There are several different types of arthritis, but the most common, and the two that that we primarily see here at Genesis Medicine, are osteoarthritis (OA) and rheumatoid arthritis (RA).
Those will be the two that we tackle here today… so let’s go!
What Is Osteoarthritis (OA)?
Osteoarthritis is a chronic disease caused by damage and degeneration of your articular cartilage.1
Articular means “having to do with joints”. In other words, the “breaking down and wearing out” of important cartilage that helps protect your joints.
As the cartilage gets damaged, the cells that make your cartilage (called chondrocytes) fail to replace the damaged cartilage. If these cells cannot keep up, the body begins to form small bony growths (called osteophytes) to provide support to the damaged joint. As this process continues, the spaces between our joints begin to narrow unevenly (or asymmetrically), and at the same time the osteophytes that are growing begin to cause pain and discomfort. The longer this process continues, the more pain it can cause leading to the need for medical intervention (i.e. medications, injections and potentially surgery).
The most common joints that are affected by OA are the “weight-bearing joints”, such as:
- Knees
- Hips
- Cervical and Lumbar Spine
If you have OA you might feel like your pain worsens with activity and improves with rest and this is because the range of motion for that joint has been decreased due to the damage of the cartilage. There are typically no signs of inflammation (i.e redness, warmth, or swelling of the joint), however you may notice that the joints that are in pain are getting bigger and misshapen. This is from the growth of those osteophytes around the joint space.
So what makes this different than Rheumatoid Arthritis?
What Is Rheumatoid Arthritis (RA)?
The biggest difference is the cause of the inflammation.
Rheumatoid arthritis is a chronic autoimmune inflammatory disease. This means that it is caused by your immune system mistakenly attacking your own body. It typically shows up in multiple joints (called polyarthritis) and is accompanied by bone erosion, cartilage destruction and joint structure loss due to tissue that erodes into the cartilage and bone.2 Rheumatoid arthritis is known to effect small joints such as:
- Fingers
- Wrist
- Shoulders, and
- Ankles
If you have RA you probably feel like your joints are swollen, tender, red, “boggy” (a spongy sensation), and that the pain can actually increase with rest. You may also experience that your joint stiffness is worse in the morning, sometimes lasting more than hour, and progressively getting better throughout the day. Some of the key things that your healthcare provider will look for with RA are:
- If you have pain in more than 3 joints
- If you are experiencing morning stiffness, and
- If your symptoms have been present for more than 6 months
If you are experiencing all of these, your provider may recommend lab testing. The most common tests to determine if you have Rheumatoid Arthritis include:
- The Rheumatoid Factor
- Antibodies Test (the most specific test for RA)
- ESR, and CRP, which are elevated in patients that have active inflammation in the body. 2
Once you’ve been properly tested, the next step is determining what the best treatment plan is for you and your specific needs.
So let’s talk about what the treatment options are for both of these types of Arthritis…
How Do We Treat These?
First line treatments for osteoarthritis (OA) include nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, or acetaminophen if there is concern for bleeding risk. Other treatment options include low impact exercises, steroid injections, platelet – rich plasma (PRP) injections, or surgical interventions.
Management of rheumatoid arthritis (RA) begins by quickly starting on a type of medication called a disease-modifying anti-rheumatic drug (DMAR). These medications help reduce permanent joint damage. Methotrexate is typically the first of these types of medications to be offered, but this should be discussed with your healthcare provider before beginning any treatment plan. In addition, you may be instructed to take NSAIDs for the pain as these have proven to be beneficial. If you are not feeling any benefit from the NSAIDs, it is best to talk with your healthcare provider about considering more advanced options.
Here at Genesis Medicine, we treat people everyday who suffer from Osteoarthritis and Rheumatoid Arthritis. As an Interventional (i.e. procedural) based clinic, we specialize in treatment options such as therapeutic steroid joint injections, nerve blocks, and PRP injections that can help provide additional pain relief.
What Do I Do Now?
If you are suffering from joint pain that is affecting your quality of life, you can give us a call or request an appointment online to see one of the Genesis Medicine specialists and begin to find some answers.
Not quite ready to make an appointment? You can join us for a FREE webinar on Tuesday, June 7th from 12-1pm where we will go deeper into these conditions, and answer any questions that you might have. You can REGISTER HERE for this upcoming Tuesday Talk. We look forward to seeing you there!
