Arthritis or osteoarthritis? We explain the difference

Despite all the information we have available at the click of Google, most of us continue to confuse the arthritis with the osteoarthritis, and backwards. The fact that both pathologies affect the joints and that both hurt and limit movements increases confusion. But, in reality, we would do well to learn to differentiate them, since both are very common pathologies. According to the Global Disease Impact Study, seven million Spaniards suffer from osteoarthritis and according to the EPISER Study (Study of Prevalence of Diseases in the adult population) one million suffer from arthritis.

The main difference between the two is that each damages a different tissue of the joint. In osteoarthritis there is a degenerative cartilage process of the bones that, with age, wear away. On the other hand, arthritis is a disease in which the synovial membrane is inflamed (the tissue that covers and protects the joints). The nature of arthritis is very complex, because it involves both a inflammatory reaction as to the defense system of the organism that attacks, it is not yet known why, that synovial membrane causing inflammation and pain.

While osteoarthritis is usually associated with age (or to risk behaviors carried out over years, such as over-exercising without paying attention to the warning signs), arthritis can attack at any time, although above all it affects women between 30 and 50 years. But this is not the only difference between the two. Keep reading and you will learn to distinguish them even more.

1. And what hurts you?

-Both conditions hurt, but differently. “Osteoarthritis is a mechanical pain that worsens with the activity and improves with the repose. The arthritis is inflammatory, worsens at rest and improves by taking a while of activity. The stiffness of arthritis is also greater, ”explains Dr. Elisa Trujillo, assistant rheumatologist of the Rheumatology service of the University Hospital of the Canary Islands (Tenerife).

-People with osteoarthritis often wake up with seized joints and that stiffness usually disappears with the movement. In contrast, pain, which is located at very specific points, worsens with activity. The most common osteoarthritis it is located in the hands, although it can also appear on the knees, feet, hip and spine.

-In the case of arthritis, pain is a problem, but it is usually accompanied by others such as symmetrical inflammation of the joints (for example, both hands), the tingle and the fever.

-As for the risk factor's, osteoarthritis is related to the passing of the years and the activity we have performed. The cause of arthritis is more complex: some risk factors are sex (more frequent in women), being a smoker, obese and having a family history.

2. How are they diagnosed?

-The first step in making a successful diagnosis is in answering the questions of the rheumatologist. A well-conducted interrogation of symptom helps to discern between them diseases. That is why it is important to be clear that the first symptom of osteoarthritis is pain during activity or when moving the affected joint and that of arthritis stiffness and pain when getting up in the morning or after resting and is usually accompanied by sensation of joint inflammation.

-After answering the doctor's questions, it is time for the exploration, which allows to identify the presence or not of joint inflammation and to see if there are the typical deformities of osteoarthritis or arthritis. "For him diagnosis of arthritis we will also need an analytical study that includes markers of inflammation and autoimmunity, and a radiological study to observe the presence of changes that are typical of the disease. For the diagnosis of osteoarthritis it is not necessary analytical study, it is enough to do an x-ray, ”explains Dr. Elisa Trujillo

3. What problems can they be associated with?

-If you suffer from osteoarthritis and you also have over weight, you may be in trouble. Obesity worsens the pain of osteoarthritis in the spine, hips and knees. Unfortunately, it is a fish that bites its tail: having osteoarthritis limits mobility, but exercising is essential not only to control weight, but also to avoid metabolic syndrome, diabetes and hypertension. That is why it is important to seek advice to do the right exercise and prevent the rest of the conditions from getting worse.

-People with arthritis have increased the cardiovascular risk, simply by living in a constant state of inflammation. To make matters worse, arthritis, such as osteoarthritis, can also reduce the physical activity of patients and this (of course) is very necessary to control the rest of the risk factors that can cause cardiovascular problems (both obesity and hypertension like cholesterol).

A tailored diet:

  • The most recommended diet for joints has to be "varied, balanced, with a good consumption of foods of plant origin and moderate in those of animal origin. The Mediterranean diet adapts to all these objectives, ”says Dr. Elisa Trujillo
  • “There is a positive association between adherence to the Mediterranean diet and a lower prevalence of osteoarthritis. This diet prevents inflammation and destruction of cartilage. On the other hand, in patients with rheumatoid arthritis this eating pattern also has benefits over inflammation and pain, ”says Dr. Montserrat Romera Baurés, rheumatologist at the University Hospital of Bellvitge and head of the Communication Commission of the Spanish Rheumatology Society.
  • Olive oil, one of the staples of the Mediterranean diet, "has shown that it reduces pain and improves the functionality and quality of life in patients with osteoarthritis and can improve the symptoms of inflammatory diseases such as arthritis," he concludes. .

4. Can they be prevented?

We can't prevent osteoarthritis at all because it is closely related to the passing of the years, but it does slow its progression and postpone its appearance if we pamper the joints. We must maintain a correct weight and exercise to have a good muscle tone, of course, avoiding impact or overload sports. The exercise that best suits the joints is the aerobic (walking, swimming, cycling …). It is also important not to carry excessive weight, try not to stand for a long time standing or kneeling, avoid walking often on rough terrain and wear cushioned footwear.

Nor can we prevent arthritis because it is an autoimmune process that is started by factors that are not yet identified. In your case, the early diagnostic: going to the rheumatologist early favors the success of the treatment and improves the quality of life. If you feel pain or stiffness in your joints, do not hesitate, go to the doctor.

5. How are they treated?

-For arthritis patients, it's not all bad news. 20 years ago the first ones were released biological drugs against this disease, achieved through biotechnology and that completely changed its evolution. “In these years, different subcutaneous or intravenous biotechnological drugs have been added that have proven their effectiveness. But the most recent therapeutic novelty, which is a great advance for patients, are the so-called “small molecules" These are synthetic molecules that act on the signals that occur within the inflammatory cells. Its main advantage over the previous drugs is its oral administration. The effectiveness of these "small molecules" opens a new path in the management of arthritis, "explains Dr. Elisa Trujillo

-He osteoarthritis treatment is currently based on improving pain and mobility with analgesic-anti-inflammatory drugs (such as acetaminophen or NSAIDs), some chondroprotective medications and physical measures "although many are currently being developed that are still pending to demonstrate their efficacy and safety," says Dr. Trujillo

-The most novel thing in the treatment of osteoarthritis is to employ a family of drugs, the sysadoas, as the first choice to treat symptoms in specially chosen cases (because they do not work equally well in all types of osteoarthritis). As he chondroitin sulfate, which is part of this family of drugs, as the combination of this with glucosamine (another sysadoa), have been clinically proven to be able to reduce pain, stiffness and have a good safety profile. Glucosamine is an amino sugar that is produced naturally by the body, as is chondroitin sulfate, which is a structural component of cartilage.

– “If we want the treatment not to fail, What you should never do if you suffer from arthritis is to stop going to the rheumatologist and abandon treatment without consulting the specialist. Y what you never have to do if you suffer from osteoarthritis is to gain weight, make a sedentary life and wear inappropriate footwear, ”summarizes Dr. Elisa Trujillo

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