Joint pain: rheumatoid arthritis or arthrosis?

Arthritis: what it is, what are the symptoms and what are the differences from osteoarthritis

By Cristiano Antonino On Feb 20, 2023

Arthritis is an inflammatory condition that affects one or more joints and can present in an acute or chronic form

There are several types and forms of arthritis, the best known of which is certainly rheumatoid arthritis.

All forms of arthritis have specific causes and characteristics and fall into the broader category of rheumatic diseases, which can occur at any age.

The most affected are the small joints of the wrists, hands, ankles and feet. Find out below everything you need to know about this inflammatory condition, what the symptoms and causes are, how it is diagnosed and what is the recommended therapy.

What is Arthritis?

The term “arthritis” refers to an inflammatory condition involving one or more joints.

These anatomical structures have the task of bringing two or more bones into contact and are therefore essential for the mobility of the limbs and the skeleton.

There are many types of arthritis and its various forms are currently a serious public health problem given the high impact on the population and the associated treatment and social security costs.

Arthritis is often a chronic condition which, once it appears, accompanies the affected person for the rest of their life, sometimes making them unable to perform even the simplest tasks.

In fact, both in the United States and in Europe, arthritis, together with other rheumatic diseases, are considered as the main cause of disability in the population, especially in the elderly.

Arthritis and osteoarthritis: the differences

We still often tend to confuse or associate arthritis with arthrosis which, despite having some characteristics in common and falling within the rheumatic pathologies, is however totally different from the pathology in question.

But how does it differ from osteoarthritis?

The confusion between the two terms, in addition to the terminological similarity, probably derives from the fact that both diseases attack the joints, causing pain that makes it difficult to move the limbs.

However, the substantial difference lies in the fact that osteoarthritis is a degenerative joint disease that leads to the progressive loss of articular cartilage.

The pain brought by arthrosis, therefore, is a mechanical pain caused by the unnatural closeness and direct contact of the joint heads.

The painful symptoms generally occur with the use of the joint and tend to decrease with rest.

Osteoarthritis also develops mainly in people over 50, often overweight, and the most affected joints are those most subject to small traumas such as the hands, feet, hips, knees and spine.

Unlike osteoarthritis, arthritis can affect people of any age, and pain can occur to the affected person at any time of day.

Various types of arthritis

As previously mentioned, the forms of arthritis can be different and have specific characteristics.

Let’s see below which are the most common.

Rheumatoid arthritis

Rheumatoid arthritis is considered an autoimmune disease, i.e. a morbid condition that develops as a result of a malfunction of the immune system.

According to the MSD Manual, the disease affects approximately 1% of the population and predominantly affects women 2 to 3 times more frequently than men.

People can develop rheumatoid arthritis at any age, although the disease most often affects people who are more active (35 to 50 years old).

It is not uncommon, however, for the disease to affect people in old age or even develop in childhood.

The triggering cause of rheumatoid arthritis, unfortunately, is still unknown even if several risk factors have been highlighted.

These include genetic predisposition, but also non-genetic and environmental factors such as gender, age, cigarette smoking, food, hormonal, socio-economic factors and coming into contact with infectious agents.

Rheumatoid arthritis is one of the most severe osteoarticular diseases as it leads to severe structural damage to the joints, also causing secondary bone damage, extra-articular complications and increasing the risk of mortality.

The target of the abnormal antibodies that are formed in those suffering from rheumatoid arthritis is the synovial membrane which, increasing in volume due to inflammation, expands until it causes the gradual destruction of the cartilage.

Furthermore, in the most serious cases, the proliferative process reaches both the bones and the other surrounding tissues

The disease can be systemic, and the inflammatory process can also affect the non-articular level, involving the skin, the respiratory system, the eyes and the lympho-glandular system.

Gouty arthritis

Gouty arthritis is a type of arthritis caused by the formation and precipitation of small crystals of uric acid around and in the joints.

As a result of this dysfunction, the joint becomes inflamed and causes the patient severe pain.

The inflammatory process can affect any joint even if it usually develops mostly in the lower limbs.

The pathology is much more frequent in men, generally between the ages of 40-50, while in women it usually appears only during menopause.

Risk factors for inflammation include: drug use, poor diet, alcohol abuse or other pre-existing diseases.

Psoriatic arthritis

This chronic inflammatory disease affects the joints of people with the skin disease called psoriasis or who have family members with the disease.

Generally, those affected develop psoriasis first and then arthritis, but there are cases where the opposite occurs.

The inflammatory state develops more frequently in people between 30 and 50 years of age and affects both men and women equally.

The causes of psoriatic arthritis are so far unknown.

However, it has been established that the disease develops when the immune system attacks healthy cells in the body, causing excessive production of skin cells and inflammation of the joints.

The reasons for this reaction of the immune system are not yet known, but it is assumed that genetic and environmental factors play an important role in predisposed subjects.

Septic arthritis

This type of joint inflammation is caused by an infectious agent (bacteria, fungus, or virus) elsewhere in the body that can reach the joint later through contact or blood.

Typically, only one joint is affected, usually a large one such as the knee or hip, but it can also affect the wrist, shoulder, ankle or elbow joints. The most affected subjects are the elderly and children.

The presence of pre-existing joint pathologies, the use of drugs, the presence of diseases that favor infections and the abuse of alcohol and drugs are among the main risk factors for this pathology.

Reactive arthritis

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Reactive arthritis has a dual origin: infectious and autoimmune.

It is in fact called reactive because it is an abnormal joint response to an infectious factor that usually affects the genitourinary or gastrointestinal tract.

Symptoms

Being a joint inflammation, the symptoms and signs of arthritis mainly involve the joints.

People who suffer from this disease generally complain of:

Ache;
joint swelling;
joint stiffness;
Redness of the affected area and strong feeling of heat;
Reduced mobility.

Some forms of arthritis can also affect other anatomical regions such as the skin, eyes, lympho-glandular system and respiratory system.

These symptoms can be both constant and appear intermittently and with varying degrees of intensity.

Diagnosis and therapy

As we have seen previously, there are numerous types of arthritis, which is why it is necessary to consult a doctor to carry out a detailed history and understand what type of arthritis it is and possibly be able to understand the causes.

The specialist will not only have to analyze the state of the joints, but also carry out a complete visit to highlight any alterations that may have led to rheumatic disease.

The patient could therefore be advised both laboratory tests (analysis of blood, urine, synovial fluid, etc.) and / or instrumental ones (ultrasound, radiography and, in some cases, an MRI).

The aim will be not only to arrive at a diagnosis, but also to understand the severity of the disease in order to understand what will be the best therapeutic approach for the patient.

Depending on the type of arthritis diagnosed, the doctor may prescribe a specific therapy for the patient, which generally has two main purposes:

Reduce the pain caused by inflammation and prevent its becoming chronic;
Improving the patient’s motor skills, improving his quality of life.

The doctor could prescribe to the patient not only drugs that modify the progression of the disease and NSAIDs to relieve pain, but also give indications for lifestyle changes (take a few days of rest, stop smoking and alcohol, etc.).

Physiotherapy sessions may also be prescribed to the person suffering from arthritis with the aim of improving mobility.

In the most serious cases, surgery may be useful.

Surgery will be necessary if advanced-stage arthritis has irreparably damaged the joint, so much so that it requires replacement or fixation of the ends of the bones affected by joint damage.

In order not to risk serious joint damage, it is advisable to contact your doctor or rheumatologist immediately if you experience the classic symptoms of arthritis.

In this way it will be possible to immediately start the most suitable treatment for the case and contain the inflammation.

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