The reader should be aware of the differences
between Osteoarthritis (OA) and Rheumatoid arthritis (RA) in order to understand both
mainstream and alternative approaches to these disorders.
Osteoarthritis (OA) is the more common of the
two in the general North American population, particularly
among middle-aged and older adults. It is
estimated to affect about 21 million adults in the
United States, and to account for $86 billion in health
care costs each year. It is also the single most common
condition for which people seek help from complementary
and alternative medical (CAM) treatments.
The rate of OA increases in older age groups; about
70% of people over 70 are found to have some evidence
of OA when they are X-rayed. Only half of these
elderly adults, however, are affected severely enough
to develop noticeable symptoms.
OA is not usually a
disease that completely disables people; most patients
can manage its symptoms by watching their weight,
staying active, avoiding overuse of affected joints, and
taking over-the-counter or prescription pain relievers.
OA most commonly affects the weight-bearing joints
in the hips, knees, and spine, although some people
first notice its symptoms in their fingers or neck. It is
often unilateral, which means that it affects the joints
on only one side of the body.
The symptoms of OA
vary considerably in severity from one patient to
another; some people are only mildly affected by the
disorder.
OA results from progressive damage to the cartilage
that cushions the joints of the long bones. As the
cartilage deteriorates, fluid accumulates in the joints,
bony overgrowths develop, and the muscles and tendons
may weaken, leading to stiffness on arising, pain,
swelling, and limitation of movement.
OA is gradual
in onset, often taking years to develop before the
person notices pain or a limited range of motion in
the joint. OA is most likely to be diagnosed in people
over 45 or 50, although younger adults are occasionally
affected. OA affects more men than women under
age 45 while more women than men are affected in the
age group over 55. As of the early 2000s, OA is
thought to result from a combination of factors,
including heredity (possibly related to a mutation on
chromosome 12); traumatic damage to joints from
accidents, type of employment, or sports injuries;
and obesity. It is not, however, caused by the aging
process itself. Race does not appear to be a factor in OA, although some studies indicate that African
American women have a higher risk of developing
OA in the knee joints. Other risk factors for OA
include osteoporosis and vitamin D deficiency.
RA, by contrast, is most likely to be diagnosed in
adults between the ages of 30 and 50, two-thirds of
whom are women. RA affects about 0.8% of adults
worldwide, or 25 in every 100,000 men and 54 in every
100,000 women. Unlike OA, which is caused by degeneration
of a body tissue, RA is an autoimmune
disorder—one in which the body’s immune system
attacks some of its own tissues. It is often sudden in
onset and may affect other organ systems, not just the
joints.
RA is a more serious disease than OA; 30% of
patients with RA will become permanently disabled
within two to three years of diagnosis if they are not
treated. In addition, patients with RA have a higher risk of heart attacks and stroke. RA differs from OA,
too, in the joints that it most commonly affects—often
the fingers, wrists, knuckles, elbows, and shoulders.
RA is typically a bilateral disorder, which means that
both sides of the patient’s body are affected.
In addition,
patients with RA often feel sick, feverish, or
generally unwell, while patients with OA usually feel
normal except for the stiffness or discomfort in the
affected joints.
