Osteoarthritis (OA) is the most common type of arthritis, caused by gradual changes in joint cartilage and bone, usually affecting knees, hips, hands and spine in older adults. Rheumatoid arthritis (RA) is an autoimmune disease where the immune system attacks the joint lining, typically causing swollen, painful small joints on both sides of the body, with long morning stiffness. RA needs early specialist treatment to prevent joint damage.
Comparison table
| Osteoarthritis | Rheumatoid arthritis | |
|---|---|---|
| Cause | Joint wear and repair, ageing, injury, obesity | Autoimmune inflammation |
| Typical age | Usually over 45–50 | Any age, often 30–60 |
| Joints | Knees, hips, base of thumb, end finger joints, spine | Small joints of hands, wrists and feet, often symmetrical |
| Morning stiffness | Usually under 30 minutes | Often more than 30–60 minutes |
| Swelling | Bony, hard | Soft, warm, tender |
| Whole-body symptoms | None | Tiredness, low-grade fever, weight loss; can affect lungs, eyes, heart |
| Tests | Clinical diagnosis, X-ray | Blood tests (rheumatoid factor, anti-CCP, ESR/CRP), X-ray or ultrasound |
| Treatment | Exercise, weight loss, pain relief, joint replacement if severe | Disease-modifying drugs (e.g. methotrexate), biologics, steroids short-term |
Self-care for both
- Stay active: strengthening and low-impact exercise (walking, swimming, cycling) reduce pain
- Healthy weight: each kilogram lost reduces load on knees
- Heat or cold packs for pain and stiffness
- Supportive footwear and walking aids if needed
- Pacing: balance activity and rest
- Stop smoking, especially with RA
Medicines
- Paracetamol and topical anti-inflammatory gels for OA
- Oral anti-inflammatories for short periods, with caution in older adults and people with kidney, heart or stomach problems
- Steroid injections for flare-ups in some joints
- For RA, methotrexate is taken once weekly, never daily, with folic acid and regular blood tests
When to see a healthcare provider
- Swollen, warm joints in several places
- Morning stiffness lasting more than 30 minutes
- Joint pain with fever or a hot, red joint (possible infection or gout)
- Pain that stops you sleeping or working
Frequently asked questions
Can arthritis be cured?
Not usually, but treatment can control symptoms well, and early RA treatment can prevent joint damage.
Does cracking knuckles cause arthritis?
Studies have not shown a link.
Related reading: Gout guide · Hip fracture nursing care · High-alert medications
Checked against NHS guidance on rheumatoid arthritis. Updated 5 November 2026.
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