Osteoporosis, osteoarthritis and rheumatoid arthritis – what's the difference?


When it comes to conditions affecting your bones and joints, many people confuse osteoporosis and certain types of arthritis including osteoarthritis. Although there are some similarities between these conditions, there are also many important differences.

Osteoporosis means 'porous bones' and is a condition in which the bones become weak and more prone to fracture due to a loss of bone density. Almost 1 in 10 Australians over the age of 50 years has osteoporosis (or osteopenia where bone density is low but not low enough to be classified as osteoporosis), with the condition being more prevalent in women than men. Osteoporosis can result is chronic pain, loss of independence and prolonged or permanent disability.

Arthritis
Arthritis is the term used for a group of conditions that affect the joints and surrounding tissues, causing pain, inflammation and damage to the joints. Arthritis is the major cause of chronic pain and disability in Australia with an estimated 3.85 million Australians affected. There are many different types of arthritis, the main two being osteoarthritis and rheumatoid arthritis.

Similarities between osteoporosis and arthritis
Much of the confusion between these two conditions is due to the similarity of their names – osteoporosis and osteoarthritis (by far the most common type of arthritis). It is true that osteoporosis and arthritis do share many coping strategies for the management of the disease. For example, many people with arthritis or osteoporosis benefit from exercise programs that emphasise a range of motion, stretching, strengthening and posture such as swimming, tai-chi and low-stress yoga. Physical therapy and rehabilitation may also be of benefit to some people. However, it is important that any exercise program is discussed with your doctor first to ensure your safety as your condition will affect your ability and you may need to compensate for certain movements.
Pain management strategies are also often similar where required, as is often the case for people suffering from arthritis, although less so for people with osteoporosis other than when in recovery from a fracture.

Other than these similarities in coping with and managing your disease, osteoporosis and arthritis are very different conditions.

Differences between osteoporosis, osteoarthritis and rheumatoid arthritis
Despite the similarity in name, osteoporosis and osteoarthritis are completely different conditions in terms of development, symptoms, diagnosis and treatment.

Even within arthritis, both osteoarthritis and rheumatoid arthritis are very different diseases. They may share some similar characteristics, but each has different symptoms and requires different treatment, thus an accurate diagnosis is essential. The primary difference between osteoarthritis and rheumatoid arthritis is the cause of the joint symptoms. Joint damage in osteoarthritis is a result of mechanical wear and tear that breaks down the cartilage between the joints, causing the bone ends to rub together. Rheumatoid arthritis on the other hand is an autoimmune disease where the body's own immune system attacks the tissue lining the joints. Both result in inflammation, pain and swelling of the joint.

Characteristic
Osteoporosis
Osteoarthritis
Rheumatoid arthritis
Characteristic of disease
Loss of bone density causing weak and brittle bones
Chronic joint disorder of the cartilage
Autoimmune disease that attacks the tissue lining the joint
Age of onset
Usually later in life
Usually later in life
At any time in life
Speed on onset
Over years
Over years
Weeks to months
Who is affected?
1 in 10 Australians over 50 years of age
1 in 11 Australians
2 in 100 Australians
Affect on joints
N/A
Pain and stiffness, usually located in one set of joints on one side of the body, although symptoms may spread
Pain, swelling and stiffness affecting joints symmetrically (on both sides of the body)
Affect on bones
Loss of bone density causes bones to become weak and brittle and prone to fractures.
Bone ends rubbing against one another may result in bone projections known as bone spurs (osteophytes)
N/A
Systemic symptoms
N/A
N/A
Fatigue and general feeling of being unwell
Long-term impact
Increased risk to fractures and fracture cascade. Chronic pain, inability to walk, change in posture, disability, loss of independence.
Difficulty in performing everyday activities
Bone erosion, irreversible joint damage and permanent disability.
Diagnosis
May progress undetected for years until a fracture occurs. Diagnosed using a bone mineral density scan.
Physical examination, x-rays, blood tests (to rule out other types of arthritis)
Physical examination, blood tests, x-rays
Treatment
Lifestyle changes including fall and fracture avoidance, increase in calcium and vitamin D levels, regular exercise. Medications to promote bone formation and prevent bone degradation.
Analgesics, NSAIDs, Exercise and physical therapy, joint replacement therapy
Exercise and physical therapy, NSAIDs, Corticosteroids, DMARDs


Useful Resources

AIHW
http://www.aihw.gov.au/arthritis-and-musculoskeletal-conditions/

Osteoporosis Australia

Artritis WA
https://www.arthritiswa.org.au/

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