Read time: 8 min.
Issue 14 * 02 March 2024

Living with Osteoarthritis or Rheumatoid Arthritis

Dr Wendy Holden, Consultant Rheumatologist and Medical Advisor to the Charity Arthritis Action shares the lowdown on the debilitating conditions of Osteoarthritis and Rheumatoid Arthritis.

Dr Wendy Holden

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Understanding Osteoarthritis and Rheumatoid Arthritis

“Arthritis comes from a Greek word meaning ‘inflammation in the joints’,” explains Dr Wendy Holden, Consultant Rheumatologist and Medical Advisor to the charity Arthritis Action (link). “It causes pain, stiffness and swelling in the joints.”

However, arthritis is not a simple condition – there are over 100 different types of it. But there are two main ones: Osteoarthritis (or degenerative arthritis) which is by far the most common one (and is more common still, with age) and Rheumatoid Arthritis (or inflammatory arthritis) which only affects between 1 and 3% of the population. “Osteoarthritis is caused by wear and tear on the joints,” continues Dr Wendy, “it happens with age and/or if joints are injured. It’s the most expensive form for the NHS because people have to have their joints replaced. It can happen in younger people who’ve had an injury, but it’s mostly older people. It can run in families. The risk factors are being overweight and inactivity.”

Inflammatory or Rheumatoid Arthritis, by contrast, happens when the immune system attacks the joints, according to Dr Wendy. “It can occur at any age, but usually starts in the 30s and 40s.”

The Impact of Osteoarthritis and Rheumatoid Arthritis on Daily Life

In three words Osteoarthritis and Rheumatoid Arthritis can cause quite severe stiffness, pain and swelling. “All types of arthritis have mental health issues,” clarifies Dr Wendy, “people may suffer from depression and/or anxiety because of the pain. 80% of people with either condition have impaired sleep. Relationships can suffer because of it. Mobility can be reduced considerably. Work and career prospects can be affected too.”

The Importance of Early Diagnosis of Osteoarthritis and especially Rheumatoid Arthritis

When you are diagnosed a healthcare expert will probably take a look at your medical history and the symptoms you are displaying and then make a close examination of your joints. Laboratory tests, blood tests, X-rays, ultrasound or MRI scans may then take place as may arthrocentesis (removing and analysing fluid from a joint). “Early diagnosis is key for Rheumatoid Arthritis,” says Dr Wendy, “because within 6-12 months a joint can be badly damaged. Joint damage happens very quickly so ideally you are seen within a few weeks of symptoms arising.”

Treatment Options

“There is no cure for either Osteoarthritis or Rheumatoid Arthritis and the sooner treatment is started the better,” states Dr Wendy. For Osteoarthritis, self-management is key and anti-inflammatory drugs may be prescribed. “A healthy weight can reduce Osteoarthritis by 30%,” continues Dr Wendy, “so staying active is really important. You should be exercising more. For every extra 1lb overweight you are putting more pressure on your joints. It’s also important that your mood stays positive and that you sleep. If you don’t sleep the pain will be worse.”

According to Dr Wendy, the same applies to Rheumatoid or inflammatory arthritis. Drug treatment will be used to prevent joint damage and there are disease-modifying drugs known as Biologics. “The more exercise you do the better you’ll be. Weight loss is good. Bowel health is important and sleep is crucial. Not smoking is also vital.”

Arthritis Dietary Advice

In terms of diet, for both Osteoarthritis and Rheumatoid Arthritis the Mediterranean diet is recommended. “In terms of making arthritis better or worse, however, current guidelines suggest that we should be following a Mediterranean diet with lots of fruit and vegetables,” considers Dr Wendy, “whole grains and fish rather than red meat, sugar and processed foods. High sugar intake is also associated with obesity which adversely affects the joints, so sugar intake, this includes honey and other sweeteners like agave syrup, should be reduced whenever possible.”

The Future of Treatment

“For Rheumatoid Arthritis then Biologics can switch off the immune system,” concludes Dr Wendy. “They may be rationed on the NHS because they are expensive.” These are the most recent developments and have been in existence for about 20 years. But she says lots of people will still have symptoms of Rheumatoid Arthritis with taking the medication. Of people taking Biologics, for up to two-thirds or three-quarters of them, the medicine works. “Some people still live with pain,” she considers, “The drugs make a massive improvement but there is still an unmet need. This is where self-management is important.”