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Rheumatoid Arthritis vs Osteoarthritis

Rheumatoid arthritis and osteoarthritis are two common forms of arthritis which can cause joint pain and stiffness, but they have different causes and treatments.

Rheumatoid Arthritis (RA)

RA is a chronic and progressive auto-immune condition in which the joint tissue is targeted by the body’s own immune system. In RA, enzymes in the body attack and destroy the linings of joints. This causes inflammation (pain and swelling), stiffness, reduced movement and function, and even malformation. People with RA may also experience systemic symptoms, such as fatigue, fever, weight loss, eye inflammation, anaemia, subcutaneous nodules (bumps under the skin), or pleurisy (a lung inflammation). (1) RA affects approximately 400,000 people in the UK. (2)

Risk Factors

  • Gender - RA generally affects women more than men (3)

  • Age - RA can begin at any age, but it most commonly occurs between ages 40-60 (3)

  • Smoking (4)

  • Infection - Bacteria and viruses such as Mycobacterium tuberculosis, Proteus mirabilis, Escherichia coli, Epstein-Barr virus, retroviruses, parvovirus B19, and periodontal disease have been connected with RA (4,5)

  • Food allergy (17)

  • Gut permeability (17)

Signs and Symptoms

  • Stiffness in symmetrical joints (occurring in the same joint on both sides of the body) which is most painful in the morning, lasting longer than one hour, or after periods of inactivity. These joints include hands, wrists, and small joints of the feet (3), but can also include knees, ankles, elbows, hips and shoulders. (6)

  • Inflamed, tender, swollen, warm joints (3)

  • Non-specific systemic symptoms including fever and weight loss (3), fatigue and depression (6)

RA and the Microbiome

As the prevalence of RA (and autoimmune disease in general) has risen in recent decades, researchers are looking into changes in our microbiome as a potential cause. Changes in our diets, the usage of antibiotics, and decreasing contact with bacteria through hygiene and lifestyle are all contributing factors. Animal studies have successfully linked arthritis to the gut microbiome, with scientists theorising that an imbalance in the gut leads to an excessive immune response. Furthermore, studies and observations in RA patients indicate that gut dysbiosis may contribute to the onset or severity of the condition (7 - 14).


OA is a painful, degenerative condition in which gradual wear and tear of the protective cartilage in the joints causes the bones to rub together (15). OA often involves larger joints such as hips, knees, neck, or lower back, but can also affect the small joints of the hands. Sports, repetitive motion, and obesity are often implicated in the development of OA. OA can cause swelling, pain, reduced flexibility, and bony spurs. (1) OA is not associated with systemic symptoms,often affects non-symmetrical joints, and does not involve an autoimmune response.

Risk Factors

  • Being overweight

  • Joint deformities

  • Diabetes

  • Gout

  • Traumatic joint injury (16)

Signs and Symptoms

  • Mild stiffness in the morning which doesn’t last more than an hour

  • Pain with joint usage

  • Loss of function

  • Tenderness

  • Swelling of soft tissue around the joint

  • Creaking/cracking of joints (17)

Nutritional Management

Nutritional therapy can help manage the symptoms of both Rheumatoid Arthritis and Osteoarthritis. Effective treatment can improve the quality of life and slow the progression of the condition.

Reducing inflammation to help alleviate pain and stiffness can improve your range of motion. Diet and lifestyle modification can improve your gut health and help you maintain a healthy weight to reduce pressure on the joints.

Contact Us

If you suffer from either of these conditions or are experiencing any of the above symptoms, contact us to discuss your options.



4: Edwards, C. J. (2008) 'Commensal Gut Bacteria and the Etiopathogenesis of Rheumatoid Arthritis', The Journal of Rheumatology, 35(8), pp. 1477-1479.

5: McInnes, I.B. & Schett, G. (2011) 'The Pathogenesis of Rheumatoid Arthritis', The New England Journal of Medicine, 365(23), pp. 2205-2219.

8: Taneja, V. (2014) 'Arthritis susceptibility and the gut microbiome', Federation of European Biochemical Societies Letters, 588, pp 4244-4249.

9: Jacob, A. (2013) 'Research Suggests Digestive Abnormalities May Be the Underlying Cause', Today's Dietitian, 15(2), pp 38.

10: Fasano, A. 2 (2012) 'Leaky gut and autoimmune diseases', Clinical Reviews in Allergy & Immunology, 42(1), pp 71-78.

13: Taneja, V. (2014) 'Arthritis susceptibility and the gut microbiome', Federation of European Biochemical Societies Letters, 588, pp 4244-4249.

14: Abdollahi-Roodsaz, S.; Abramson, S.B. And Scher, J.U. (2016) 'The metabolic role of the gut microbiota in health and rheumatic disease: mechanisms and interventions', Nature Reviews Rheumatology, 12, pp 446-455.

17: Langley, S. (2015) The Naturopathy Workbook. 4th ed. UK: CNM.


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