Osteoarthritis, or Rheumatoid?

Today I had an interesting encounter with a new patient.  He was referred for therapy for two sore knees.  The patient, let’s call him Steve, was pretty certain he had Rheumatoid Arthritis because his pain has been severe in both his knees, and he had heard that Rheumatoid Arthritis is the “bad kind.”

There are two major types of arthritis: Osteoarthritis, and Rheumatoid Arthritis.  Osteoarthritis is inflammation in the joint, usually caused by wear and tear.  It’s more common with age, and occurs in joints that have seen some use and abuse in their time.  Steve is on his feet working on concrete all day long.  He has severe pain in both knees by the end of the day.  This is a common scenario leading to Osteoarthritis of the knees.

Rheumatoid Arthritis, on the other hand, is an AUTOIMMUNE DISEASE.   Autoimmune diseases occur when the body turns on itself and begins to target and destroy certain types of tissues.  The immune reaction may target the pancreas, causing Type I Diabetes, or the thyroid, causing Hashimoto’s Disease, or the joints, causing Rheumatoid Arthritis. A few others you’ve probably heard of are Lupus, Multiple Sclerosis, Alzheimer’s, Fibromyalgia, and there is even evidence that severe morning sickness is caused by an autoimmune response.  There are too many to list here, but if you google it, you may be surprised.

Back to Rheumatoid Arthritis (RA):  RA is a disease that attacks joint tissue without regard to wear and tear.  Young people, even children, can get RA.  Certainly wear and tear can worsen RA, but it does not cause it.  Typically a person with RA has multiple joints, in multiple areas of the body, which are painful, swollen, and can eventually become deformed.  Steve’s scenario did not fit RA because the only joints affected were the load bearing, impact absorbing, knees that have seen almost 30 years of standing and walking in Steve’s profession.

**Until recently, there seemed to be very few leads as to what caused autoimmune responses. There is growing research now however, that food intolerance, such as gluten or dairy intolerance may be behind autoimmune responses.  This happened in our own family.  If you haven’t read it, please refer to “Our Diabetes Story” posted under the Diabetes and Gluten Free categories.


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