Inflammatory vs. Degenerative Arthritis: What’s the Difference?
Arthritis is a non-specific term we often hear simply meaning “joint inflammation.” At the core, the difference between inflammatory and degenerative is the etiology or cause of the arthritis. Inflammatory arthritis is caused by an autoimmune reaction leading to inflammation in and around the joint. Degenerative arthritis is due to breakdown of the protective cartilage in the joint space. Understating the difference between inflammatory arthritis and degenerative arthritis is crucial for effective management and treatment of these painful conditions.
Inflammatory Arthritis:
Inflammatory arthritis is a group of diseases characterized by inflammation in the joints due to an autoimmune disease process. Some common types of inflammatory arthritis include rheumatoid arthritis, psoriatic arthritis, lupus, and ankylosing spondylitis. Some, but not all, of these conditions have laboratory markers that can help identify the type of autoimmune conditions.
Symptoms:
- Timing of Pain: Pain and stiffness are usually worse in the morning or after periods of inactivity. Pain tends to improve after movement of the inflammatory cells out of the joint spaces.
- Pain Pattern: Pain tends to be symmetrical, affecting the same joints on both sides of the body. For example, if the joints in the right hand are affected, the joints in the left hand are likely to be affected as well. There can often be pain and swelling around the joints as well. In cases of spondyloarthropathies, often referred to as “seronegative” due to lack of laboratory markers, often have arthritis in the spine as well as other joints.
- Other Symptoms: Because inflammatory arthritis is due to an autoimmune conditions we can see inflammation in other parts of the body. These include the digestive tract, eyes, skin, and other organ systems.
Treatment: The goal of treatment is always to prevent permanent damage to the joint.
- Conventional Treatment: Nonsteroidal anti-inflammatory drugs (NSAIDs), disease-modifying antirheumatic drugs (DMARDs), and biologic agents are commonly used to manage symptoms and slow the progression of inflammatory arthritis.
- Alternative Treatment: Identifying immune system triggers to overactive immune response: microbial, dietary, hormonal, and other environmental triggers. Some people find relief from symptoms through therapies such as acupuncture and certain supplements like fish oil or turmeric.
Incidence: Inflammatory arthritis, particularly rheumatoid arthritis, affects approximately 1.3 million adults in the United States. It is important to note that inflammatory arthritis is an autoimmune condition, where the body’s immune system attacks its tissues, leading to joint inflammation.
Degenerative Arthritis (Osteoarthritis):
Degenerative arthritis, also known as osteoarthritis, is the most common type of arthritis. It occurs when the cartilage that cushions the ends of bones in the joints gradually deteriorates.
Symptoms:
- Timing of Pain: Pain tends to worsen throughout the day, especially with activity.
- Pain Pattern: Unlike inflammatory arthritis, degenerative arthritis typically affects one specific joint or a few joints. For example, osteoarthritis of the knee may cause pain and stiffness in that joint, but not in other joints.
Treatment:
- Conventional Treatment: Treatment for degenerative arthritis focuses on relieving pain and improving joint function. This may include over-the-counter pain relievers, corticosteroid injections, physical therapy, and in severe cases, joint replacement surgery.
- Alternative Treatment: Alternative therapies such as acupuncture, massage, and dietary supplements like glucosamine and chondroitin may also provide relief for some people.
Incidence: Degenerative arthritis affects more than 32.5 million adults in the United States. It is primarily associated with aging and wear and tear on the joints.
Why Treat Inflammatory Arthritis?
It’s essential to treat inflammatory arthritis promptly to prevent joint destruction and disability. Unlike degenerative arthritis, which primarily affects the cartilage, inflammatory arthritis can lead to joint damage and deformity if left untreated. Inflammatory arthritis causes inflammation not only in the cartilage but also in the surrounding tissues, including the synovium (the lining of the joint). Over time, this chronic inflammation can erode the cartilage, leading to pain, stiffness, and loss of function in the affected joints.
While both inflammatory and degenerative arthritis can cause joint pain and stiffness, they have different causes, symptoms, and treatment approaches. If you are experiencing joint pain or stiffness, it’s essential to consult with a healthcare professional for an accurate diagnosis and appropriate treatment plan. Early intervention is key to managing symptoms and preventing joint damage and disability.
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