Osteoarthritis vs. Rheumatoid Arthritis: What’s the Difference?

Reviewed by the Physiotherapy Team at Waterloo Sports Medicine Centre    

Experiencing joint pain, stiffness, or swelling? Osteoarthritis and rheumatoid arthritis have similar symptoms but very different causes and approaches to treatment. Understanding the difference between osteoarthritis (OA) and rheumatoid arthritis (RA) can help you find the right care and management strategies. 

What Is Osteoarthritis? 

Osteoarthritis (OA) is the most common form of arthritis. It involves changes to the tissues within and around a joint, including cartilage, bone, and other joint structures. OA commonly affects the knees, hips, hands, and spine. 

Rather than being simply “wear and tear,” osteoarthritis develops through a combination of mechanical, biological, and other factors. Symptoms can include joint pain, stiffness, swelling, reduced range of motion, and difficulty with activities such as walking, climbing stairs, or gripping objects.

What Is Rheumatoid Arthritis? 

Rheumatoid arthritis (RA) is an autoimmune disease. Instead of primarily resulting from joint degeneration, the immune system mistakenly attacks tissues surrounding the joints, causing inflammation. RA commonly affects the hands, wrists, and feet, although it can affect other joints and body systems as well. 

RA can cause joint pain, swelling, stiffness, fatigue, and reduced physical function. Because ongoing inflammation can lead to joint damage, early diagnosis and appropriate medical treatment are important. 

Osteoarthritis vs. Rheumatoid Arthritis 

While the conditions can sometimes cause similar symptoms, there are several important differences:

Osteoarthritis (OA)	Rheumatoid Arthritis (RA)
Primarily involves progressive changes to joint tissues	Autoimmune disease involving systemic inflammation
Often affects the knees, hips, hands, and spine	Commonly affects the hands, wrists, and feet
Can affect one or several joints	Often affects multiple joints, frequently in a symmetrical pattern
Morning stiffness is generally shorter-lasting	Morning stiffness is often prolonged
Pain may worsen with activity or joint loading	Pain and stiffness may occur with or without activity
Usually does not cause widespread systemic symptoms	May cause fatigue and other systemic symptoms
Managed with exercise, education, physical activity, symptom management, and other treatments	Requires medical management, often including disease-modifying medications, alongside rehabilitation

The distinction is important because OA and RA have different underlying mechanisms and treatment approaches.

How Can Physiotherapy Help Osteoarthritis? 

• Strengthening exercises to improve muscle capacity and support joint function 

• Mobility exercises to maintain or improve range of motion 

• Aerobic exercise such as walking, cycling, or swimming 

• Balance and functional training to improve everyday movement 

• Activity modification to help manage painful activities while maintaining physical activity 

• Education and self-management strategies to help you manage symptoms independently 

A systematic review of clinical practice guidelines found strong support for exercise and other non-surgical management strategies for hip and knee osteoarthritis.

How Can Physiotherapy Help Rheumatoid Arthritis? 

Physiotherapy can also play an important role in managing rheumatoid arthritis, but it is part of a broader medical treatment plan rather than a replacement for medical care. A physiotherapist may help you: 

• Maintain joint mobility 

• Build or maintain muscle strength 

• Improve cardiovascular fitness 

• Manage fatigue and physical activity 

• Adapt activities during periods of increased symptoms 

• Maintain independence and participation in daily activities 

  
  

The American College of Rheumatology recommends exercise and rehabilitation as part of comprehensive rheumatoid arthritis management. If you have RA, your physiotherapist can also work alongside your physician or rheumatology team to ensure your exercise program is appropriate for your symptoms and disease activity. 

Can Physiotherapy Cure Arthritis? 

There is currently no physiotherapy treatment that can cure osteoarthritis or rheumatoid arthritis. However, physiotherapy can help you manage symptoms, maintain physical function, and stay active. 

For OA, treatment focuses heavily on exercise, physical activity, education, and managing factors that contribute to symptoms.

For RA, physiotherapy complements medical treatment by helping maintain mobility, strength, fitness, and function. 

Your treatment plan may also change over time depending on your symptoms and goals. 

When Should You See a Physiotherapist? 

Consider speaking with a physiotherapist if joint pain or stiffness is affecting: 

• Walking, stairs, or other daily activities 

• Exercise or sports 

• Work or hobbies 

• Strength or mobility 

• Your confidence with movement 

If you have persistent joint swelling, prolonged morning stiffness, multiple swollen joints, or symptoms affecting several areas of your body, speak with your physician or another healthcare professional. These symptoms can occur with rheumatoid arthritis and may require further medical assessment. 

Looking for Arthritis Treatment in Waterloo? 

Whether you are managing osteoarthritis, rheumatoid arthritis, or unexplained joint pain, physiotherapy can help you stay active and maintain your quality of life. At Waterloo Sports Medicine Centre, our physiotherapists provide individualized treatment plans focused on improving strength, mobility, physical function, and confidence with movement!