Can You Have Osteoarthritis and Rheumatoid Arthritis Together?

Osteoarthritis (OA) and rheumatoid arthritis (RA) are the most well-known types of arthritis. Osteoarthritis is the most common type of the disease, affecting about 27 million Americans. Rheumatoid arthritis affects far fewer people—about 1.3 million Americans—but it is the most disabling form.

The two diseases have a lot of similarities and differences. Most people will only have one or the other, but it is possible to have them both at the same time.

The Difference Between Rheumatoid Arthritis and Osteoarthritis
Verywell / Tim Liedtke

Causes

RA and OA have very different causes. RA is autoimmune, while OA is caused by a physical problem in the joint. OA can be classified as primary or secondary, depending on what led to it.

Rheumatoid Arthritis

Rheumatoid arthritis is an autoimmune disease. Your own immune system attacks your joint lining (called the synovium), causes inflammation, and eventually damages the cartilage. It typically targets joints in a symmetrical pattern (both sides at once). RA can go beyond the joints as well, attacking your cardiovascular and respiratory systems.

Thus far, the causes of RA are unclear. Known risk factors include a genetic predisposition, obesity, smoking, and exposure to smoke early in life.

Primary (Idiopathic) Osteoarthritis

When OA crops up on its own, there might not be an obvious reason for it other than wear and tear on your joints as you age.

Primary OA may affect just one or two joints, such as the knee or the hip, and it generally only impacts the joint on one side (e.g., one knee, but not both).

Secondary Osteoarthritis

When OA is the result of an injury or pre-existing medical condition, it's classified as secondary. The underlying condition may be a joint injury or medical condition.

That medical condition can be RA because of the damage it does to your joints. However, that's not always the case in someone with RA who develops OA. The co-occurrence can be just a coincidence.

Diagnosis

While the two types of arthritis have some distinct differences, your doctor may not be able to tell right away whether you have RA, OA, or both.

Findings from a physical exam, blood tests, and X-rays all help distinguish between, or confirm the co-existence of, rheumatoid arthritis and osteoarthritis.

If you already have one of these conditions but start having new symptoms, don't assume they're just part of your disease. Talk to your doctor to see if you've developed another illness.

Expect a lot of testing and possibly a lot of time before you get a firm diagnosis, especially if you haven't been previously diagnosed with OA or RA but have symptoms of both.

Treatment Interactions

In osteoarthritis, treatment deals primarily with lowering inflammation and pain levels. It can include medication, topical pain relievers, exercise, braces or splints, heat and/or ice, and losing weight. All of those things can also help alleviate pain from RA—in fact, many of them are routinely recommended for RA patients.

However, drugs that are specifically for rheumatoid arthritis, such as biologic drugs, will have no effect on OA. They target the autoimmune response and don't do anything directly to your joints.

The good news is that treatments for one condition shouldn't exacerbate the other condition or conflict with its treatment.

While negative drug interactions between the classes of drugs prescribed for these conditions aren't common, you should make sure your doctor knows everything you're taking, including over-the-counter medications, supplements, and complementary/alternative treatments.

A Word From Verywell

It can be hard to manage two conditions at once, and it can be discouraging to get one under control only to discover you have something else to tackle. Keep in mind that you have a lot of tools available for managing your pain and other symptoms. Stay in contact with your medical team about what is and isn't working so you can find the right combination of treatments for you.

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Article Sources
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  2. Woetzel D, Huber R, Kupfer P, et al. Identification of rheumatoid arthritis and osteoarthritis patients by transcriptome-based rule set generation. Arthritis Res Ther. 2014;16(2):R84. doi:10.1186/ar4526

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