Is Osteoarthritis an Autoimmune Disease?

“My arthritis is acting up.”

You probably grew up hearing older relatives say that, and maybe you’re saying it yourself. If you have joint pain, you have a lot of company; the Arthritis Foundation estimates more than 30 million people in the U.S. suffer from a joint condition called osteoarthritis. But what is osteoarthritis, exactly?

“Arthritis” is a broad term for many different ailments affecting joints and other parts of the body. There are more than 150 forms of arthritis; osteoarthritis (OA) is the most common source of bodily aches and pains (and muttered complaints).

It is a progressive condition where cartilage that cushions the space between bones breaks down over time. The more the cartilage wears down, the more uncomfortable movement becomes.

The major weight-bearing joints in the body—the hips and knees—are most often affected, but OA also can target the spine, shoulders, wrists, fingers, and feet. Symptoms include:

• Pain
• Stiffness (especially after a night’s sleep or long periods of inactivity)
• Swelling
• Grinding or clicking sounds when the joint moves.
  
  

At the final stage, pain can be excruciating, and total joint replacement is usually recommended.

Is osteoarthritis an autoimmune disease?

OA is not an autoimmune disorder.

It is primarily caused by aging, injury, or overuse, which causes wear-and-tear on cartilage in the joint. With an autoimmune disease, on the other hand, the body’s immune system mistakenly attacks its own tissue and causes health issues. That’s the case with rheumatoid arthritis (RA), sometimes called autoimmune arthritis.

Is Osteoarthritis hereditary?

Research shows that people with a family history of OA are at higher risk of developing it, but it isn’t inevitable that they do. Genes play a role in whether you develop arthritis, but many other factors contribute to it, including aging, excess weight, injury, and overuse.

Osteoarthritis vs. Rheumatoid Arthritis

Like osteoarthritis, rheumatoid arthritis causes pain, swelling, and stiffness in joints. But it also affects other organs and systems—eyes, heart, lungs, skin, and nerves. It can cause severe joint damage and disability, as well as fatigue, weakness, and fever.

There are notable differences in how the two types affect the body, says Allen Anandarajah, MBBS, an adult rheumatologist who directs the Early Arthritis Clinic at UR Medicine.

• Osteoarthritis often affects one or few joints, and typically the large joints. Onset of symptoms is usually after age 50 years. Pain is often brought on by activity and improves with rest.
• Rheumatoid arthritis often affects the small joints – hands, wrists, and feet. Multiple joints are involved, and it typically affects both sides of the body. Pain is often associated with stiffness (lasting one to several hours in the mornings) and swelling, often improving with activity, and can get worse with prolonged rest. RA is commonly associated with abnormal immunology tests and elevated inflammatory markers.

"Some patients can have both RA and OA and thus may need treatment for both conditions.”

How to Relieve Symptoms of Osteoarthritis

Treating OA requires a holistic approach to lifestyle changes, appropriate medications to control pain, and sometimes physical therapy to maximize a patient’s mobility and health.

Exercise and Lifestyle Adjustments

“We used to think of osteoarthritis as just a cartilage problem, but inflammation affects the entire joint: cartilage, ligaments, bone, synovium (the joint lining), and the fluid within the joint,” says Dr. Katherine Rizzone, a sports medicine physician at UR Medicine.

Patients can work with a registered dietitian or their physician to develop healthy eating plans to reduce their weight.

“I have had patients headed for joint replacement surgery lose some weight—either on their own or with the help of semaglutides or bariatric surgery—who have seen their joint pain resolve to the point surgery wasn’t needed,” Dr. Rizzone says. “That was a great result for them, and being able to avoid surgery has motivated them to stay the course with physical activity.”

Medications for Symptom Relief

Non-steroidal anti-inflammatory drugs (NSAIDS) such as aspirin, ibuprofen, and naproxen are over-the-counter options that can help patients manage pain as needed.

Some patients need to be cautious about NSAIDS or avoid them altogether, so consult your doctor before beginning any medication regimen.

Pain Management Techniques

As arthritis progresses, other treatments come into play, including steroid injections to reduce inflammation in joints. Dr. Rizzone also offers radiofrequency nerve ablation, which can reduce or eliminate pain by disrupting nerve signals.

Pain shouldn’t keep people with arthritis from moving. UR Medicine’s Fitness Science has developed classes for people with arthritis and osteoporosis that focus on slowly and safely building their mobility and strength.

“Patients with OA may be reluctant to exercise because their joints already hurt, but by engaging in low-impact activity, they see improvement in their pain and they can increase their joint range of motion,” says Conner Lorenzo, Director of Fitness Science at UR Medicine.

Physical Training for Osteoarthritis

“Exercise is one of the best therapies for people with osteoarthritis; it builds their confidence as well as their strength, and the group classes bring together people with a common condition who provide emotional support and socialization.”