Credit: Eileen Davidson

In my early 20s, I started experiencing unexplained pain throughout my body. I mostly shrugged it off because I didn’t “look sick.” Then at 26, I became pregnant and the pain intensified. I started to take this seriously and embarked on a marathon of doctor’s visits, hoping someone would have an explanation other than my job as an aesthetician to blame for the pain in my feet, back, hands, and jaw.

Finally, a few months after I turned 29, I finally found a doctor who took my pain seriously enough to test for a condition most doctors said I was “too young” for: rheumatoid arthritis (RA). That was the cause of all my pain. Or so I naively thought.

I would later learn that I also had osteoarthritis (OA) – a chronic disease that I find has many as similarities to rheumatoid arthritis as it does differences. I’ve been puzzled by pain in my back, neck, hands, feet, and knees that shouldn’t be there if my biologics are working — after a joint exam, ultrasound, and x-rays we discovered my joints were also sore from osteoarthritis.

Now, at 35, my life is drastically different than when this journey began. I no longer work as an aesthetician, as the joint pain from my illnesses makes it nearly impossible. I have lost partial mobility in my dominant hand, which has turned once-easy tasks into challenges. And I find myself spending way too much time explaining what it’s like to live with not one, but two life-changing chronic conditions.

Rheumatoid arthritis and osteoarthritis are two forms of arthritis that affect the joints differently

When I tell people I have rheumatoid arthritis and osteoarthritis, I’m usually met with shock and confusion. Shock because I, a 30-something, don’t match the image in their head of a “typical” person living with arthritis. Confusion because, despite all the efforts to raise awareness about arthritis, many people don’t know there are multiple types of arthritis.

Arthritis is not a single disease that affects only the elderly. Rather, it is a category of diseases characterized by joint pain, swelling, and stiffness. While arthritis becomes more common with age, it can affect anyone — even kids can have arthritis. Some of the diseases that fall within the broader category of arthritis or rheumatic diseases include lupus, gout, fibromyalgia, and, of course, my conditions — osteoarthritis and rheumatoid arthritis.

Although each of these diseases affect the joints, they do so in different ways.

  • Osteoarthritis is the result of wear and tear on your bones’ protective cartilage.
  • Rheumatoid arthritis, on the other hand, occurs when your immune system turns against your body’s tissues, causing inflammation, swelling, and pain that impacts the lining of your joints.

The pain of these two conditions affects more than just the joints

As an autoimmune disease, rheumatoid arthritis has side effects beyond joint pain. To start, the same underlying inflammation that damages the joints can affect organs and systems throughout the body, causing an increased risk of heart disease, lung disease, and more.

Certain medications used to treat rheumatoid arthritis can affect kidney and liver function. RA and the medications that treat it also make me immunocompromised, which makes fighting infections more difficult.

The pain and mobility limitations of OA also take a toll on people. OA can cause sleep issues, for example, and social limitations. OA can force people to give up their favorite activities or need to stop working. And while OA doesn’t necessarily cause these conditions, there are a number of co-occurring health problems that are common in OA patients and could affect how it is able to be treated, such as high blood pressure, heart disease, and diabetes.

Figuring out which arthritis is causing my pain can be a guessing game — even for my doctors

When I feel any type of joint pain, I make the trek to my general practitioner or rheumatologist. The same scene often plays out: I describe the severe stiffness pulsing through my hand, foot, neck, or back. They put me through a medical ringer; drawing blood, checking for inflammation, and scanning me with MRIs, X-rays, and ultrasounds. (Yes, all three. Thoroughness is key.) Then they tell me that yes, there are nodules in my joints, but all of the test results are “normal.”

Sometimes I get lucky and the doctors are able to pinpoint which arthritis is to blame. Usually, at that point, I’ve already been self-treating for the other. But hey, at least I got an official answer.  Part of the difficulty is that rheumatoid arthritis and osteoarthritis have many similarities.

  • Both can cause swelling
  • Both cause joint pain, occasionally at the same time
  • Both cause mobility problems
  • Both can require joint replacement surgeries
  • Both can cause irreversible damage
  • Both are more common in women
  • Both are expensive to treat for the person living with the condition
  • Both lack any type of cure

Living with two types of arthritis doubles the mental, physical, and emotional toll

For me, the biggest similarity between rheumatoid arthritis and osteoarthritis is that they’ve both taken parts of my life that I won’t get back — a job I loved, activities I enjoyed, and simple physical freedoms. Sure, some may think osteoarthritis is “better” because my body can still fight infections. And there’s the fact that OA causes way less fatigue and cognitive dysfunction (brain fog). But there are far more treatments for RA than for OA. Whenever the OA flares up, I have to accept that there isn’t much I can do to ease the pain; just wait and hope it passes a little faster than the last time.

There isn’t necessarily one I would rather live with over the other. I would, however, rather be living with just one — or, ideally, none.

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