Arthritic bones and joints can be painful, but treatment options can the discomfort.

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Old sports injuries. Repetitive stress. Swollen joints from “rheumatism.” Whatever the osteoarthritis and rheumatoid arthritis symptoms you may be experiencing, the next strategy is to come up with ways to beat it. Options for rheumatoid arthritis (RA) and osteoarthritis (OA) treatment range from prescribed medications to simple over-the-counter pain relievers to full-blown joint replacement.

First, you need to understand what’s going on.

Osteoarthritis and Rheumatoid Arthritis Symptoms

No matter which form of arthritis you have, it can cause pain, swelling, stiffness, loss of motion, and deformity (such as bone loss or bone spurs). Once the arthritis becomes advanced, it can erode the joint cartilage enough to let bone rub against bone. This rubbing is usually painful because, unlike cartilage, bone contains nerves.

• Pain in the joint: Localized pain is the chief symptom of both OA and RA. In the early stages, the pain might be occasional, yet worsens with activity. Pain level can vary—days or weeks of no pain followed by periods of continual discomfort.
• Loss of mobility: As arthritis advances, the mobility in the affected joint diminishes.
• Noisy joints: As cartilage is lost from the ends of your bones, the movement of bone against bone, or sliding of ligaments along bone, is no longer smooth and can cause clicking, grinding, or popping noises.
• Swelling around the joint: The irritation of bone rubbing against bone, or the inflammation of the joint lining and surrounding tissue due to a faulty immune response, can cause the joint to swell and become red and tender to the touch.
• Reduced strength: Because people with painful arthritis often limit their activity, the muscles, ligaments, and tendons around a joint don’t get sufficient exercise, and muscle strength decreases. (See our post “Does Exercise Help Arthritis? The Benefits of Regular Physical Activity for Rheumatoid Arthritis.”)

Osteoarthritis Treatment Goals and Strategies

The goal in osteoarthritis treatment is to reduce pain and stiffness, improve mobility in the affected joint, stabilize the joint, slow down the gradual destruction of cartilage and bone, and restore your ability to get on with your day-to-day life.

OA is typically treated with a combination of approaches, including:

• Exercise and stretching
• Application of heat and cold to the joint
• Physical therapy
• Rest
• Weight control
• Support devices, such as braces, canes, or crutches
• Medications (oral, topical, and injectable)
• Surgery to bring relief if all else fails

Newer methods of treating OA include finding ways to slow or halt the breakdown of cartilage. The search for such disease-modifying OA drugs continues; although some drugs have shown potential, at this point there is no proven way to halt or reverse the disease process once it has started.

Rheumatoid Arthritis: Treatment Goals and Strategies

Rheumatoid arthritis symptoms can flare up and then disappear for extended periods of time, so early diagnosis is often challenging. Yet it’s crucial to begin treatment before the joint becomes seriously damaged. Evidence suggests a “window of opportunity” in early RA; hitting the disease early and hard with combinations of disease-modifying drugs during this window can push arthritis into remission or minimize joint damage.

The immediate treatment goal for RA is to reduce joint inflammation. Caught early enough, RA can often be managed with medications, avoiding the need for surgery. Evidence suggests that doctors and patients are doing just that, as rates of joint-replacement surgery related to RA appear to be on the decline. And today, patients with RA are enjoying a better quality of life than they did in years past. A 2014 study found that in the previous two decades, the level of psychological distress and physical disability experienced by rheumatoid arthritis patients has decreased significantly.

Your Medical History

If you’re suffering from arthritis, it’s important to carefully document your symptoms—duration, location, and pattern of pain—and share this information with your physician.

• Morning stiffness: Another hallmark of both rheumatoid arthritis (RA) and osteoarthritis (OA) is morning stiffness. For those with OA, the temporary stiffness in the back, hips, and other joints usually subsides within a half-hour or so. For those with RA, the stiffness may require several hours, if not all morning, to finally clear.
• Exercise and rest: RA can often be distinguished from OA on the basis of how joint pain responds to activity and to rest. OA pain tends to gradually worsen if you’re on your feet all day, but then eases at night with rest.
• Steady or episodic pain: Whether your joint pain is steady or comes and goes is another measure used to help distinguish between the two forms of arthritis. OA results in continuous pain that gradually worsens over time. Conversely, RA can be episodic or constant, alternating between painful flare-ups that last for days or weeks, and months of less pain or even remission.

Physical Exam

Before determining rheumatoid arthritis and osteoarthritis treatment plans, your doctor will examine your painful joints, looking for tenderness, redness, warmth, or a buildup of fluid. Your doctor also will be trying to get a sense of any limited motion, deformity, or instability. If RA is suspected, the distribution of inflammation is important in making the diagnosis, since in this disease the hands, wrists, feet, and knees are typically inflamed symmetrically.

It’s in the Hands…: When your hands are affected by either RA or OA, your doctor will look to the pattern of finger involvement to help distinguish the two. RA occurs more often in the joints at the base of your fingers (the metacarpal-phalangeal joints, or MCPs, sometimes written as “metacarpophalangeal”) and the joints in the middle of the fingers (the proximal interphalangeal joints, or PIPs). OA is more common in the base of the thumbs (the first carpometacarpal joints), and the knuckles at the end and middle of your fingers (the distal interphalangeal joints and the PIPs).

…Or Hips: OA frequently occurs in the large weight-bearing joints of your hips, knees, and spine. Conversely, RA usually occurs first in the smaller joints of your hands, and the wrists.

For further reading, see these University Health News posts:

• “What Is Arthritis? It Could Be Gout, Rheumatoid Arthritis, or Osteoarthritis“
• “Psoriatic Arthritis Causes and Symptoms“

Originally published in 2016, this post is regularly updated.