Massage Therapy Journal Summer 2026

34 • Massage Therapy Journal

AMTA Continuing Education

Table 1: OA vs. RA Osteoarthritis

Rheumatoid Arthritis

Gradual onset

Sudden onset

Localized inflammation No gender preference

Systemic inflammation Women predominate Symptoms always bilateral Joint synovium is destroyed Many complications are possible

Symptoms usually unilateral Hyaline cartilage erodes in joints

Few complications

Only synovial joints are affected No acute and subacute periods

Joints and other organs can be affected Acute and subacute periods are typical

share with clients the differences between these two conditions, which actually have little in common, as summarized in Table 1 . The most fundamental difference is that in OA, hyaline cartilage erodes at synovial joints, as a result of use and abuse over time, as one ages. 3 In RA, joint damage results from bone deterioration and deformity as a result of the chronic inflammation that characterizes an autoimmune response. 8 Still’s disease . Also called adult-onset Still’s disease to distinguish it from childhood onset Still’s disease, this form of inflammatory arthritis includes symptoms that can mimic RA, including joint pain and stiffness, as well as fever, rash and swollen glands. Still’s disease is not, however, an autoimmune disease, and its cause is unclear. While some researchers characterize it as a reactive syndrome, triggered by infectious agents in people with a genetic predisposition, others consider Still’s disease an auto inflammatory syndrome (distinct from autoimmune in that it occurs from an innate

immune system abnormality, not an immune system attack on one’s own tissues). The chronic inflammation of Still’s disease, like RA, does cause joint deterioration. 9 Table 2 contrasts Still’s disease with RA. 8 Reactive arthritis . Also a form of inflammatory arthritis, this disease shares symptoms with RA, though there are distinct differences, and reactive arthritis is less common. 9 Reactive arthritis is caused by a bacterial infection that is transmitted during sex or in contaminated food; common bacterial agents include chlamydia, salmonella and shigella. 8 Although reactive arthritis itself is not contagious, the causative bacterial infection can be passed from person-to-person. It is unclear why some people exposed to these bacteria get the disease and others do not, although researchers have identified a gene, human leukocyte antigen (HLA) B27, that makes a person more likely to get reactive arthritis. 10 The differences between reactive arthritis and RA are summarized in Table 3 .

Table 2: Still’s Disease vs. RA Still’s Disease No periods of remission/recurrence

Rheumatoid Arthritis

Periods of remission/recurrence Spleen, liver not typically enlarged Positive test for rheumatoid factor

Spleen, liver enlarged

Negative test for rheumatoid factor

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