What Is Rheumatoid Arthritis vs. MS?

Symptoms of rheumatoid arthritis and MS (multiple sclerosis) that are similar include: 

• Numbness and tingling
• Muscle weakness 
• Fatigue
• Vision problems
• Eye pain
• Difficulty walking

Other symptoms of rheumatoid arthritis include: 

• Joint pain or stiffness 
  • Usually occurs in the small joints, such as those joints at the base of the fingers, the middle of the fingers, and the base of the toes, or may occur in a single, large joint, such as the knee or shoulder, or it may shift from one joint to another
  • Usually affects the same joints on both sides of the body (symmetrical)
• Muscle pain
• Low-grade fever
• Weight loss
• Feeling unwell (malaise) 
• Carpal tunnel syndrome
• Finger deformities/bent fingers 
• Difficulty bending the knee 
• “Baker's cyst” (a fluid-filled cyst in the space at the back of the knee)
• Painful and stiff neck, difficulty bending the neck and turning the head
• Hoarseness and difficulty breathing
• Eye redness 
• Bone loss — decreased bone density
• Skin problems — rheumatoid nodules (painless lumps that appear beneath the skin) 
• Lung disease — shortness of breath and a dry cough
• Pericarditis — inflammation of the tissue around the heart that can cause chest pain and difficulty breathing
• Vasculitis — inflammation of the blood vessels
• Sjögren's syndrome — causes dry eyes and dry mouth

Other symptoms of multiple sclerosis can be mild, moderate, or severe and may include:

• Muscle spasms
• Unusual eye movements
• Dizziness
• Spinning sensation (vertigo)
• Loss of coordination 
• Difficulty speaking
• Loss of balance/falls
• Bowel or bladder problems
• Sexual dysfunction 
• Sensitivity to heat (may worsen symptoms)
• Trouble thinking clearly
• Memory problems
• Mood swings

Children with MS may have seizures and extreme fatigue in addition to any of the symptoms above. 

The causes of both rheumatoid arthritis and MS (multiple sclerosis) are unknown but in both diseases, genetics are believed to increase the risk of developing the conditions.

Risk factors for developing RA include:

• Being middle-aged or older
• Being female 

Triggers that increase the chances a susceptible person will develop rheumatoid arthritis include:

• Infection: bacteria in the gut or mouth and gums infection (periodontitis) in particular 
• Smoking 
• Stress 

The cause of multiple sclerosis is unknown, but in addition to genetics, it is believed to be a combination of factors, including:

• Environment
• Immune system dysfunction
• Infections

Triggers for multiple sclerosis relapses include: 

• Stress
• Infections
• Vaccinations (e.g., influenza, hepatitis B, or any travel vaccines) 
• Smoking 
• High temperatures, such as from hot weather, saunas, hot tubs, and hot showers and baths
• Pregnancy
  • Risk of relapse is increased in the months immediately after giving birth (though many women with MS have fewer relapses during pregnancy)
• Skipping medications

The diagnosis of rheumatoid arthritis uses a combination of clinical, laboratory, and imaging information. 

Blood tests used to diagnose rheumatoid arthritis include:

• Erythrocyte sedimentation rate (ESR)
• C-reactive protein level (CRP)
• Complete blood count (CBC)
• Rheumatoid factor (RF) assay 
• Antinuclear antibody assay (ANA)
• Anti-cyclic citrullinated peptide and anti−mutated citrullinated vimentin assays 

Imaging studies used to diagnose rheumatoid arthritis include:

• X-rays (first choice)
• Magnetic resonance imaging (MRI)
• Ultrasound of joints

Joint aspiration and analysis of synovial fluid may also be indicated.

If multiple sclerosis (MS) is suspected tests used to help confirm a diagnosis include: 

• Magnetic resonance imaging (MRI)
• Lumbar puncture (“spinal tap”) 
• Evoked potentials (or evoked responses) tests electrical signals in the brain and spinal cord
• Optical coherence tomography 
• Blood tests to rule out other conditions that can cause symptoms similar to MS

Sometimes nerve damage may be detected, but MS is not diagnosed at first. In many cases, MS is only diagnosed after observing symptoms and comparing test results over time. 

Medications used to treat rheumatoid arthritis include:

• Nonbiologic disease-modifying antirheumatic drugs (DMARDS) 
• Biologic tumor necrosis factor (TNF)-inhibiting DMARDs 
• Biologic non-TNF DMARDs 
• Corticosteroids 
• Nonsteroidal anti-inflammatory drugs (NSAIDs) 
• Pain relievers (analgesics)
• Topical skin products

Other therapies for rheumatoid arthritis include:

• Heat and cold therapies 
• Orthotics and splints 
• Physical therapy and exercise 
• Occupational therapy 
• Adaptive equipment 
• Joint-protection education 
• Energy-conservation education
• Surgery 

Treatment for multiple sclerosis (MS) depends on the type of MS. 

• Treatment for MS attacks includes steroids to reduce inflammation.
• Disease-modifying therapy medications can help reduce flares and can help slow down progressive MS. 

Other medications may be used to treat specific symptoms of multiple sclerosis, such as: 

• Antibiotics for infections 
• Medicines for dizziness and vertigo
• Central nervous system stimulants for fatigue
• Bladder and bowel medications for bladder and bowel dysfunction
• Antidepressants for depression and mood changes
• Antihistamines for itching
• Antidepressants and anti-seizures medications for nerve pain
• Muscle relaxants, benzodiazepines, and onabotulinumtoxinA (Botox) for muscle spasticity
• Medicines to treat tremors
• Potassium channel blockers to treat difficulty walking 
• Erectile dysfunction medicines for sexual dysfunction