What is the difference between osteoarthritis and osteoporosis?

This is a commonly asked question and tends to be confusing to many of my patients.

Osteoarthritis is the breakdown of the cartilage that covers the ends of each long bone. Think of each long bone in your body as having a hat over each end. The hat is the cartilage. As the hat material wears out, the end of the bone becomes exposed. Osteoarthritis is the process where the cartilage is wearing down, similar to the hat material. Eventually the bone becomes exposed and that is extremely painful.

Osteoporosis is a condition where your bones become thin. It has nothing to do with cartilage. It has everything to do with the fact that your bone goes from being a very strong structure to a very thin fragile structure. That occurs in women as we lose estrogen and in men as testosterone levels go down as they age. In women, this can typically occur after age 60 and in men typically after age 75.

Osteoporosis is a silent condition because it doesn’t cause any pain until the bone become so fragile it breaks. Osteoarthritis is a process that occurs over time and typically there is pain associated with the joint where osteoarthritis is occurring. There are cases where people will have the arthritic process occurring for years and be completely asymptomatic until they reach the end stage where there is no cartilage left in the joint.