Treatment for Rheumatoid Arthritis

Rheumatoid arthritis can lead to permanent joint damage, chronic pain, and deformed joints, along with organ problems. Here's what you should know about treatment.

Rheumatoid arthritis (RA) is a chronic autoimmune condition. Your body's immune system mistakenly attacks healthy cells in your joints, most often your hands, wrists, and knees.

The attack triggers inflammation in the joint lining (also called a synovial membrane), creating painful swelling that can make your joint stiff. Some people also have fever and fatigue.

The cause of RA is unknown, but it might involve a combination of genetic and environmental factors.

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RA can lead to permanent joint damage, chronic pain, unsteadiness, and an odd appearance in your joints. It can also impact other tissues and cause problems in your lungs, heart, and eyes.

RA tends to flare up and then go into remission. Early treatment can make a difference.

Lifestyle changes to treat rheumatoid arthritis

• Lose extra weight. Losing as little as 5 percent of your weight if you’re and adult could lower your pain and relieve stress on your knees. Maintaining a healthy weight can limit the progress of the illness.
• Protect your joints. Changing how you do everyday activities (like opening jars) can protect your joints from damage and increase your confidence, so you can stay more independent and active. Take breaks and lighten your schedule if necessary.
• Stay active. Adults with arthritis need at least 150 minutes of moderate physical activity each week. Specific exercise programs can help.
• Quit smoking. Smoking increases inflammation and may affect your response to treatment for rheumatoid arthritis.
• Experiment with self-care. Hot and cold treatments, deep breathing, massage, and pain creams may help relieve your pain.

Medication for rheumatoid arthritis 

Because RA can be complicated, rheumatologists or specialists in arthritis and other conditions can manage your care. Your doctor may prescribe medication.

Nonsteroidal anti-inflammatory drugs (NSAIDs)

NSAIDs help lessen pain and inflammation. They are available over-the-counter and by prescription. Ibuprofen (Advil, Motrin) and naproxen sodium (Aleve) are common over-the counter NSAIDs. There are also several prescription NSAIDs.

NSAIDs can cause stomach problems, including bleeding, as well as other side effects. One, celecoxib (Celebrex) is safer for your stomach. But it may cause other side effects, such as weight gain, difficulty breathing, and swelling in your legs and feet. Make sure you talk with your healthcare provider about potential side effects before taking these medications.

Corticosteroids

Corticosteroids, or steroids, are strong anti-inflammatory medications. They can quickly control inflammation. Prednisone, prednisolone, and methylprednisolone are commonly used steroid medications. They are used short-term because of serious side effects.

Disease-modifying antirheumatic drugs (DMARDs)

DMARDs change the course of RA. You usually take them soon after your diagnosis to prevent joint damage. You may receive a combination of them. Methotrexate is used most often. Other options include leflunomide, hydroxychloroquine, and sulfasalazine.

Biologic agents

Especially if you do not respond to DMARDs, another option is biologic agents (also called biologics), which can change the course of RA. The drugs slow inflammation and prevents damage to your joints. There are several biologics, all given either through injection or an infusion.

Janus kinase (JAK) inhibitors

You will take these newer drugs for RA orally. JAK inhibitors block an enzyme that may be a trigger for your symptoms. Three current drugs for RA are tofacitinib (Xeljanz), baricitinib (Olumiant), and upadacitinib (Rinvoq).

The American College of Rheumatology, made up of experts in arthritis treatment, have set guidelines for using RA remedies. The recommendations help doctors know which medications to use as well as how and when to make changes. Because RA medications increase the chance of serious infections, the recommendations also guide doctors about when to screen for tuberculosis and what vaccinations patients should have.

Work with your rheumatologist to find the medications that work best for you. Your provider may try different medications or combinations of them. In order to get the most benefit and lessen the chance of side effects, make sure you go to all appointments, get all recommended tests and vaccines, and carefully follow all instructions.

Surgery for rheumatoid arthritis

Hip and knee replacements have become common choices for RA patients. It is also possible to replace joints in your hands and repair some joints rather than replace them.

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