Rheumatoid Arthritis Treatment

Rheumatoid arthritis (RA) causes chronic inflammation of the joints, leading to joint pain, stiffness, and irreversible damage. The treatment for rheumatoid arthritis prioritizes how to control the inflammation, delay and minimize joint damage, and increase the ability to function and maintain the quality of life.

A proper treatment plan depends on each person’s preexisting condition, the severity of rheumatoid arthritis, response to treatment, and medication side effects. It usually includes:

Medications

Most people with RA need medications to control the inflammation when the disease is active or flares up. Joint damage occurs within the first two years when inflammation is usually at its worst.

Classes of medications to manage RA symptoms are:

• Pain relievers: non-NSAIDs, NSAIDs.
• Anti-inflammatory drugs, steroids have a strong anti-inflammatory effect, available in pill, intramuscular, and intravenous forms.
• Disease-modifying antirheumatic drugs (DMARDs)
  • Conventional synthetic DMARDs: Methotrexate, hydroxychloroquine, and sulfasalazine were available before 1998.
  • Biologic DMARDs, manufactured with recombinant DNA technology, such as etanercept, adalimumab, abatacept, and tocilizumab, are given by the IV route, available after 1998
  • Targeted synthetic DMARDs, such as tofacitinib in pill form

Nonpharmacologic therapies 

Non-drug therapies are also effective in reducing pain and improving self-confidence and self-esteem. They can help people with rheumatoid arthritis to gain some control over their sickness and deal with their depression and mobility limitations.

• Education
  Having a better understanding of rheumatoid arthritis can help you to anticipate and cope with health issues. Your doctor can work with you to formulate an appropriate treatment plan and short-term and long-term goals.
  
  
• Exercise
  Designing a personalized exercise program to include mobility, resistance, and aerobic exercise can improve the ability to function and prevent pain and stiffness caused by rheumatoid arthritis. Exercise can restore the joint range of motion and increase muscle strength and endurance. It improves mood and boosts self-confidence.
  
  
• Biofeedback
  
  
• Cognitive behavioral therapy
  
  
• Physical and occupational therapies
  These therapies can help preserve joint structure and function. Your doctor may design specific forms of treatments, such as 
  • Balance training to prevent falls
  • Functional training and activity modification 
  • Use of splints or assistive devices to help you with your daily activities, such as walking or opening a jar
    
    
• Surgery
  Usually, a patient with rheumatoid arthritis does not require surgery. In patients with end-stage RA with pain and dysfunction-- even without ongoing active inflammation-- consideration for surgery or joint replacement to prevent further joint damage and restore joint motion and function is an option.

Selecting a suitable treatment modality depends on its side effects and success in stopping joint damage. Treatment modalities that can control joint damage should continue. Rheumatoid arthritis also requires long-term medical care. It is essential to keep the follow-up doctor’s appointments for evaluation of the result of the treatment and monitor its side effects.