A chronic inflammatory disorder, rheumatoid arthritis (RA) arises when the immune system starts mistakenly attacking body tissues, including joints. While RA cannot be cured, there remains a range of treatment methods which can be used to relieve its symptoms.
Disease-modifying anti-rheumatic drugs (DMARDs)
When you seek RA treatment help, the first medication given to you will probably be a DMARD such as azathioprine, leflunomide or hydroxychloroquine for relieving the inflammation. You are especially likely to be given methotrexate, which you can take yourself as injections for rheumatoid arthritis treatment.
Methotrexate is effective, safe and fairly inexpensive; however, once a rheumatologist has looked closely at your RA, they might decide that you actually need multiple DMARDs. Triple therapy - including methotrexate, hydroxychloroquine and sulfasalazine - can work well.
DMARDs can produce side effects which, nonetheless, you might not struggle to handle. They include diarrhea, rashes, nausea, hair loss, and mouth sores.
A biologic is a drug capable of halting inflammation and helping slow an immune system that has veered off course. As they inhibit the immune system, biologics may curb your body's ability to ward off infections such as pneumonia. However, typically, this isn't an overly unhelpful tradeoff.
As various biologics are available, your doctor will question you in depth to discern which of these will be most effective in treating your specific RA. This questioning will also help the doctor to assess how prone you could be to side effects, though most patients handle biologic therapy nicely.
As biologics outweigh DMARDs in expense, don't be surprised to see drug manufacturers offering discounts to bring biologics further within your financial reach.
Non-steroidal anti-inflammatory drugs (NSAIDs)
Capable of relieving pain and reducing inflammation, some of these drugs - including ibuprofen and naproxen sodium - are available over the counter. Stronger NSAIDs can be sourced by prescription.
However, various side effects are associated with NSAIDs - which could, for example, irritate the stomach, damage the liver and kidneys, and produce ringing in the ears. Heart attacks and strokes are also a greater risk with NSAIDs, which are not taken as often as they used to be.
These are available as a form of infusion treatment for rheumatoid arthritis. Should more standard rheumatoid arthritis treatment medications fail to bring an improvement in serious instances, corticosteroids may be provided intravenously as a means of lowering joint swelling and pain.
Nonetheless, it remains crucial to account for various unpleasant side effects of corticosteroids, which can trigger more bone loss or even bring steroid-induced psychosis. This kind of treatment can also thin the skin, increase weight, and inflict the gastrointestinal tract with ulcers.
If your RA sometimes painfully flares up, your doctor might react by prescribing analgesic drugs to help you deal with these temporary anguishes. Among these drugs are relatively familiar pain relievers such as acetaminophen and stronger drugs known as opioids.
If you have previously suffered ulcers, or NSAIDs seriously upset your stomach, your doctor might advise that you temporarily use analgesics. However, don't consider these a replacement for DMARDs. Analgesics merely dull pain rather than treat inflammation underpinning it, but can still assist you in handling inconvenient flares before allowing DMARDs to control the disease.
Physical or occupational therapy
Your doctor may know a physical or occupational therapist capable of teaching you exercises that can help preserve your joints' flexibility. This therapist could also introduce you to new ways in which you could complete daily tasks without putting unnecessary stress on your joints.
Examples of techniques you could learn include picking up items with forearms instead of sore fingers and using a saw-handle-equipped kitchen knife to help protect the joints in your finger and wrist. Getting dressed, too, can become easier with the use of tools like buttonhooks.
Taking DMARDs shortly after your RA's initial onset could help you prevent your joints incurring damage. However, surgery can become crucial if those joints are inflicted with permanent damage that hinders their daily functionality and mobility.
Surgical procedures used for treating RA include synovectomy, where the inflamed synovium - joint lining - is removed. It is also possible for tendons near joints to be surgically repaired if they have loosened or ruptured due to inflammation and joint damage.
Another option is largely self-explanatory total joint replacement surgery. This procedure would involve the surgeon removing your joint's damaged parts before inserting a metal-and-plastic prosthesis. If this surgery isn't possible in your case, a joint can instead be surgically fused.
How to treat arthritis appropriately in your case can depend on particular questions that your doctor asks at your appointment with them. They might ask when your symptoms started and whether these symptoms have changed with time or improve or worsen in particular situations.