Rheumatoid arthritis (RA) is a common autoimmune disorder and can cause significant immobility. Joint pain caused by this condition can significantly reduce a person’s quality of life.
RA generally affects smaller joints like in the wrists and fingers. As a result, performing simple routine activities like tying a shoelace or buttoning a shirt can become difficult. [1]
Proper treatment of this disorder with medication and lifestyle changes can provide relief from the symptoms. Let’s have a look at the best treatments for rheumatoid arthritis.
What are the treatments for rheumatoid arthritis?
1. Medications
It is possible to control the symptoms and progress of RA by using medications that can modify the response of the immune system. Treatment aimed at relieving specific symptoms are also beneficial. [2]
The medications you may need to use for treating RA depend on the extent of joint involvement, the severity of symptoms, and how long you have had rheumatoid arthritis.
2. NSAIDs
NSAIDs or nonsteroidal anti-inflammatory drugs can reduce inflammation and relieve joint pain. Over-the-counter NSAIDs such as ibuprofen and naproxen sodium are commonly used for the management of RA. However, when used regularly and over a long period of time, these drugs may cause a few side effects like stomach pain, heart problems, and gastritis. [3]
3. Corticosteroid medications
Corticosteroid medications like prednisone can help to relieve pain and minimize damage to the joints by reducing inflammation.
Long-term side effects of these medicines include weight gain, thinning of bones, and diabetes. However, corticosteroids could be considered safe and highly effective when used to relieve acute symptoms. It is recommended to taper off the dose gradually.
4. DMARDs
DMARDs or disease-modifying antirheumatic drugs include methotrexate, leflunomide, sulfasalazine, and hydroxychloroquine.
These medications can slow down the progress of rheumatoid arthritis and protect joints against permanent damage.
5. Biologic agents
Biologic agents, sometimes referred to as biologic response modifiers, are a newer class of DMARDs that work by regulating the response of the immune system. Biologic agents commonly used for the treatment of RA include abatacept, adalimumab, anakinra, and baricitinib. [4]
These drugs can target the immune system and control the release of pro-inflammatory substances by the immune cells thereby preventing joint damage. Biological agents may also suppress the immune system and inhibit the production of autoantibodies against the body’s tissues such as the joints. This can minimize joint damage and prevent the progress of RA.
However, the suppression of the immune system may weaken your body’s defense mechanisms and increase your risk of infections. The efficacy and safety of Biologic DMARDs may be improved by combining the treatment with nonbiologic DMARDs like methotrexate. [5]
6. Surgery
Surgery may be needed in severe cases of RA when medications or other treatments have failed to provide adequate relief.
Surgery for RA usually involves repair of the damaged joints. It is aimed at reducing pain and restoring your ability to use the joint. [6] [7]
Surgical procedures for rheumatoid arthritis may involve one of the following:
- Joint fusion: This surgery involves fusing a joint to realign and stabilize the bones to relieve pain.
- Tendon repair: Joint damage and chronic inflammation may cause tears in the tendons around the joints. Your doctor may recommend surgery to repair the damaged tendons.
- Synovectomy: It involves the removal of the synovium, the inflamed lining of the joints, to reduce pain.
- Total joint replacement: If the joint damage is extensive, your surgeon may advise you to undergo a total joint replacement. In this procedure, the damaged part of the affected joint is removed. This is followed by the insertion of a metal or plastic prosthesis.
7. Occupational therapy
Occupational therapy can play an integral role in the comprehensive management of RA. An occupational therapist can teach you some exercises to keep your joints flexible. The therapist will also show you less painful ways to perform daily tasks. [8]
The use of assistive devices recommended by an occupational therapist can also make it easier for you to avoid stress and pressure on your painful joints. For example, a kitchen knife having a firm hand grip would protect your wrist and finger joints. Other tools like buttonhooks can make it easier for you to get dressed.
8. Lifestyle choices
RA is a progressive condition. It is possible to slow down joint damage by adopting healthy lifestyle habits. Alternative therapies can also be effective in relieving the symptoms of this condition. Here are some self-care measures, which you can include in your treatment plan for RA for faster and better results.
9. Exercise regularly
Gentle exercises strengthen the muscles around the joints and help you avoid fatigue. If you are a beginner, you can try simple exercises like walking.
Talk to your doctor before you start any exercise program. Also, it is best to avoid exercises that involve excessive movements of the severely inflamed or injured joints.
10. Apply heat or cold
The application of heat can relieve pain and reduce the stiffness of the muscles. It will also improve blood circulation in the tissues and accelerate healing.
The application of cold can help to reduce pain by creating a sensation of numbness. Applying cold packs may also decrease swelling in the joints. [9]
11. Avoid mental stress
Constant joint pain caused due to RA can create immense mental stress. Stress-busting techniques such as guided imagery, yoga, and deep breathing exercises can be practiced to improve mental health. [10]
Conclusion
Regular treatment of RA would help you derive long-term relief from joint pain and other symptoms. Proper treatment of RA is also essential for preventing further damage to the joints. Treatment will help to maintain the mobility of the joints and allow you to perform your routine activities.
References:
- https://www.arthritis.org/diseases/rheumatoid-arthritis
- https://www.rheumatoidarthritis.org/treatment/
- https://www.hopkinsarthritis.org/arthritis-info/rheumatoid-arthritis/ra-treatment/
- https://journals.sagepub.com/doi/pdf/10.1177/1759720X16687481
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6370601/
- https://www.ncbi.nlm.nih.gov/pubmed/19577394
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1820165/
- https://www.sciencedirect.com/science/article/pii/S2255502114002028
- https://www.webmd.com/rheumatoid-arthritis/understanding-rheumatoid-arthritis-treatment
- https://www.mayoclinic.org/diseases-conditions/rheumatoid-arthritis/diagnosis-treatment/drc-20353653
