How is Rheumatoid Arthritis (RA) Treated?

Treating RA requires a team approach in which you benefit from the expertise of health professionals from different disciplines. A rheumatologist, a physician with special training in arthritis and other diseases of the bones, muscles and joints, generally serves as the leader of the health-care team. The rheumatologist may coordinate care with your primary-care physician and others in helping you to manage your RA and find the best treatment program.

Your treatment program should be tailored to meet your needs, taking into account the severity of your arthritis, other medical conditions you may have and your individual lifestyle. Currently, there is no cure for RA. However, highly effective treatments exist, and early treatment may help to prevent the damage that RA can cause. So once you have a diagnosis, you should begin treatment right away.

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Current treatment methods include drug treatments and lifestyle modifications. They focus on relieving pain, reducing inflammation, stopping or slowing joint damage, and improving patient function and well-being. Modern treatments have substantially improved the outlook for people with RA.

Medications

Medications used to treat RA can be divided into two groups: symptomatic and disease-modifying. Symptomatic medications may relieve symptoms such as pain and inflammation associated with RA. Disease-modifying drugs relieve symptoms, help control RA and prevent deformity and disability. Disease-modifying antirheumatic drugs (DMARDs) – including a class of drugs called biologic response modifiers, or biologics – are an important option in the treatment plan for people with RA.

Your rheumatologist may recommend using two or more medications at a time. However, some medications, eg, RA biologic medicines, should not be taken together as there is a greater risk of getting a serious infection. Each medication has a distinct purpose in the treatment of RA. Some of these medications affect the immune system or have other serious side effects, making careful monitoring very important during your treatment. It is important to talk to your doctor about risks, dosing and side effects, as well as if you have any questions about your medications. Your doctor will inform you about additional tests and medications required while taking some medications to treat your RA. As with all medications, notify your doctor immediately if you experience an adverse reaction or develop an unusual symptom while taking these drugs.

Exercise and Activity

Doctors and therapists agree that you can improve your health and fitness through appropriate exercise – without hurting your joints. With this in mind, you can work with your health-care team to determine the best combination of exercise and activity for your condition. When you have RA, it’s important to exercise to keep joints flexible, muscles strong and your heart and lungs fit. Moderate aerobic exercise on a regular basis has benefits for weight control, mood, sleep pattern, joint mobility, muscle strength and psychological well-being. As well, the Arthritis Foundation’s exercise program has been shown to decrease fatigue and stiffness.

It is important to learn how to adjust your activities to achieve the best physical health. When a joint is warm, painful and swollen, rest will help reduce the joint’s inflammation. Your doctor or therapist can guide you as to how much and what type of rest you need. However, temporarily reducing your activity level does not mean stopping all exercise. You should still work on joint mobility by performing range-of-motion and stretching exercises. Low-impact conditioning programs, like swimming or riding a stationary bicycle, are generally good options. You should consult your doctor or therapist about an appropriate exercise program for you.

When Is Joint Surgery the Best Option?

Doctors typically prescribe a program of medications and therapy before considering joint replacement. However, if you experience prolonged pain and disability caused by severe joint damage, you may think about total joint replacement (also called total joint arthroplasty). These procedures are done by orthopedic surgeons and involve replacing damaged parts of the joints with metal and plastic parts.

Nutrition Facts

It is very important to maintain a healthy diet that includes adequate protein and calcium as instructed by your physician or health-care professional. All patients with RA, and particularly those taking corticosteroids, should take calcium supplements and a multivitamin containing vitamin D.