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Treatments for Rheumatoid Arthritis
How is rheumatoid arthritis (RA) treated?
RA is most often treated with medicine. Physical therapy and finding the right balance between rest and activity can also help. There's no cure for RA, but treatment may help relieve symptoms and control the disease. Treatment usually continues throughout your life, but it will vary depending on:
- The stage. RA may be active or in remission (not having symptoms).
- How severe RA is.
- Your treatment history.
- The benefits and risks of treatment options.
- What you prefer for treatment options, such as cost, side effects, and daily schedules.
The goal of treatment is to help you maintain your lifestyle, reduce joint pain, slow joint damage, and prevent disability. Treatment should start with education about the disease. Learn what might happen with joint damage and disability. Find out the risks and benefits of potential treatments. You and your team of doctors can make a long-term treatment plan.
If you try medicine, exercise, and lifestyle changes for at least a few years but pain and disability get much worse, surgery may be an option. Total joint replacement of the hip and knee work best.
Early and ongoing treatment of RA with medicines called disease-modifying antirheumatic drugs (DMARDs) can slow or sometimes prevent joint destruction. Other medicines may be combined with DMARDs to relieve symptoms. These medicines include:
- Medicines that reduce swelling. Examples are ibuprofen (such as Advil or Motrin) and naproxen (such as Aleve or Naprosyn).
- Medicines that relieve pain. Examples are acetaminophen (Tylenol), codeine, and hydrocodone.
- Corticosteroids. These may be used for early treatment, to control flare-ups, or to help manage the disease.
Many of the medicines used to treat RA have side effects. So it's important to have regular checkups and talk with your doctor about any problems. This will help your doctor find a treatment that works for you.
In some cases, the disease doesn't respond to the first several treatments. When this happens, the disease may be treated with much higher doses of medicines or with different combinations of medicines.
Types of treatment that may help you control some of the symptoms of rheumatoid arthritis include:
- Self care, which can include rest, protecting your joints, and healthy eating.
- Physical therapy, to improve joint function. Physical therapy includes exercise, hot and cold therapy, and massage.
- Occupational therapy. This helps you learn how to maintain movement in the joints while carrying out the activities of daily living.
- Assistive devices such as household aids or mobility aids. For more information and a catalog, contact the Arthritis Foundation at www.arthritis.org.
- Behavioral modification techniques to reduce pain and stress. They include biofeedback and relaxation therapy, such as breathing exercises and muscle relaxation.
- Counseling. It can help you cope with long-term pain and disability. Counseling can also help if you feel depressed. It's common for people with RA to feel depressed. Also, be sure to seek the help and support you need from friends and family members.
- Complementary medicine, such as acupuncture and herbs.
To help monitor and manage your RA, your doctor may order certain tests. They include:
- Antinuclear antibody assay.
- Bone density test, to check for bone loss (osteoporosis).
- Complete blood count.
- Eye exam.
- Imaging tests such as MRI, ultrasound, or X-rays.
- Joint fluid analysis.
- Kidney function tests.
- Liver and muscle enzyme tests.
- Tissue type test.
Your doctor will want to closely watch your condition. Depending on your symptoms and treatment, this could be done as often as every 2 to 3 months or every 6 to 12 months. Testing, such as blood tests, may be done more often.
During each follow-up visit, your doctor will assess:
- The amount of joint pain.
- How long morning stiffness lasts.
- The number of actively inflamed joints.
- How well you are functioning.
- Results of lab tests.
Clinical trials are research studies that evaluate a new medical approach, device, drug, or other treatment. As a Stanford Health Care patient, you may have access to the latest, advanced clinical trials.
Open trials refer to studies currently accepting participants. Closed trials are not currently enrolling, but may open in the future.