Rheumatoid Arthritis Treatment

There isn’t a cure for Rheumatoid Arthritis (RA), but it can be treated according to each person. The goal of treatment is to reduce inflammation and pain, maximize joint function, and prevent joint destruction. It is best to start treatment right after being diagnosed. Aggressive management can prevent work disability, stop damage to joints, and improve mobility. Aggressive management consists of medications, rest, joint-strengthening exercises, joint protection, and patient education. Treatment depends on the age of the person, health, which joints are involved, and how progressed the disease is.

There are two types of medications. The “first line drugs” are used to reduce inflammation and help with the pain such as ibuprofen, aspirin, and corticosteroids. The “second line drugs”, such as methotrexate and hydroxychloroquine (Plaquenil), are slow-acting to prevent joint destruction. Patients with a less destructive form of disease can be treated with rest, pain and inflammatory medications alone, but this is less common. People have seen improved function and less joint destruction when second line drugs are used soon after diagnosis. Treatments can also include using a combination of two different second line drugs; it varies from person to person. If there are severe deformities sometimes surgery may be the answer.

Aspirin used in higher doses than what you would use for a headache can be very effective in reducing inflammation; it has been used to treat joints since the Egyptian era. A common side effect from aspirin is stomach pain or ulcers, to avoid this you can take it with food and sometimes a medication will be prescribed to protect the stomach. Other anti-inflammatory medications are just as effective; people react to each one differently. Corticosteroids (steroids) can be given orally or by injection. Steroids are used when the disease isn’t responding to other anti-inflammatory medications or during severe flares of the disease. Steroids are usually used for a short period of time because they can have serious side effects if used for long periods. Side effects include thinning of bone, weight gain, easy bruising, and cataracts. These side effects can be avoided if you are slowly eased off of steroids rather than an abrupt discontinuation which could cause the disease to flare back up. Thinning of the bones can be prevented by taking calcium and vitamin D supplements.

The second line drugs are used for weeks or even months before seeing improvement. They can be used for years at different doses. If effective these drugs can lead to remission. These drugs suppress the immune system which in the case of RA is the cause of the inflammation since the immune system is attacking the body’s tissues. The dosage varies among the many options available of these drugs and side effects differ, but many can be avoided by having blood tests done frequently to observe levels of your blood count and liver functions.