Treatments for RA consist of several methods, including prescription medication, lifestyle adjustments, and monitoring through blood tests and visits with your rheumatologist. If severe joint damage occurs, surgery may be an option. Most people combine several medications and lifestyle changes at the same time. Since RA is a disease that affects each person differently, treatment is tailored to the individual and usually self-managed (under the supervision and guidance of your doctor).
The goals of RA treatment are to stop or reduce inflammation; relieve pain and other symptoms; prevent permanent joint damage; and improve physical function and quality of life. The above reasons highlight the importance of following your individual treatment plan exactly as instructed (or as close as physically possible).
There are several types of medications prescribed to control pain and reduce damage caused by RA. Such medications include, but are not limited to, NSAIDs and analgesics, DMARDs, glucocorticoids and biologic response modifiers.
- NSAIDs, or nonsteroidal anti-inflammatory drugs, help relieve symptoms but do not prevent joint damage or lower disease activity. Analgesics are pain relievers. These medications can be obtained over the counter or a stronger version can be prescribed by your doctor. Examples of such medications include aspirin, acetaminophen, ibuprofen, naproxen sodium and opioids (strong prescription painkillers).
- DMARDs, or disease-modifying antirheumatic drugs, suppress the immune system to control inflammation and limiting joint damage and disease progression. These drugs may take weeks or months to begin working in your body. Examples include methotrexate, hydroxychloroquine, sulfasalazine and leflunomide.
- Glucocorticoids, also known as corticosteroids, are hormones which suppress inflammation and activity of the immune system. The most commonly prescribed is prednisone, which can be very helpful for controlling RA but also causes serious side effects if used long-term.
- Biologic Response Modifiers, commonly referred to as biologics, are genetically engineered proteins that target or block certain inflammatory proteins in the blood. Biologics require strict monitoring because they can cause very serious or life-threatening side effects. Biologic drugs are usually self-injected or infused in a vein at a doctor's office. Patients must be trained by a qualified doctor or nurse before treatment begins. These drugs are also extremely expensive and may not be a realistic option for some patients. Examples include Xeljanz (a pill), Enbrel, Humira, Rituxan, Kineret and Cimzia.
Surgery is an option for severely damaged joints. If other treatments fail or if you have major difficulty moving a joint to the point that it affects your quality of life, this may become necessary to provide relief. Only your doctor can determine if surgery is the best option for you.
Another aspect of RA treatment is lifestyle adjustment. This refers to changes made to your lifestyle to reduce stress, pain and fatigue. Lifestyle adjustments are unique to each person, but commonly suggested changes include: a healthly diet; regular exercise; good sleep habits; stress management; relaxation techniques; hot/cold therapy and positive thinking. It's also important to have a support network to rely upon when life gets tough.
Two very important parts of your RA treatment plan are complying with routine blood tests and regular visits with your rheumatologist. These are the main ways to monitor your health while living with RA. Blood tests measure markers of inflammation, which will tell your doctor if your disease is active and how much damage is likely occurring within your joints. They also monitor your liver and kidneys, which can become damaged due to the various medications used to control your RA.