Treatment and Prevention
Rheumatoid arthritis can't be prevented or cured. However, it is possible
to treat the symptoms and, with certain medications, to slow down the progress
of the disease.
Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, naproxen,
and diclofenac are effective for reducing pain and reducing inflammation of
the joints. The side effects of NSAIDs - including upset stomach or
ulcers - can be minimized by other medications. Ask your doctor about
these medications if you feel you need them. There are several new NSAIDs (e.g., celecoxib*)
that may be easier on the stomach. If you find you can't tolerate the NSAID
you're taking, talk to your doctor.
Although disease-modifying drugs (DMARDs) such as gold injections,
methotrexate, and sulfasalazine require time (weeks to months) to work, they
are important in combating the autoimmune component of rheumatoid arthritis.
They slow the damage by fighting immune system cells that attack the joints.
These medications can be taken together with NSAIDs for inflammation and pain.
Newer disease-modifying drugs called biologics are sometimes used in
the treatment of rheumatoid arthritis. Examples of these
medications in the United States include adalimumab, anakinra, etanercept, and infliximab. These medications improve physical symptoms and slow down joint destruction.
They are frequently used along with other DMARDs such as methotrexate.
Corticosteroids (e.g., prednisone) are also effective medications
for reducing inflammation and relieving pain and stiffness. They can be taken
as pills or as injections directly into the joints. Unfortunately, their effects
get weaker over time, and they don't actually slow down the damage done by the
RA. As well, corticosteroids have long-term side effects. Side effects of corticosteroid
use include thinning of the skin and bones (increasing the risk of osteoporosis),
higher blood pressure and blood sugar levels, fluid retention, weight gain,
and lowered immunity against infection.
In spite of good medical treatment and lifestyle changes, rheumatoid arthritis
may progress, increasing damage to your joints. With advanced disease, surgery
may be the only option to restore more regular movement.
Day-to-day, there are certain lifestyle adjustments you can make to help
cope with the RA:
- Apply cold packs to numb a sore joint and reduce inflammation.
- Use hot compresses to reduce pain and stiffness by relaxing muscles and
increasing circulation.
- Seek physical therapy: a health care professional can help you manage
pain, and teach you ways to strengthen muscles and restore motion in your
joints. Low-impact exercises such as swimming and walking may also help prevent
flare-ups.
- Protect your joints by learning which positions are less stressful on your
joints when doing various activities. Pace yourself, and use canes, bath bars,
shower seats, and reaching aids to make daily tasks easier.
- Consider a weight-loss program if you are above your ideal weight. Excess
body mass is a "mechanical stress" on the joints, especially the
hips and knees.
Learning to manage rheumatoid arthritis will give you a feeling of control
over the disease. With medical and lifestyle intervention, it's possible to
remain active and productive in all aspects of daily life.
*All medications have both common (generic) and brand names. The brand name
is what a specific manufacturer calls the product (e.g., Tylenol®).
The common name is the medical name for the medication (e.g., acetaminophen).
A medication may have many brand names, but only one common name. This article
lists medications by their common names. For more information on brand names,
speak with your doctor or pharmacist.