Rheumatoid arthritis (RA) 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.
A key factor, developed from careful studies over time, is to start treatment very early on before joint damage has occurred. If successful, this strategy can preserve joint health, something not often accomplished in the past.
Diagnosis, treatment, and management of RA require very experienced and skilled care by doctors who are very familiar with RA therapy. Rheumatologists specialize in severe arthritis such as RA. Before starting any medication, it is important to discuss the risks and benefits with your doctor.
Nonsteroidal anti-inflammatory drugs (NSAIDs) are effective for reducing pain and reducing inflammation of the joints. Examples of NSAIDs include celebrex*, diclofenac, ibuprofen, indomethacin, meloxicam, and naproxen. 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. Some NSAIDs cause less stomach upset than others. If you find you can't tolerate the NSAID you're taking, talk to your doctor.
Although disease-modifying antirheumatic drugs (DMARDs) such as azathioprine, hydroxychloroquine, methotrexate, and sulfasalazine require time (weeks to months) to work, they are important in combating the autoimmune component of RA. 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, or with corticosteroids when treatment is first started.
A group of medications called biologics or biologic response modifiers are sometimes used in the treatment of RA. Examples of these medications in Canada include abatacept, adalimumab, anakinra, etanercept, infliximab, rituximab, and tofacitinib. 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, triamcinolone) are also effective medications for reducing inflammation and relieving pain and stiffness. They are used sparingly as they don't actually slow down the damage done by the RA. They may be useful during the period before DMARDs begin to work or for managing flare-ups. Corticosteroids can be taken as pills or as injections directly into the joints. Corticosteroids have long-term side effects including 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.
Physical therapy and orthopedic intervention are often important in the management of the disease.
In spite of good medical treatment and lifestyle changes, RA may progress, increasing damage to your joints. When there is advanced disease or strong pain, surgery may be required to restore more regular movement. Surgery may help lessen pain, improve movement and function of joints, and, in some circumstances, improve physical appearance.
There are certain daily 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.
- Do not smoke.
Learning to manage RA 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 information on a given medication, check our Drug Information database. For more information on brand names, speak with your doctor or pharmacist.
All material copyright MediResource Inc. 1996 – 2019. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/condition/getcondition/Rheumatoid-Arthritis
