Treatment of Rheumatoid Arthritis

The goal of treatment of arthritis is to reduce inflammation and joint pain while preventing damage and improving and maintaining joint function.

Updated: September 29, 2019

Several treatment options for rheumatoid arthritis are available which include nonprescription and prescription medications, joint injections, and surgical operations. Weight reduction and avoiding activities that strive excessive stress on the joint can also help in treating RA to some extent. The goal of treatment of arthritis is to reduce  inflammation and joint pain while preventing damage and improving and maintaining joint function.

Treatment of Rheumatoid Arthritis:

To reduce or stop inflammation as quickly as possible is the first thing need to be done in treatment of Rheumatoid Arthritis. The result will be better if the treatment starts as soon as the disease is diagnosed. The ultimate goal is to stop it and achieve remission which means presence of minimal or no signs or symptoms of active inflammation.
The doctor will focus on tight control of RA which can prevent or slow the pace of joint damage. So, the main goal of treatment include:

  • Stop inflammation and put disease in remission
  • Relieve symptoms
  • Improve physical function and overall well-being
  • Prevent joint and organ damage
  • Reduce long-term complications

Medications for Rheumatoid Arthritis:

Treatment of rheumatoid arthritis can be done with certain medication which can be used primarily to ease the symptoms of RA. Also there are certain medication which are used to slow or stop the course of the disease as well as prevent structural damage.

Symptoms Relieve Medications:

Nonsteroidal anti-inflammatory drugs (NSAIDs) are available over-the-counter and by prescription which can be used to help ease arthritis pain and inflammation. Ibuprofen, ketoprofen and naproxen sodium are some of the examples of these medication.
Usually celecoxib, a type of NSAID called a COX-2 inhibitor is prescribed for people who have had or are at risk of stomach ulcers. This inhibitor is safe for the stomach and can be taken by mouth or applied to the skin as a patch or cream, directly to a swollen joint.

Medicines That Slow Disease Activity:


Corticosteroids:

Corticosteroid medications are potent and quick-acting anti-inflammatory medications. These include prednisone, prednisolone and methyprednisolone and may be used in RA to get potentially damaging inflammation under control. Rather then waiting for NSAIDs and DMARDs to take effect these medicines can be used for rapid effect.
But, these medicines are preferred to use for a short period of time and in doses as low as possible because of the risk of side effects.

DMARDs:

DMARD or disease-modifying antirheumatic drugs are use to modify the course of the disease. Methotrexate, hydroxycholorquine, sulfasalazine, leflunomide, cyclophosphamide and azathioprine are some of the example of these drug.
These medicines can be taken by mouth, be self-injected or given as an infusion in a doctor's office.

Biologics:

These drugs are a subset of DMARDs. Biologics may work more quickly than traditional DMARDs and can slow, modify or stop the disease. These medicines can be given as an injection or by infusion in a doctor's office. They are not capable of effecting the entire immune response as they target specific steps in the inflammatory process.

JAK inhibitors:

This is a subcategory of DMARDs block the Janus kinase or JAK, pathways, which are involved in immune response of the body. It can be taken by mouth.

Surgery for Rheumatoid Arthritis:

Surgery can be considered as an option for people with permanent damage that limits daily function, mobility and independence. Surgical procedures can be performed to relieve pain, improve function, and correct deformity. Occasionally, joint tissue is surgically removed for the purpose of biopsy and diagnosis. Orthopedic surgeons are doctors who is specialized in joint surgery.
Arthroscopy is a cutting instrument with viewing tube is generally used for this surgery. A bone-removal procedure called osteotomy can help realign some of the deformity in selected patients, usually those with knee disease. Removal of inflamed joint lining tissue is called synovectomy.

Joint replacement surgery can relieve pain and restore function in joints which are badly damaged by RA. Damaged parts of a joint can be replaced with artificial joint (arthroplasty) such as metal and plastic parts in surgery. The small joints of the hand can be replaced with plastic material where as large joints, such as the hips or knees, are replaced with metals. Most common replacement are done for hip and knee. However, ankles, shoulders, wrists, elbows, and other joints may also be considered for replacement.


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