Rheumatoid arthritis (RA) is an autoimmune disease that causes inflammation of the tissue that lines the inside of your joints. It’s a chronic progressive disease that can be quite painful, and even debilitating. It especially affects fingers, wrists, ankles, and feet.
Currently, there is no cure for rheumatoid arthritis. Treatment focuses on reducing symptoms, maintaining joint function, and slowing progression of the disease.
Rest and Exercise
With RA, keeping your muscles healthy and strong can help maintain flexibility and mobility. During flare-ups, resting your muscles helps reduce inflammation and pain. A careful balance of rest and exercise should reduce your RA symptoms overall. Rest more when symptoms are worse, and exercise more when they lessen.
Physical and Occupational Therapy
A physical or occupational therapist will observe your specific problems and symptoms. Then they’ll offer ways to reduce your pain and swelling and to improve your quality of life. They may suggest wearing a splint to support painful joints. Or they may recommend using self-help devices to make daily tasks easier and less painful. These self-help devices include:
- long-handled shoehorns
- extra-depth shoes with semi-rigid soles
- raised toilet seats
Drugs and Medication
Drug therapy is almost always the first line of treatment used for RA. There are four major categories of RA drugs:
- nonsteroidal anti-inflammatory drugs (NSAIDs), which reduce pain and inflammation in the long-term
- corticosteroids, which reduce severe pain and inflammation in the short-term
- disease-modifying anti-rheumatic drugs (DMARDs), which slow the progression of RA in various ways
- biologic agents (e.g., Humira, Enbrel), which interrupt your body's inflammation process
Surgery is generally a last-resort treatment for RA. It’s used if your joints become severely damaged or if drug therapy stops working. There are several different types of surgery used in RA:
Total Joint Replacement, or Arthroplasty
In this type of surgery, the damaged parts of your joints are removed completely and replaced with prosthetics made of metal or plastic. Arthroplasty is a long-term solution. However, many joints, such as those in the wrists and hands, can be complex and costly to replace.
Tendons are strands of tissue that connect muscles to bones, enabling movement. RA can damage tendons and even cause them to rupture. This type of surgery, most commonly used on hands, reattaches and repairs damaged tendons. This restores movement and function.
This type of surgery removes inflamed synovial tissue. This tissue forms the membranes surrounding the inflamed joints responsible for RA. Removing this reduces pain and swelling. However, it’s impossible to remove all synovial tissue, and it will also grow back after surgery. So synovectomy is a temporary solution at best. It’s rarely done by itself and can be combined with tendon reconstruction and arthroscopy.
Joint Fusion, or Arthrodesis
If total joint replacement is not an option, your doctor may choose joint fusion. This type of surgery removes a damaged joint and fuses the affected bones together, often using bone grafts taken from your pelvis. Joint fusion limits movement but reduces pain and stops further bone damage. It’s commonly used on wrists, ankles, fingers, toes, thumbs, or hips.
Although there is no cure for rheumatoid arthritis, it’s possible to reduce its symptoms, manage your pain and restore your joint function. Physical therapy, medication, and surgery as a last resort can help you live a pain-free life.