Rheumatoid arthritis (RA) is a chronic disorder that involves inflammation of the lining of the joints. It typically starts in the small joints of the hands, and causes pain, redness, and swelling. As the condition progresses, it may spread to other joints, like the feet, ankles, wrists, elbows, and knees. It may also advance to the joints between the vertebrae in the spine, and even affect major organs like the skin, heart, lungs, eyes, and kidneys.
While there’s no cure for RA, it’s possible to slow its progression and treat its symptoms. Healthcare providers typically use a combination of drug treatment, reducing stress on the joints, and physical therapy. In some cases, surgery may be necessary to relieve pain and restore function in severely damaged joints.
Three types of drugs are commonly given to RA patients:
DMARDs: The first line of defense against RA is a class of drugs known as DMARDs, or disease-modifying antirheumatic drugs. DMARDs include newer biologic medications and are very effective. Doctors are now turning to DMARDs as soon as a diagnosis is made. These drugs are a type of anti-inflammatory, so they actually work to change the course of RA, rather than just treating the symptoms.
NSAIDs: For acute pain and inflammation, over-the-counter NSAIDs (nonsteroidal anti-inflammatory drugs) may be used. These include household staples like ibuprofen (Advil, Motrin) and naproxen (Aleve).
Corticosteroids: Drugs like prednisone and other corticosteroids reduce inflammation and modify the body’s immune response. Corticosteroids are often used as short-term fixes, or during the four- to six-week period before DMARDs begin to take effect. There are a number of side effects and risks associated with corticosteroids, so some doctors may avoid prescribing them.
Reducing joint stress
The next step in managing the progression of RA is reducing stress on the joints. During a flare-up, when joints are at their most painful, rest is important. Maintaining a healthy weight will also prevent added strain, as carrying even a little extra weight greatly increases stress on the joints. If walking is difficult, using a cane or walker can take some of the burden off of stressed joints.
Regular exercise is important to help maintain joint health. It strengthens muscles around the joints, reduces stress and inflammation, and improves mobility and flexibility. For people with RA, doctors typically recommend low-impact or non-impact exercise. However, in some cases your doctor may permit a more intensive exercise program. A physical or occupational therapist can help you create a personalized exercise plan geared towards your needs.
Dealing with side effects
As RA progresses, you may experience complications and side effects such as:
- skin problems, like rashes, bumps, or ulcers
- eye problems, like inflammation and dry eyes
- inflammation of the blood vessels or the membrane around the heart
- increased risk of heart attack and stroke
- anemia, or low red blood cell count
- diseases of the lungs or kidneys
- lack of sleep
It’s important to talk to your doctor if you have these symptoms, or any other unusual symptoms that could be related to your RA. Side effects like skin and eye problems, anemia, fatigue, and depression are treatable with either medications or lifestyle changes. Other problems involving the heart, lungs, and kidneys need to be caught early. Ask your doctor about regular monitoring of these major organs, especially if you’re taking corticosteroids or nonsteroidal anti-inflammatory medications.
As with any disease, your overall health plays a key role in managing your RA. It also affects your ability to cope with side effects and your risk of complications. Try to maintain a healthy diet, get plenty of rest and exercise, and stay in open communication with your healthcare providers to manage your RA progression.