Rheumatoid arthritis (RA) is an autoimmune disease 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 progression and treat symptoms. Treatment typically involves a combination of drugs, 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.
These medications are commonly used to treat RA.
Biologics are a class of drugs that are made through biotechnology. They’re designed to act like natural proteins in your immune system, so they generally cause fewer side effects.
They work by interrupting signals the immune system sends that tell it to attack healthy joint tissue. There are different types of biologics that work in different ways in the body to prevent inflammation caused by RA.
Disease-modifying antirheumatic drugs (DMARDs) are another class of drugs used to treat RA. These drugs have anti-inflammatory properties, and they suppress your body’s immune system. They actually work to change the course of RA, rather than just treating the symptoms.
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).
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.
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 it may be okay to do a more intensive exercise program. A physical or occupational therapist can help you create a personalized exercise plan geared toward your needs.
As RA progresses, you may experience complications and side effects, such as:
- skin problems, like rashes, bumps (nodules), 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.
The earlier you catch issues involving the heart, lungs, and kidneys, the better your possible treatment outcome. Ask your doctor about regular monitoring of these major organs, especially if you’re taking corticosteroids or nonsteroidal anti-inflammatory medications.
Taking care of your overall health can also play a key role in managing your RA. It may help reduce your risk of complications or reduce negative side effects.
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.