Rheumatoid arthritis (RA) is an autoimmune disease that causes pain and inflammation in your joints. The condition is chronic and there is no cure. However, in recent years, new treatment options are providing a much better quality of life for people living with RA.
Treatment for the condition is comprehensive and focuses on:
- stopping the progression of the disease
- avoiding joint damage
- reducing daily pain
- helping you stay active
Doctors typically recommend a combination of medications, physical therapy, and lifestyle changes to help manage RA. Sometimes, surgery and other treatments might be needed.
This article provides an overview of the common treatment options for RA and what to expect from each.
There are multiple types of medication used to treat RA. You’ll likely take medications to slow the progression of the disease and reduce inflammation and pain. The exact medications will depend on the severity of your condition, how you respond to medications, and your overall health.
Medications that slow the progression of rheumatoid arthritis
Medications that slow the progression of RA can help reduce your symptoms while preventing joint damage and disability. Options include:
- Disease-modifying antirheumatic drugs (DMARDs). DMARDs help prevent joint damage and are normally part of the initial treatment of RA. It can take a few months to feel the full effects of a DMARD, and you and your doctor might need to try a couple of options before you find the right one for you. Common DMARDs include methotrexate, leflunomide (Arava), hydroxychloroquine, and sulfasalazine (Azulfidine).
- Biologic treatments. Biologic treatments are given by injection and usually in combination with a DMARD when DMARDs have not been effective on their own. Biologic treatments are a newer form of treatment that can prevent your immune system from attacking your joints. Common biologic treatments include etanercept (Enbrel) and infliximab (Remicade).
- Janus kinase (JAK) inhibitors. JAK inhibitors are a new type of DMARD that can be helpful for people who can’t take traditional DMARDs or who didn’t see improvements from traditional DMARDs. Common JAK inhibitors include tofacitinib (Xeljanz) and baricitinib (Olumiant).
Medications to reduce the inflammation and pain of rheumatoid arthritis
Many people with RA also take medications to help manage pain. You might take these medications temporarily, during a flare-up, or every day depending on your condition and the treatment plan you discuss with your doctor. Pain-relieving options include:
- Nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs reduce inflammation and relieve pain. Your doctor might recommend over-the-counter NSAIDs, such as ibuprofen or naproxen sodium, or might prescribe stronger NSAIDs.
- COX-2 inhibitors. COX-2 inhibitors, such as celecoxib (Celebrex), also reduce inflammation and pain. They’re intended to have fewer side effects and be safer for daily use than NSAIDs.
- Steroids. Steroids can reduce inflammation and help relieve pain. You can take steroids as an injection or tablet. Steroids can have serious side effects and are only meant for short-term use.
- assess your current ability level
- build your strength
- reduce your pain
- slow down joint damage
- help you adapt your movements
A physical therapist can also provide pain relief through massages and muscle stimulation. They can teach you exercises to do at home that will build your strength and reduce your pain.
You might have physical therapy when you first get an RA diagnosis, or over the course of your condition when needed, such as if a specific joint begins causing you pain and difficulty.
An occupational therapist can help you maintain your ability to do everyday tasks on your own. They can also recommend supports and devices to assist you and teach you how to use them. These can include:
- mobility aids
- jar grips and door knob grips
- railings for stairs and bathroom bars for support
Surgery is sometimes needed to fix damaged joints. The exact surgery you need will depend on the joint that’s damaged and on the extent of the damage. Surgical options include:
- Arthroscopy and synovectomy. An arthroscopy is a minimally invasive surgical procedure that can be used to perform a synovectomy. A synovectomy is done to remove the inflamed lining of a joint.
- Tendon repair. Surgery can help fix tendons around your joints that are torn or loose.
- Joint replacement. A joint replacement removes the entire damaged joint and replaces it with an artificial joint.
Some people report that dietary changes help reduce their RA symptoms. This generally involves following an anti-inflammatory diet and avoiding foods high in sugar, artificial ingredients, and carbohydrates.
An anti-inflammatory diet includes foods such as:
- dark leafy green vegetables
- extra-virgin olive oil
- dark chocolate
Talk with your doctor before you begin any supplements to make sure they won’t negatively interact with your current prescriptions.
There are lifestyle steps you can take at home to reduce pain and manage your RA. These include:
- Increasing movement. It’s a great idea to keep moving even if you can’t fit a workout into your schedule. Little changes like taking the stairs instead of the elevator can help you stay active and manage your RA.
- Getting enough rest. Rest can reduce inflammation and restore your energy. It’s important to take breaks as often as you need, especially during a flare-up.
- Using hot and cold treatments. The heat of a warm bath or heating bed can soothe your joints and muscles, while the chill of an ice pack can numb the pain of swollen joints and reduce inflammation.
Some people find relief using complementary therapies. It’s important to use caution before trying complementary therapies. Most of these therapies haven’t been studied enough to prove that they are effective in treating RA. Talk with your doctor before you begin any complementary therapy program to make sure it’s safe for you.
Complementary therapies that may help relieve pain include:
It’s a good idea to look into the qualifications of complementary therapy providers before you see them. Acupuncturists, massage therapists, and chiropractors need to be licensed in many states. You can look up these professionals before your first visit to make sure they provide safe and appropriate care.
One of the most important tools for managing a chronic condition like RA is support. It can make a big difference in your treatment to have a doctor and other medical staff you feel comfortable with as part of your care team. Support from friends and family can also help you get through flare-ups and challenging days.
It can also be helpful to connect with other people living with RA. A support group can give you a place to share struggles and triumphs with people in a similar situation. To find an RA support group, check out:
- MyRAteam. MyRAteam is an online social network and support system for people with RA.
- Rheumatoid Arthritis Support. Rheumatoid Arthritis Support is an online forum where you can connect with other people with RA.
- Live Yes! Connect Groups. Offered by the Arthritis Foundation, Live Yes! Connect Groups are online support groups for people with RA.
- Arthritis Introspective. Arthritis Introspective is focused on young and middle-aged adults living with rheumatoid and other forms of arthritis. You can find an Arthritis Introspective support group in your area using their locator service.
There’s no cure for RA, but treatment can help reduce your pain, slow joint damage, and manage your condition. The right treatment options for you will depend on the severity of your RA and your overall health.
Treatment might include a combination of medications, physical and occupational therapy, surgery, and lifestyle measures. Some people also report pain relief from alternative treatments such as supplements or complementary therapies.
A support group can be a great place to discuss your treatment and get tips from others.