Rheumatoid Arthritis: Treatments

How is rheumatoid arthritis treated?

Rheumatoid arthritis treatment plans use a multifaceted approach and are individualized to the stage of advancement of the disease and your age, medical history, and coexisting diseases or conditions. There is no cure for rheumatoid arthritis, but with early recognition and treatment, it is possible to minimize or delay joint damage and complications of the disease, such as chronic pain and disability. Because rheumatoid arthritis is progressive and chronic in nature, treatment usually needs to be continuous, even lifelong in some cases.

Medications that are commonly used to treat rheumatoid arthritis include:

• Acetaminophen (Tylenol)

• Anakinra (Kineret)

• Corticosteroid medications, which reduce inflammation but have a potential for serious long-term side effects. These drugs are generally used only for short periods and in low doses.

• Disease-modifying anti-rheumatic drugs (DMARDs), which may reduce inflammation and slow the destruction of joints

• Glucosamine and chondroitin, which can help strengthen damaged joint cartilage

• Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin) and aspirin. NSAIDs are effective in treating the pain and inflammation of rheumatoid arthritis. However, long-term use of NSAIDs can cause serious, even adverse events and life-threatening conditions. These include bleeding gastrointestinal ulcers, possible heart problems, and other cardiovascular events.

• Tumor necrosis factor (TNF) inhibitors

Other treatments for rheumatoid arthritis may include:

• Electrical stimulation

• Heat and cold therapies

• Occupational therapy to help maximize function

• Orthopedic splints

• Physical therapy, including range-of-motion exercises that can help strengthen joints, which supports the muscles and may delay the loss of joint function

• Surgery to help improve joint pain, correct deformities, and increase function in seriously affected joints. Surgery may include a synovectomy, the removal of the joint lining. Total joint replacement may also be performed in severe cases. In these cases, a diseased joint in the knee or hip is replaced with a new, synthetic joint (prosthesis).

What are the possible complications of rheumatoid arthritis?

Because of the generalized inflammatory nature of rheumatoid arthritis, it can affect almost any organ in the body and lead to serious and life-threatening complications. These include:

• Anemia

• Bleeding gastric ulcers

• Chronic pain

• Immobility and disability

• Instability of neck bones

• Joint deformity and destruction

• Nerve problems that cause pain, numbness or tingling

• Rheumatoid vasculitis, a type of inflammation of the blood vessels, which can lead to atherosclerosis, stroke, heart attack, and other cardiac conditions

• Skin ulcerations and infections

It is important to seek medical care if you have symptoms of rheumatoid arthritis. Early diagnosis and treatment can minimize discomfort and reduce your risk of these serious complications.