Treatment for Rheumatoid Arthritis

Searching for options in the treatment for rheumatoid arthritis? If you are experiencing rheumatoid arthritis symptoms, you’ll want to understand all the options you have available to you. What medications and natural treatments work best? Arming yourself with information will offer you the best opportunity to minimize your arthritis symptoms.




Rheumatoid arthritis (RA) is a chronic autoimmune disorder in which the immune system attacks and breaks down joints throughout the body. A variety of tests, including a blood test called rheumatoid factor, , are utilized to help make the diagnosis. Because there is no cure, treatment focuses on minimizing the effects of the disease. The treatment plan for rheumatoid arthritis typically includes medications, physical and occupational therapy, and at times, surgery.


rheumatoid arthritis joints



Medications: NSAIDS

Non-steroidal anti-inflammatory medication is one potential treatment option for RA. The most common NDSIDS include aspirin, Alleve, and ibuprofen. These medications work exceptionally well for acute inflammatory reactions. The drawback is that they can be hard on the stomach. Although a good option for acute flares, long term use may not be tolerated secondary to GI distress.

Another class of NDAIDS that does not have the same impact on the stomach is a class called COX-2 inhibitors. The most commonly prescribed is Celebrex. These COX-2 inhibitors can allow for longer term use secondary to less GI stress but may have a negative impact on the cardiovascular system with long term use.


Medications: Steroids

Corticosteroids are another treatment for rheumatoid arthritis that works on reducing joint inflammation. This class of medication provides the dual benefit of reducing joint inflammation as well as suppressing the immune system.

The most common of these steroids include prednisone and Medrol. The dosage of a steroid is generally kept rather minimal, between 5 and 10 mg with the goal of reducing the dosage over time. In situations in which a specific joint is painful and limiting function, the use of a cortisone injection may also be recommended.

rheumatoid arthritis hands


Side effects from the use of steroids include weight gain and a ‘puffy’ appearance in the face. Long term use can lead to bone loss associated with osteoporosis. Other side effects can include increased blood pressure, increased blood sugar, and even avascular necrosis.



Disease Modifying Medications

Both NSAIDS and steroids are used to help decrease the inflammation associated with RA. In contrast, disease modifying anti-rheumatic drugs (DMARDS) serve to not only reduce the inflammation associated with RA but aide in modifying the disease processes itself. These medications can improve joint deterioration associated with rheumatoid arthritis.


There are variety a of DMARDS available but the most commonly used is Methotrexate. Compared to other medications it works rather quickly (4 to 6 weeks) in reducing RA symptoms, has minimal side effects, slows joint damage, and is cost effective.


Physical and Occupational Physical Therapy

Both PT and OT can be helpful in reducing joint inflammation, improving joint mobility, and preserving function. Strong muscles work to help protect joints by absorbing stress thus maintaining muscle strength can be greatly beneficial in preserving joint function.

ulnar drift


Typical goals for PT and OT include increasing joint range of motion, improving muscle strength, and reducing inflammation by using modalities such as ice, ultrasound, iontophoresis, and electric stimulation. Water exercise can also be greatly helpful as a means of providing exercise in a environment that limits joint stress.

Physical aides can also be utilized to help preserve function. Splints, braces and crutches can all be used to minimize deformity and preserve function. A common deformity in the hands of those with rheumatoid arthritis is ulnar drift. The use of splints or braces can help to minimize the progression of this deformity and maintain hand function.




Surgery

A last resort treatment for rheumatoid arthritis is surgery. When significant joint degeneration has occurred and when conservative treatment is not effective in preserving function, joint replacement surgery is generally recommended. Hip replacement and knee replacement surgery are the most common joints requiring replacement. Weight bearing joints are prone to early degenerative changes and can have the greatest impact on function. As with any surgery, caution must be taken to ensure that surgery is the option of last resort. Seek a second opinion if surgery is recommended.

As with many chronic diseases, the treatment for rheumatoid arthritis includes a variety of options. Be an active participant by communicating with your physician to ensure you are incorporating the most effective options.


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