Rheumatoid Arthritis Treatment
Rheumatoid arthritis (RA) is an inflammatory autoimmune disease that impacts over 1.3 million people in the United States.
The body’s immune system normally protects and fights against infections. When rheumatoid arthritis is present, that same immune system mistakenly attacks the joints and sometimes other organs and body systems. This causes inflammation.
Inflammation can affect other areas of the body besides the joints, making them swollen, warm, painful and stiff. Since rheumatoid arthritis can also attack the cardiovascular system and the respiratory system as well as joints, it is referred to as a systemic disease. It is important to know what kind of arthritis you have so that you can treat it in the best way possible.
When the inflammation attacks joints, it most often occurs in the hands, feet, knees, wrists, ankles or elbows. It will also present in both of your joints, not just one. If you are feeling symptoms in only one joint and not the other, the odds are you are dealing with osteoarthritis (OA). OA is similar to RA in that both kinds of arthritis work to destroy the much-needed cartilage.
The biggest difference between them is that in OA you can only have one joint affected and it does not attack other systems in your body. Rheumatoid arthritis treatment approaches are different as well, so your rheumatologist needs to have a clear picture of what kind of arthritis you have.
A Multifaceted Approach to Rheumatoid Arthritis Treatment
Treatment for rheumatoid arthritis seeks to put the disease into remission, reduce pain and increase mobility and function in the joint. Remission is when the symptoms are reduced as much as possible and further joint damage is slowed.
As soon as RA is diagnosed, most doctors pursue an aggressive treatment approach because the sooner it can be brought into remission, the less permanent damage can occur.
Your treatment is an ongoing process that requires monitoring and communication with your doctors to maximize its effectiveness. Also, your rheumatoid arthritis treatment plan will most likely be a combination of prescription medication, lifestyle changes including diet and stress management, and natural therapies.
There are many combinations of treatments to try, and it is very important to work with a doctor who will take the time to explain the pros and cons of various RA treatments in detail according to your specific medical requirements.
Prescription Medications to Help Treat Rheumatoid Arthritis
Rheumatoid arthritis impacts the body in different ways, and the drugs used to treat it are varied as well. Some drugs are used to ease the symptoms of RA like inflammation, pain, and stiffness. To combat the damage to other body organs or systems, other prescription medications for RA are available.
Two of the most widely used medications available for reducing pain and inflammation are in a group of medications known as NSAIDs. NSAIDs (non-steroidal anti-inflammatory drugs) can work well for people looking to control these challenging symptoms.
NSAIDs can cause stomach irritation and ulcers if used for a prolonged time, so you will need to monitor your progress carefully. If you have a history of stomach ulcers, there is celecoxib, a medication that is gentler on the stomach. Both of these medications can be very successful in treating inflammation.
Drugs to treat the system damage that can occur with rheumatoid arthritis include corticosteroids (like prednisone), DMARDs, biologics, and JAK inhibitors.
- Corticosteroids are medications that act quickly in the body and are very strong medications to get the inflammation under control. Prednisone is a well-known name for these drugs. They are usually used in small doses for short periods of time due to their potentially strong side effects.
- DMARDs (disease-modifying antirheumatic drugs) are used to modify the progression of RA. They can be taken by mouth, or given by self-injection or by infusion in your doctor’s office. Biologics are a kind of DMARDs as well, in that they both are used to slow the damage caused by the inflammatory response.
- Biologics are administered by injection or infusion in a doctor’s office. These medications can slow the disease and prevent further damage to the joints. One of the perks of using biologics to control your RA symptoms is that it’s aimed directly at the inflammation process. As such, it doesn’t lower your immune system the way other medications can.
- JAK inhibitors are another kind of DMARDs, much like biologics with the goal of slowing RA’s course in its tracks. The difference with JAK inhibitors is that this medication is designed to block the “Janus kinase”, or JAK pathways, which play a role in the body’s response system. These medications can be taken by mouth and not by injections or infusion.
Surgery for Rheumatoid Arthritis Relief
Replacing damaged joints can be a welcome option for those suffering from the long-term damage of RA. Metal or plastic parts of the joints are placed in and the damaged part of the joint is removed.
This procedure can be highly successful in providing years of mobility. The most common joints that are replaced are the knees and hips, although other joints can be considered as well.
Hips and knees take the brunt of the damage in both OA and RA because they have the stressful job of bearing the majority of body weight. We’ll talk about this in greater detail when we talk about nutrition, but added body weight causes stress for your body, and stress is not your friend these days. Losing even 10 percent of your body weight can help ease inflammation in your body.
Self-Care and Natural Remedies for Rheumatoid Arthritis
Prescription medication can be an integral part of your rheumatoid arthritis treatment plan, but there are many options you can explore to complement your RA treatment. There may be times you need to take a break from your prescription regimen due to illness, or if the medication needs to be changed because it was started to lose its effectiveness.
If you decide to add supplements or take anything over the counter to help your RA, be sure to consult with your doctor first. Even herbal medications or supplements can interact with prescriptions, so either ask your pharmacist or doctor before trying anything new that you plan to take orally.
Managing a chronic condition like rheumatoid arthritis brings a great deal of stress with it. This stress can affect every aspect of your life: your health, your relationships, your energy level, and your job. Many of the natural approaches to treating RA symptoms seek to serve as a stress reliever in addition to providing a reprieve from the pain, inflammation, swelling, and stiffness you live with every day.
Acupuncture, massage, talk therapy, exercise, and nutrition can be areas to explore on your RA journey. If you are unsure where to start, ask your doctor or rheumatologist for suggestions, or ask for recommendations from your friends.
Your rheumatoid arthritis treatment plan will most likely be a variety of some of these suggestions, and others won’t suit you for whatever reason, and that’s fine!
- Acupuncture involves inserting thin needles into various pressure points around your body. The use of the needles is designed to provide a relaxed response, with days of increased mobility and flexibility. If you were interested in trying it but simply cannot be around needles, try looking for acupressure treatments. They can provide the same benefits by applying pressure instead of a needle.
- Massage should definitely be done by someone who is highly qualified in
treating people with arthritis. Massage can provide a much-needed endorphin release as well as work tight muscles brought on by stiffness and joint pain. That being said, some people find that massages are too uncomfortable, so you will have to do your homework to find one that matches your pain level.
- Therapy. Anxiety and depression can be brought on by managing a chronic illness day after day. Relationships can suffer, and you can find that you are frustrated about having to withdraw from activities that once gave you pleasure. Talking with a licensed therapist can provide a way to vent, or brainstorm new management techniques for your symptoms.
- Resting. One of the most challenging parts of managing arthritis of any kind involves walking the line between when to rest, which your body will need and will demand of you during a flare; and when to exercise, which is known to help ease RA symptoms and aid in managing stress. The best advice I can give with this is that exercise is supposed to be gentle. Gentle stretching, swimming, walking, yoga or dancing can provide immense benefits without you pushing yourself so hard you’re in bed for a few days after.
- Nutrition is as unique as arthritis. If you are looking at your diet to help treat your RA, you’ll want to aim for an anti-inflammatory diet. Talk with a nutritionist to make sure that you are getting the necessary nutrition you need and inform them of your diagnosis so they can help develop a rheumatoid arthritis diet with your needs in mind. What works for one person with RA may not work for another, and they will be able to work with you to ensure your nutritional needs are met during treatment.
Getting Through the Day
Daily tasks that were once completed quickly and easily may slow you down during an RA flare. From ways to manage around the house to how you can adapt to meet the demands of your job, you will start finding little ways to make your life easier.
Managing fatigue is a huge part of living with chronic illness, so you will need to prioritize what needs to get done first and which tasks can wait.
You will need to conserve your energy as much as you can, since doing things with limited mobility can take twice as long and leave you feeling exhausted. You may want to consider delegating tasks or asking for help. Many people find that asking for help or making certain accommodations a stressful task, and I was no different.
You will need to decide for yourself what you can do to make your daily life more successful without allowing the stress to overtake you.
- At home: use assistive tools like jar openers, lighter plates and cups, and a tool to grab things off high shelves instead of balancing on a chair; delegate or take turns with labor-intensive jobs like scrubbing, shoveling or lifting; carve out a space for your physical therapy exercises; consider the use of a cane or mobility scooter to aid with mobility.
- On the job: when driving, alternate pressure on hands; reduce commute or take public transportation when possible to cut down on driving; speak to your boss about any adaptations that you may need to do your job well; take frequent movement breaks, even if it’s just to stand up and stretch. Staying in one position for too long adds to the strain and inflammation in your joints.
Rheumatoid Arthritis and Relationships: Communication Counts
Treatment for rheumatoid arthritis involves treating the physical and the emotional toll that RA can take on a person. It can be difficult to communicate your needs when you are busy trying to figure all of this out for yourself at the same time.
In addition, rheumatoid arthritis treatment can be time-consuming, co-pays can add up, and canceled plans can dampen even the most optimistic friend or family member.
Taking time to practice self-care may seem difficult at first, but it sets in motion how the rest of the day will most likely go. You will need to make your health more of a priority than ever before. Even if you were very health conscious to start with, the changes and modifications you need to make to manage the pain, limited mobility and fatigue of RA take time to adjust to.
Some popular suggestions for self-care include:
- Getting enough sleep: chronic pain and stiffness can disrupt your ability to get a good night’s sleep. You may have to be more proactive than you’re used to in order to make sure you give yourself the best chance. Remove electronics from the bedroom at least an hour before going to bed; keep the bedroom dark and cool; avoid caffeine later in the day; finish eating at least a few hours before going to bed. There are some nights the pain may get the better of you. If that’s the case, watch something funny to lift your spirits and then try again. You may need to talk to your doctor if your sleep is so off that you are not able to function well during the day.
- Epsom salt baths: you can get Epsom salt at the grocery store in the personal care section. Epsom salt has magnesium, which relaxes tight muscles. Taking a hot bath before going to bed can help ensure a good night’s sleep.
- Heating pad: some are electric and some you can heat in the microwave. If you use one with an electrical cord, remember to unplug it before going to bed. Applying heat to sore joints and muscles helps them (and you!) relax.
- Attending a community/support group: if you are religious, you may find attending church helpful with managing the stress of living with RA. There are also numerous social groups to participate in if you are not interested in attending religious services. Participating in various events can help lift your spirits, improve your mobility and help keep you active in your community.
You will need to tell your family members and friends what you need and not take for granted that they know. Try to set up a time to share with them the information given to you from your doctors and give them a chance to ask questions.
You may need to be more assertive than before or may need to learn how to set boundaries for your treatment plan. If you find this process especially stressful, be sure to reach out to a trusted friend or therapist for more specific suggestions.
It’s not always easy for the people around you to adjust to your diagnosis, so the more they learn from you, the easier it will become in time for everyone.
Your Best Is Good Enough
Do what you can to manage what you have control over. Plans may need some adjustments to be successful.
For example, if you’re in the midst of a flare and can’t go to the movies, invite a friend over to watch something at home. If you are honest with someone about why you can’t attend and they are dismissive of your explanation, don’t take it personally. You have to guard your health at the cost of someone’s response. If they are rude and not willing to accommodate you, that reflects more on them than you. You will be surprised how many people are willing to help if you just tell them what you need.
It may feel like an effort at times, but it is so important to stay connected with other people as much as you can. If you find you are home a lot from either prepping or recovering from another procedure, you can join an online support group. Make an effort to stay connected to people in other ways, such as texting, video chat or phone calls.
Keeping your mind occupied on something else can provide some comfort from RA symptoms, even if for a short time. Take some time to discover a new talent, or develop one you didn’t know you had. Spending even a few minutes learning something new can help keep you focused on something besides your achy joints.
Beating yourself over what you can’t do on any given day will definitely not help, so be sure to be kind to yourself when you are unable to participate.