When you're trying to figure out how to manage the pain and stiffness that come with RA, you'll have lots of questions about how to sort through the options. WebMD spoke with Ana-Maria Orbai, MD, assistant professor of medicine in rheumatology at Johns Hopkins Medicine in Baltimore, to get ideas on how you can make a plan that's right for you.
When your doctor tells you that you have rheumatoid arthritis (RA), he may also say it's an autoimmune disease. You might not think it has anything in common with conditions like type 1 diabetes or multiple sclerosis. But it does. They all result when something misfires in your immune system. Instead of attacking threats, it goes after you.
We have multiple families of medications. We still have the traditional medications known as disease-modifying antirheumatic drugs [DMARDs]. These drugs don't just relieve symptoms, they actually slow the progression of the disease.
Then we have … targeted medications (biologics and small molecules) to treat rheumatoid arthritis and prevent disease progression. If one medication doesn't work or if a person can't use it for whatever reason, we can move to other medications or we can combine medications.
How well do RA drugs work?
They are very effective. In the past, people with rheumatoid arthritis might have had trouble opening a jar. When properly treated, some people can run 5 miles.
How soon should you start taking medicine?
Damage from rheumatoid arthritis cannot be reversed, so the key is to treat it as soon as possible.
Are there ways to manage fatigue?
Often you can treat fatigue by treating rheumatoid arthritis. In some cases, the rheumatoid arthritis improves but not the fatigue. This is more difficult to handle. The advice is to be as active as you can. Physical activity is also important to preserve muscle mass.
What type of exercise is good for people with RA?
I encourage any type of physical activity that the person feels is beneficial to them and doesn't cause pain. There's no single activity. Doing something you enjoy is important.
People should also listen to their bodies. Don't do what hurts. Pain is clearly a signal that you're close to injury, if not already causing injury.
Are there other lifestyle changes people can make?
The No. 1 thing is quitting smoking. People with RA who smoke are less likely to respond to therapy.