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Getting a Grip on Rheumatoid Arthritis Pain

Options for managing the pain and damage of severe chronic RA.

RA Therapy Is Trial-and-Error continued...

John Melendez tried several different medications, including prednisone and Enbrel, with varying degrees of success. Then Samuels put him on a combination of methotrexate and Humira. “When I talk with Dr. Samuels, he calls it ‘cocktails,’” Melendez says. “He’s trying to find the right cocktail for the right person.”

Samuels started him on the steroid prednisone, which he says helped with the swelling. Then he began taking the biologic drug Enbrel. “I did improve, but it was very slight,” he says. “The doctor and I weren’t very happy with the progress.” After a few months, he switched to his current “cocktail” -- a combination of methotrexate and Humira. Although the methotrexate tends to upset his stomach, Melendez has tolerated his medications pretty well.

Non-Medication Options for Severe RA

Ruderman tells WebMD that medication has become so effective at preventing joint degeneration that joint replacements for chronic RA are a lot less common than they used to be. But for patients whose RA doesn’t respond to medication, surgery to repair damaged joints may still be an option. Surgery involves replacing the entire joint (arthroplasty), repairing the tendons around the joint, or removing the joint lining (synovectomy).


Finding the Right RA Treatment

Getting relief from the pain of severe RA starts with a visit to an experienced rheumatologist. The doctor can start you on medication and adjust the drug and dose until your symptoms and joint damage start to improve.

A year after his diagnosis, Melendez says his medications have dramatically improved his rheumatoid arthritis symptoms. “It’s a big difference,” he says. “I guess I’m never going to be 100%, where I say there’s no pain. But compared to what it was in the beginning, it’s like 90% better.” After taking a short break from work, he says he feels well enough to get back on the job.

Reviewed on May 29, 2009

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