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Understanding Rheumatoid Arthritis -- Treatment

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When methotrexate or other DMARDS don’t ease RA symptoms and inflammation, doctors may recommend a biologic. These are genetically engineered proteins. They block specific parts of the immune system that play a key role in inflammation of rheumatoid arthritis. They may slow or stop RA.

There are different biologics that target different parts of the immune system. Biologics include:

Since biologics suppress the immune system, they raise the risk of infection. Severe infections have been reported with biologics.


For severe RA or when RA symptoms flare, your doctor may recommend steroids to ease the pain and stiffness of affected joints. In most cases, they can be used temporarily to calm a symptom flare. But some people need to take steroids for a longer time to control pain and inflammation.

You can get steroids as a shot directly into an inflamed joint or take them as a pill. These are not the type of steroids that bulk up your muscles.

Potential side effects of long-term steroid use include high blood pressure, osteoporosis, and diabetes. But when used appropriately, steroids quickly improve pain and inflammation.

Surgery for Rheumatoid Arthritis

If joint pain and inflammation become unbearable or joints no longer work, some people need joint replacement surgery. The hips and knees, and sometimes the shoulders, are the most common joints that get replaced. Surgery can dramatically improve pain and mobility. Most people wait until after age 50, because artificial joints tend to wear down after 15 to 20 years.

Some joints, such as the ankles, don't respond well to artificial replacement and do better with joint fusion, which is a different operation.

Physical and Occupational Therapy

Physical and occupational therapy make a big difference to your daily life. They are a key part of any rheumatoid arthritis treatment plan.

Physical therapists can give you an exercise plan, teach you how to use heat and ice, do therapeutic massage, and encourage and motivate you.

Occupational therapists help you handle daily tasks -- like cooking or using your computer -- and show you easier ways to do those things. They can also check on whether any gadgets would help you.

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