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Understanding Rheumatoid Arthritis -- Treatment

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Drugs for Rheumatoid Arthritis continued...

Biologics are usually used when other drugs have failed to stop the inflammation of rheumatoid arthritis. Biologics may slow or even stop RA progression.

TNF blockers help to reduce pain and joint damage by blocking an inflammatory protein called tumor necrosis factor (TNF). For some patients, TNF blockers stop the progression of rheumatoid arthritis. Studies show benefits when TNF blockers are combined with methotrexate. TNF blockers include Enbrel, Humira, Remicade, Cimzia, and Simponi.

Other biologics suppress different areas of the immune system and include Actemra, Kineret, Orencia, and Rituxan.

Since biologics suppress the immune system, they also increase 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. However, in certain people, steroids are needed long term to control pain and inflammation.

Steroids can be given as injections directly into an inflamed joint or can be taken as a pill. Potential side effects of long-term steroid use include high blood pressure, osteoporosis, and diabetes. But when used appropriately, steroids are often effective and quickly improve pain and inflammation.

Surgery and Rheumatoid Arthritis

If joint pain and inflammation become truly unbearable or joints simply refuse to function, some people choose joint replacement surgery. Today, joint replacement is commonly done on the hips and knees and sometimes the shoulders. Surgery can dramatically improve pain and mobility and is typically done 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.

Physical and Occupational Therapy for Rheumatoid Arthritis

Physical and occupational therapy are key components of any rheumatoid arthritis treatment plan.

Physical therapists focus on helping you be able to keep moving around. They can help you design an exercise plan, teach you the appropriate use of heat and ice, perform therapeutic massage, and even provide motivation and encouragement.

Occupational therapists help you keep doing things you are used to doing every day. They can evaluate your daily activities, determine what you may be doing to stress your joints, and teach you easier ways to accomplish daily activities. They can also determine which assistive devices can help you throughout the day.

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