Rheumatoid arthritis is most often treated with medication, exercise, and lifestyle changes. Treatment may help relieve symptoms and control the disease, but there is no cure. Treatment for rheumatoid arthritis usually continues throughout your life, but will vary depending on:

• The stage (active or in remission) and severity of your disease.
• Your treatment history.
• The benefits and risks of treatment options.
• Your preferences for treatment options, such as cost, side effects, and daily schedules.

The goal of treatment is to help you maintain your lifestyle, reduce joint pain, slow joint damage, and prevent disability.

Initial treatment

Treatment of rheumatoid arthritis should start with education about this disease, the possibility of joint damage and disability, and the risks and benefits of potential treatments. A long-term treatment plan should be developed by you and your health professional team.⁶

The purpose of early treatment is to:

• Relieve or reduce pain.
• Reduce joint inflammation.
• Improve daily function.
• Prevent or delay significant joint damage and deformity.
• Prevent permanent disability.
• Improve the quality of life.

Experts recommend early and aggressive treatment of rheumatoid arthritis with medications called disease-modifying antirheumatic drugs (DMARDs) that can actually slow or sometimes prevent joint destruction.⁶ Examples of DMARDs include:

• Methotrexate.
• Etanercept.
• Adalimumab.
• Abatacept.
• Infliximab.
• Leflunomide.
• Sulfasalazine.
• Hydroxychloroquine sulfate.

One study suggested that advances in the treatment of rheumatoid arthritis, including DMARDs, has improved the health of people with the disease over the last 20 years.⁷ DMARD treatment, begun as soon as possible after diagnosis and continued for a prolonged period of time, may prevent damage to joints and other complications of rheumatoid arthritis.⁸

Joint pain, tenderness, and swelling are the most important means of measuring how the disease is progressing or responding to treatment. Nonsteroidal anti-inflammatory drugs (NSAIDs) and/or analgesics (pain relievers, such as acetaminophen, codeine, or hydrocodone) may be used to relieve these symptoms. NSAIDs relieve pain and lower inflammation. Analgesics relieve pain but do not affect inflammation. These medicines do not change the course of the disease or prevent joint destruction.⁶ They may be used in combination with other drug therapy (such as DMARDs).

Corticosteroids may be used to treat your rheumatoid arthritis. They may be used as:

• Initial therapy until a DMARD has a chance to work (bridge therapy).
• A means of controlling flares of rheumatoid arthritis. When a single joint is inflamed, a corticosteroid injection can be effective in relieving symptoms.
• Disease management when DMARDS do not fully control the disease.

Because of the side effects of corticosteroids, your health professional will use the lowest possible dose and will try to reduce and eventually discontinue use of oral corticosteroids. However, this is not always possible.

Exercise, physical therapy, and lifestyle changes can help you decrease joint pain. Many people with rheumatoid arthritis benefit from self-management plans that balance rest and activity. Steps you can take at home to relieve your symptoms and help control your disease include:

• Becoming involved in the day-to-day management of your disease. For more information, see:

  Taking an active role in the management of your rheumatoid arthritis.

• Staying active physically, mentally, and socially.
• Resting when you are tired.
• Protecting your joints from injury.
• Eating a balanced diet.
• Exercising regularly.
• Controlling your weight.