Rheumatoid Arthritis Overview

How Is Rheumatoid Arthritis Diagnosed? continued...

Most, but not all, people with rheumatoid arthritis have the rheumatoid-factor (RF) antibody in their blood. Rheumatoid factor may sometimes be present in people who do not have rheumatoid arthritis (other diseases can also cause the rheumatoid factor to be produced in the blood). Therefore, the diagnosis of rheumatoid arthritis is based on a combination of joint abnormalities, as well as test results.

A newer, more specific blood test for rheumatoid arthritis is the cylic citrulline antibody test, also called anti-CCP. The presence of anti-CCP antibodies suggests a tendency toward a more aggressive form of rheumatoid arthritis.

People with rheumatoid arthritis may have mild anemia. Blood tests may also reveal an elevated erythrocyte sedimentation rate (ESR) or elevated C-reactive protein (CRP) levels, which are markers of inflammation.

Some people with rheumatoid arthritis may also have a positive antinuclear antibody test (ANA), which indicates the presence of an autoimmune disorder -- whether it is rheumatoid arthritis or another autoimmune disease.

How Is Rheumatoid Arthritis Treated?

There are many different ways to treat rheumatoid arthritis. Treatments include medications, rest and exercise, and surgery to correct damage to the joint.

The type of treatment will depend on several factors, including the person's age, overall health, medical history, and severity of the arthritis.

Rheumatoid Arthritis Medications

There are many rheumatoid arthritis medications available to decrease joint pain, swelling, and inflammation. Some of these drugs prevent or minimize the progression of the disease.

Drugs that offer relief of arthritis symptoms (joint pain, stiffness, and swelling) include:

• Anti-inflammatory painkiller drugs, such as aspirin, ibuprofen, or naproxen
• Topical (applied directly to the skin) pain relievers
• Corticosteroids, such as prednisone
• Narcotic pain relievers

There are also many strong medications called disease-modifying anti-rheumatic drugs (DMARDs), which work by interfering with or suppressing the immune system's attack on the joints. They include:

• Plaquenil (originally used to treat malaria)
• Immune suppression drugs, such as methotrexate, Imuran, and Cytoxan
• Biologic treatments, such as Enbrel, Humira, Remicade, Orencia, Rituxan, and Xeljanz
• Other drugs, such as Azulfidine and Arava

Why Are Rest and Exercise Important for Rheumatoid Arthritis?

A balance of rest and exercise is important in treating rheumatoid arthritis. During flare-ups (worsening of joint inflammation), it is best to rest the joints that are inflamed. This may be accomplished by the temporary use of a cane or joint splints.

When joint inflammation is decreased, guided exercise programs are necessary to maintain flexibility of the joints and to strengthen the muscles that surround the joints. Range-of-motion exercises should be done regularly to maintain joint mobility.

When Is Surgery Necessary for Rheumatoid Arthritis?

When joint damage from the rheumatoid arthritis has become severe or pain is not controlled with drugs, surgery may be an option to help restore function to a damaged joint.