While rheumatoid arthritis can be painful, it doesn’t have to keep you from everyday activities. Your rheumatologist can help you find ways to ease pain, slow down or stop the inflammation that can damage your joints, and help your joints work better.
Drugs for Pain and Swelling
Your doctor may prescribe a few different medications to help with inflammation and pain. Nonsteroidal anti-inflammatory drugs (NSAIDs) can do both. There are many types of NSAIDs, including over-the-counter drugs like aspirin or ibuprofen. But you should always take these under your doctor’s guidance because they can cause digestive, heart, and kidney problems, especially at high doses.
Steroids are anti-inflammatory drugs that affect your body’s immune system as well. They can have serious side effects, though, so it’s typically best to take them at the lowest possible dose for the shortest amount of time. Your doctor may prescribe them to control flare-ups or ease symptoms until more powerful drugs kick in.
In some cases, your doctor may recommend drugs called analgesics, which can ease pain but don’t do anything for inflammation.
In general, experts don’t recommend opioids or other narcotics, because rheumatoid arthritis is a chronic condition and taking those for a long time can lead to addiction.
Drugs to Slow the Disease
Disease-modifying antirheumatic drugs, or DMARDs, are medications that affect your body’s immune system. This can ease inflammation and help keep your joints healthy. It also may let you take fewer anti-inflammatory and pain medications. But it can take weeks or months for DMARDs to fully take effect.
Biologics are a newer, more targeted kind of DMARD. They work on the specific parts of your immune system that cause inflammation. They’re often prescribed if you have trouble with other drugs or other drugs don’t work well enough.
Biologics also work faster than traditional DMARDs and can slow or stop the disease’s progress quickly. In some cases, you may take a biologic along with other medications.
Because of their effects on your immune system, DMARDs can make you more likely to get infections.
Physical Therapy and Exercise
Your doctor may recommend physical or occupational therapy to calm swelling, ease pain and stiffness, and help your joints work better. This can involve heat or cold on your joints, relaxation techniques, a finger splint or orthotic device, or ultrasound therapy, which uses high-frequency sound waves.
Rheumatoid arthritis can make it hard to exercise and you should definitely rest during flare-ups, but research shows that staying active can help slow or even reverse the disease. Your therapist can work with you on an exercise program to boost your range of motion and give you more strength and endurance. That can make it easier to keep doing things you enjoy.
While no food or supplement can cure RA, there’s some evidence that fish oils and plant oils may help with joint inflammation and pain. Your doctor may also suggest a cholesterol-lowering diet, since people who have RA have higher odds of coronary artery disease.
If you smoke, studies show that quitting is one of the best things you can do to slow down RA.
If one of your joints is badly damaged, your doctor may recommend replacement surgery. If that’s not possible, fusion surgery can help stabilize it.
In other cases, a surgeon may need to remove inflamed tissue around the joint. Synovectomy is a procedure that takes away the lining of the joint, called the synovium, which can get painfully inflamed by RA and cause damage to the joint. Surgeons may also repair tendons if they become loose or torn because of inflammation.