Most people with rheumatoid arthritis (RA) can lead full and active lives. Taking control of RA will help you cope with its impact on your lifestyle. As there is no known cure, early diagnosis and treatment can control its symptoms and help prevent disability.

Most RA treatments are tailored to each person’s individual symptoms and the severity of their condition – options may include:

• medicines to relieve symptoms or slow progress of the condition
• heat treatment such as warm baths or packs
• cold treatment such as cold packs or a TENS (transcutaneous electrical nerve stimulation) electrical device, which is thought to reduce pain by stimulating the nerves
• surgery to correct joint problems
• supportive treatments such as physiotherapy
• complementary therapies such as relaxation  techniques, massage, hypnosis or acupuncture which some people find helpful.

It is possible to use more than one of these approaches at the same time (for example, using a drug treatment, heat pack and relaxation techniques). The experience of pain is also unique to everybody, so what works for you may differ from what works for someone else.

When symptoms become worse it is called a ‘flare-up’ or ‘flare’, and it is impossible to predict when they will occur.

Having RA can lead to several other conditions that may cause additional symptoms. The most common complications are carpal tunnel syndrome and inflammation of other areas of the body such as the lungs, heart and eyes.

Treating team

People with RA are usually looked after by several health professionals. This might include a doctor, a rheumatologist, physiotherapist and occupational therapist.

Medicines

The medications used to treat RA fall into two main groups. The first group aims to put the fire out by suppressing the inflammation in the joints.

The first group is given the long name: disease modifying anti-rheumatic drugs (DMARDs). You might see your medications called ‘DMARDs’. Commonly-used DMARDs are methotrexate, sulfasalazine, leflunomide, prednisone and hydroxychloroquine.

The second group helps with pain. It includes medications like paracetamol and anti-inflammatories like ibuprofen, or celecoxib.

The name ‘anti-inflammatories’ is a bit confusing. These medications can help with the inflammation from things like a sprained ankle but do not treat the inflammation in RA.

The aims of treatment are to suppress joint inflammation to prevent day-to-day pain and stiffness hence to prevent long-term joint damage. Unfortunately, the medications that treat RA work well but most take several weeks to months to have their full effects. So don’t worry if they don’t work straight away. Also, like all medications these drugs can have some side effects. Most patients need to have regular blood tests while they are on medication for their RA. This is also the reason that people are started on lower doses on some medications like methotrexate and then have them increased.

Where joints have been damaged extensively, the only option may be surgery for joint replacement.

More information

Arthritis Australia can provide more information on rheumatoid arthritis on their website or by calling their Arthritis Information Line on 1800 011 041.

Source:  Arthritis Australia (Rheumatoid arthritis),NHS Choices, UK (Rheumatoid arthritis; Diagnosing rheumatoid arthritis), Virtual Medical Centre (Rheumatoid arthritis)