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You are here : 3-RX.com > Medical Encyclopedia > Diseases and Conditions > Rheumatoid Arthritis: Treatment & Monitoring
      Category : Health Centers > Arthritis

Rheumatoid Arthritis

Alternate Names : RA

Rheumatoid Arthritis | Symptoms & Signs | Diagnosis & Tests | Prevention & Expectations | Treatment & Monitoring

What are the treatments for the disease?

People who have RA should learn all they can about self-care and managing their disease. There are many treatment approaches.


Early treatment is the key. Effective self-management of RA will focus on the following goals:

  • relieve pain
  • decrease inflammation in the joints
  • slow down or stop damage to the joints
  • improve joint function and ability to do daily activities
  • increase feelings of general well-being
  • Specific self-care measures may include:

  • managing one's stress
  • applying splints to rest acutely inflamed joints
  • using assistive devices, such as zipper pulls, to decrease strain on joints
  • Medicine

    Symptom control and disease management may be enhanced when medicines are started early in treatment. A wide variety of highly effective medicines are used to treat RA. Most fall into one of two groups, including medicines that relieve symptoms and medicines that actually modify the disease process. These two types of medicines are sometimes used in combination. Examples of medicines that relieve symptoms include:

  • anti-inflammatory medicines, called NSAIDs, such as aspirin, naproxen, and ibuprofen
  • COX-2 specific inhibitor NSAIDs, such as celecoxib and rofecoxib
  • corticosteroids, such as prednisone, which can be taken orally or by injection into the joint
  • analgesics, such as acetaminophen or propoxyphene
  • Examples of medicines that modify disease include:

  • immunosuppressant medicines, which alter the body's immune response, such as methotrexate, azathioprine, and cyclophosphamide
  • anti-inflammatory medicines, such as infliximab and etanercept, which block the effects of a key protein involved in the rheumatoid process
  • antibiotics, such as doxycycline and minocycline
  • medicines that slow down joint destruction, such as d-penicillamine, sulfasalazine, hydroxychloroquine, and gold
  • Diet and Nutrition

    All people should be sure to eat a healthy diet, following the food guide pyramid. It's important to get the right amount of calories, protein, and calcium.

    The findings of some studies have shown that symptoms of RA improve with high doses of omega-3 fatty acids. These substances occur naturally in certain fish and in some plant seeds. However, it is hard to get enough of these acids to affect the disease, and some people cannot tolerate the high doses.

    There has been a great deal of interest in the last few years in the use of glucosamine and chondroitin, dietary supplements that may decrease the joint pain linked with another form of arthritis called osteoarthritis. People who have RA should discuss the value of such supplements with their doctors before taking them.


    Exercise is a key strategy in the treatment of arthritis, but the person with RA needs to be careful to balance exercise and rest to conserve energy. The exercise program should consist of a combination of aerobic exercise, strengthening (joint protection) exercises, and flexibility (or stretching) exercises.

  • For aerobic exercise, 30 minutes of moderate exercise a day can help prevent complications of arthritis, as well as heart disease, stroke, and diabetes. Exercise should be kept to a level where the person can talk without shortness of breath and is comfortable with the pace of the activity. The 30 minutes a day can be done in one session or broken up into several shorter segments. Walking and water aerobics are exercises that keep joint stress to a minimum.
  • Strengthening exercises can be done with light weights or a resistance band. The goal is to build strength and tone in the muscles around the joints affected by RA, rather than to build big muscles. Improving muscle strength and tone can help protect the joint and prevent further joint damage. Most people with RA should talk with a doctor or physical therapist to set up a program that is right for him or her.
  • Stretching exercises will help maintain flexibility and should be done each day. They can be done while lying in bed or in various positions or at different times during the day.
  • Surgery

    Surgery may be performed when pain cannot be controlled or when significant function is lost. Several types of surgery may be done, such as:

  • arthroscopy, a procedure that uses a small scope and instruments to get inside the joint without opening it
  • arthrotomy, which means opening the joint through a larger incision
  • synovectomy, which is the removal of the lining of the joint
  • osteotomy, which realigns the bone next to the joint
  • arthroplasty, which is the partial or total replacement of the joint. People with severe arthritis are often candidates for a knee joint replacement or a hip joint replacement.
  • Prosorba Therapy

    The Food and Drug Administration has approved a blood-filtering treatment called Prosorba for moderate to severe cases of RA that have not responded well to disease-modifying medicines. In this procedure, blood is drawn from the arm and then separated into two different parts called the plasma and the red blood cells. Next, the plasma is filtered through a special cylinder the size of a soup can that is filled with a sandlike substance. This is called a Prosorba column, and the filtering sand in it is coated with protein A, which removes certain antibodies from the plasma. These antibodies contribute to pain and inflammation in the joints. The plasma is then combined again with the red blood cells and put back into the person's body.

    Therapy is given once a week for 12 weeks as an outpatient procedure. Each session lasts 2 to 2.5 hours. This therapy can bring remission from RA symptoms, but it will take up to 12 to 16 weeks before the person begins to feel the benefits. Once remission is reached, it may last as long as a year and a half.

    What are the side effects of the treatments?

    Medicines used to treat RA may cause stomach upset or bleeding , allergic reaction, less resistance to infection, and other side effects. Surgery may cause bleeding, infection, or allergic reaction to anesthesia. Nearby bones, ligaments, tendons, nerves, or blood vessels can also be injured by accident.

    What happens after treatment for the disease?

    Treatment of RA is lifelong. There is no cure for the disease, but careful management can help to reduce some of its effects.

    How is the disease monitored?

    A doctor will watch the person's level of comfort and function of the joint. Any new or worsening symptoms should be reported to the doctor.

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    Rheumatoid Arthritis: Prevention & Expectations


    Author: John A.K. Davies, MD
    Reviewer: Kathleen A. MacNaughton, RN, BSN
    Date Reviewed: 09/25/02

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