While you cannot cure rheumatoid arthritis permanently, RA is a progressive disease whose symptoms can be managed through treatment options and lifestyle changes.
Rheumatoid arthritis (RA) can be prevented from getting worse with early diagnosis and administering appropriate therapy. There is no one-size-fits-all approach to treat RA because no two people experience the disease in the same manner. Figuring out the individualized optimum treatment regimen takes time and an extensive investigation.
Patients with untreated or undiagnosed RA are at a higher risk of joint deterioration, poorer long-term results, and cardiovascular disease. It is crucial to pay attention to the body and be able to recognize a flare when it occurs, so the doctor can treat it as soon as possible with medication adjustments and advise self-management measures.
Although there is no cure for RA, medication can help manage the disease. Alternative and complementary therapies can help relieve symptoms, but only conventional medications can stop the disease's progression and prevent further joint damage. Medication can help put RA into remission in some cases, and symptoms may disappear completely in others.
Certain lifestyle interventions may help keep the joints healthy and prevent flares, such as:
- Staying active
- Maintaining ideal body weight
- Managing stress with mindfulness and meditative techniques
- Eating a diet rich in vitamins and minerals (calcium, polyphenols, and antioxidants)
- Regular stretching exercises
- Workplace ergonomics
What is rheumatoid arthritis?
Rheumatoid arthritis (RA) is an autoimmune disease where the body's immune system mistakenly attacks the synovium (the thin membrane that lines the joints). Chronic inflammation results in pain, swelling, and stiffness. RA can cause bone and joint damage over time, resulting in disability.
RA typically affects both sides of the body equally, which means that if a joint on one side is affected, the same joint on the opposite side is also affected. The most affected areas are the smaller joints, such as the wrists, fingers, knees, feet, and ankles. RA can affect other organs, and people with RA are more likely to develop other diseases, especially heart disease, diabetes, and osteoporosis.
RA symptoms often appear gradually over several weeks. However, some cases can progress quickly over a few days. The symptoms vary with people, but may include:
- Pain: RA-related joint pain is typically throbbing and aching, which is frequently worse in the mornings and following periods of inactivity.
- Stiffness: RA can cause stiffness in the joints, for example, if the hands are affected, the patient may not be able to fully bend their fingers or form a fist. This stiffness or joint pain is often worse in the morning or after a period of inactivity and may last longer than other types of arthritis.
- Swelling, warmth, and redness: When RA affects a joint, the lining of that joint becomes inflamed, resulting in swelling, warmth, and redness. As a result, the joints may swell and become hot and tender to the touch. Firm swellings are called rheumatoid nodules and can form under the skin around affected joints in some people.
RA patients experience a variety of more general symptoms, including:
- Tiredness and a lack of energy
- Fever
- Sweating
- Poor appetite
- Weight loss
The inflammation caused by RA can sometimes cause problems in other parts of the body.
How is rheumatoid arthritis treated?
Rheumatoid arthritis (RA) is a perplexing disease with symptoms and progression varying greatly with people. While there is no permanent cure for RA, the condition can be treated in the following ways.
In the early stage
- Inflammation control is important at all phases of RA, but reducing it early provides the best chance of avoiding joint damage.
- Often, a low-dose steroid combined with a low dose of a disease-modifying antirheumatic drug (DMARD) provides the best control.
- Methotrexate, a drug originally developed to fight cancer but now commonly used as the first-line therapy for RA, is the most used DMARD.
- To slow the progression of the disease, combine these medications with lifestyle changes.
In the moderate stage
- Treatment options may include steroid injections. Doctors may try biologic DMARDs, such as Enbrel and Humira, which use genetically engineered proteins to suppress a portion of the immune system.
- These injectable drugs may delay the course of RA, but they can potentially have serious side effects. Physical activity is an important aspect of the recovery process.
- Some patients may require physical therapy before they may begin self-administered muscle-strengthening aerobic exercises.
In the severe stage
- Treatment options for this condition are recommended based on the patient’s condition. The possibility of joint replacement may be discussed with the orthopedic surgeon.
- Arthrodesis (also called joint fusion) and tendon reconstruction are two other surgical options.
- Patients suffering from chronic pain have benefited from cognitive behavioral therapy, which can help patients identify pain triggers and provide coping techniques to improve their overall quality of life.
In the end stage
- Treatment options may include pain modulators (gabapentin), muscle relaxers (cyclobenzaprine), and low-dose antidepressants (amitriptyline). Often, these drugs are used in combination.
- Joint replacement options could be recommended to patients to restore mobility and reduce the need for multiple pain medications along with joint replacement options.
The symptoms may remain the same for a long time, regardless of the stage the patient is in. They could go into complete remission or observe an unexpected flare-up and worsening of the condition. Communication between the patient and the physician is critical to prevent the worsening of symptoms of RA.