Rheumatoid arthritis is a recurring disorder disease and has no cure. Timely diagnosis of rheumatoid arthritis can help control pain, stiffness and fatigue. The goal of treatment for Rheumatoid Arthritis is to achieve the lowest possible level of arthritis disease activity and minimize the joint injury. The best treatment of Rheumatoid Arthritis needs a broad program that combines medical, social, and emotional support for the Arthritis patient. Knowledge about the nature of disease is most important. There is rapid development in the treatment of Rheumatoid Arthritis in the last few years, and the results are dramatically surprising.
Medication- Basically following classes of medications is used in treatment of rheumatoid arthritis:
Fast-acting/ first-line drugs – Aspirin, cortisone (corticosteroids), naprosyn, ibuprofen and etodolac are used to reduce pain and irritation.
Slow-acting/ Second-line drugs- Gold, methotrexate and hydroxychloroquine (Plaquenil) encourage disease reduction and prevent joint destruction deformity. These medicines may take from few weeks to several months to become effective. That is why they are used for long periods of time, at changing doses. The degree of destructiveness of rheumatoid arthritis is different among various patients. Patients with less destructive forms of the disease can be handled with rest, pain and anti inflammatory medications. With second-line drugs, joint destruction and disability can be minimized. Surgery is necessary if the patient is having severe joint deformity.
· Initiate treatment with methotrexate or Arava (leflunomide).
· Patients with moderate to high disease activity, Methotrexate plus Plaquenil (hydroxychloroquine) should be given.
· If the patient does not get a suitable response from methotrexate therapy, TNF blockers should be used. Those who are having a history of heart disease and multiple sclerosis should not use TNF blockers.
· If the patient is pregnant or breastfeeds the child, Methotrexate, Arava, or minocycline should not be started.
· Anakinra is the latest biologic agent to be medically accepted for use in Rheumatoid Arthritis. The efficiency of anakinra "is generally similar" to that observed with infliximab and etanercept.
Reduce stress on joints - Obesity puts stress/burden on weak joints. Maintaining a perfect weight is quite necessary. Use Canes, walkers etc to reduce stress on specific joints. You should consult with a physical and an occupational therapist before starting the course.
Rest- Take complete rest to avoid joint damage.
Joint-strengthening exercises- Do Joint-strengthening exercises (daily) after stretching exercises to make the muscles stronger.
Awareness about Rheumatoid Arthritis- Patient and his family members should be aware about the causes, symptoms and treatment of Rheumatoid Arthritis.
Surgical Approaches - This treatment is tried when other treatments fail and there is not even a single option left. It is not very popular among people. It is done to rebuild or replace the joint in order to decrease pain and make the joints functional. Synovial fluid can be injected to arthritic joint to temporarily postpone the surgery. Total joint arthroplasties of the knee, hip, wrist, and elbow, are highly successful.
Treatment for Rheumatoid Arthritis can not be successful without the close cooperation between the doctor, patient, and family members.
