Treatment for Rheumatoid Arthritis

Acute treatment, preventative therapy, and surgical options

Treatment for rheumatoid arthritis (RA) is individual to each patient, and it is important to work with your family care physician and rheumatologist to find a treatment plan that works best for you. Many factors, including the severity of your disease, and how long you have been suffering from the condition, come into play when discussing what may best reduce your symptoms in the long term.

Treatment approaches for RA share the same goals: to stop the inflammation present with the disease so that it can be put it into remission, to relieve symptoms that might come with the disease, to prevent further damage to joints or organs, and to improve physical health and overall well being to curb future complications, according to the Arthritis Foundation.

RA treatment is often aggressive and immediate. Doctors follow certain protocols and strategies to maintain and defeat the condition. This means that the earlier the inflammation is treated and taken care of, the better it is for the patient. Achieving remission is the ultimate goal for doctors in an approach called “Treat to Target.” Doctors are also vigilant to bring disease activity to a minimum and to tightly control symptoms so that patients can continue with daily activities.


According to the Mayo Clinic, while medications vary according to individual patients, many types include:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs): Over-the-counter (OTC) drugs like ibuprofen (Advil) and naproxen sodium (Aleve) can alleviate pain and reduce inflammation. Stronger, prescription NSAIDs are also available from your doctor.
  • Corticosteroids: Prednisone, for example, can reduce inflammation, pain, and slow joint damage. Due to its strength, a prescription of corticosteroids may be given to relieve acute symptoms, but with time one should wane off the drug once more preventative measures are in place.
  • Disease-modifying antirheumatic drugs (DMARDs): These RA-specific drugs can slow disease progression and save the joints and other tissues from permanent damage. Medications may include methotrexate (Trexall), leflunomide (Arava), and hydroxychloroquine (Plaquenil). A class of DMARDs, called biologic agents, or biologic response modifiers includes such drugs as adalimumab (Humira), certolizumab (Cimzia), etanercept (Enbrel), golimumab (Simponi), and tocilizumab (Actemra), among others. Biologic DMARDs are usually most effective when paired with a nonbiologic DMARD such as methotrexate.

As always, medications, especially stronger prescription medications, run the risk of causing side effects. Talk to your doctor if you are suffering from any adverse symptoms from your medication, such as stomach irritation, heart problems, or weight gain.

Alternative Therapies

There are many alternative treatments for RA that might be beneficial when used in combination with the above medications. You might also consider some lifestyle tips and dietary changes that have been known to help alleviate symptoms.

Exercise and Physical Therapy

Both physical and occupational therapists can help teach and suggest non-medication therapies to complement daily living and function. These approaches aim to build strength, mobility, adjust routines, and prevent further joint damage.

Physical therapists may recommend an exercise routine and plan, apply heat/ice treatments to alleviate symptoms after activity, refer you to massage therapists who can further target muscle treatment, and provide emotional and social support.

If RA is in more advanced forms, and simple tasks such as cooking, bathing, and carrying items become a major strain on your body, occupational therapists may recommend alternatives to daily tasks. An occupational therapist aims to make certain lifestyle changes to make living with the disease easier. Products, attachments, and other devices may be recommended to make common tasks less of a challenge.

Other therapy specialists that may be of benefit for RA sufferers include podiatrists for joint support for feet, stimulation therapy, and thermo- or hydro-therapies. More details are available on the Rheumatoid Arthritis Support Network.

Surgical Options

When joint damage becomes permanent and mobility and function are impaired due to severe inflammation and deformities, surgery may be the only option. Since surgery carries its own risks, it’s important to discuss with your doctor whether or not you are a candidate for this intervention.

Joint replacement therapy may provide relief and restore function, replacing damaged parts of a joint with metal and plastic parts and splints. This therapy can be applied to hips, knees, ankles, shoulders, wrists, and elbows, according to the Arthritis Foundation.

Surgery for rheumatoid arthritis may include a variety of minimally invasive procedures around the damaged joint. These include: a synovectomy, which aims to remove the damaged lining of the joint; repairing loose or ruptured tendons around the joint due to excessive damage; and joint fusion to stabilize or realign a joint if replacement isn’t an option, according to the Mayo Clinic.

-Additional reporting by Steven Aliano

Updated on: 10/03/19
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The Empowered Patient's Guide to Rheumatoid Arthritis