Treating RA and taking control

The goals of managing rheumatoid arthritis (RA) are to relieve pain, control inflammation, slow or prevent destruction of joints, maintain the ability to perform normal day-to-day tasks, maximize quality of life, and prevent surgery. Treatment often involves a combination of rest, exercise, physical therapy, emotional support, job and home support, diet, joint protection, and medications.

Biologic response modifiers, often called biologics, work by blocking the actions of the chemicals called cytokines, which are involved in attacking the lining of joints and tissues. Cytokines are messengers used by cells of the immune system to communicate with each other. Examples of cytokines involved in RA are tumour necrosis factor alpha (TNF-α) and interleukin (IL).

Corticosteroids, sometimes referred to as "steroids," are medications that mimic the hormone cortisone in the body and are used in the treatment of rheumatoid arthritis (RA) to control inflammation. However, they cannot slow the progression of joint damage. The way corticosteroids work to decrease inflammation is not completely understood.

Disease-modifying anti-rheumatic drugs (DMARDs) slow or suppress the immune system from attacking the joints in the treatment of rheumatoid arthritis (RA). DMARDs are often combined with each other or with other medications, such as biologics. The way DMARDs work to suppress the immune system is not completely understood.

Nonsteroidal anti-inflammatory drugs (NSAIDs) reduce joint pain and inflammation and are generally used first when rheumatoid arthritis (RA) is discovered. There are a large number of NSAIDs available. NSAIDs are believed to work by blocking the effects of enzymes COX-1 and COX-2. These enzymes help produce a substance, prostaglandin, which triggers swelling and inflammation.

Despite the use of medications to treat joint damage progression in people with rheumatoid arthritis (RA), there are times when pain relievers are needed to lessen the pain. Opioid pain relievers (e.g., morphine) usually work by acting on pain receptors in the nervous system to change the perception of pain as well as the emotional response to pain.

Surgery is usually an option for people whose joints are badly damaged or whose condition is too painful. The goal of surgery is to relieve pain and to improve joint function. For arthroscopic surgery, the surgeon inserts a scope through a small cut in the skin and cleans or removes inflamed or damaged joint tissue.