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There is no cure for rheumatoid arthritis, but there are medications that can reduce inflammation in your joints in order to relieve pain and prevent or slow joint damage. Many of the drugs used to treat rheumatoid arthritis have potentially serious side effects, so doctors will typically start patients on medications with the mildest side effects and then as the disease progresses, prescribe stronger drugs or a combination of treatments.
For people with milder symptoms, nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen sodium can relieve pain and reduce inflammation. Stronger NSAIDs are available by prescription.
Oral corticosteroids such as prednisone reduce inflammation and pain and slow joint damage. However, steroids carry side effects including thinning of the bones, weight gain and diabetes. Doctors will often prescribe a corticosteroid to relieve acute symptoms and then gradually taper the patient off the medication.
Disease-modifying antirheumatic drugs (DMARDs) are designed to slow the progression of rheumatoid arthritis and help prevent permanent damage to the joints. Common DMARDs include methotrexate, leflunomide, hydroxychloroquine and sulfasalazine. These drugs also carry potentially severe side effects like liver damage, bone marrow suppression and lung infections.
Drugs known as biologics or biologic agents represent a newer class of DMARDs that target specific parts of the immune system believed to trigger inflammation. Biologic agents include abatacept, adalimumab, anakinra, certolizumab and etanercept. Doctors will often pair a biologic with a nonbiologic DMARD to boost effectiveness.
Occupational and physical therapy can be valuable in teaching patients how to protect their joints. A physical therapist can show you new ways to perform daily tasks, such as picking up objects with your forearms if your fingers are sore. Physical therapy can also help keep joints flexible and strengthen the muscles that support them. Surgery, such as joint replacement or joint fusion to stabilize damaged joints, is an option for joints that are severely damaged by rheumatoid arthritis.
Regular gentle exercise such as walking, tai chi (movement therapy that uses gentle exercises and stretches combined with deep breathing) or swimming can also help strengthen the muscles around the joints and combat fatigue. Heat and cold compresses can help ease pain by relaxing tense muscles or dulling the pain, respectively. Stress reduction and relaxation techniques such as medication and guided imagery may aid in muscle relaxation and pain control.
Some studies show that fish oil supplements may reduce rheumatoid arthritis pain and stiffness. Since fish oil can interfere with some medications, it’s important to check with your doctor before taking it. Research on other supplements such as ginger, green tea and turmeric is ongoing, but preliminary studies show they may be helpful in managing rheumatoid arthritis.