Understanding Rheumatoid Arthritis - Treatment
How Do I Know If I Have rheumatoid arthritis?
In addition to a physical examination and symptoms, blood tests and X-rays are commonly used to diagnose rheumatoid arthritis. A blood test called an erythrocyte sedimentation rate (ESR or "sed rate") and another called the C-reactive protein (CRP) indicate the presence of inflammation. The majority of sufferers -- about 4 out of 5 people -- have antibodies called rheumatoid factors (RF) in their blood, although RF may also be present in other disorders.
What Is the Treatment for rheumatoid arthritis?
Controlling inflammation is the goal, usually with anti-inflammatory drugs or medications that suppress the immune system, occupational or physical therapy, and exercise. Surgery may be advised to correct joint damage. Sometimes, arthritic damage can be slowed or stopped, but in other cases damage continues as the disease runs its course, regardless of the drugs or other treatments used. Early treatment, though, is associated with less joint damage.
Treatment for rheumatoid arthritis involves three stages:
- medication to relieve pain and inflammation.
- rest to let injured tissues heal themselves.
- exercise to rebuild mobility and strength.
Joint Protection
Learning to protect your joints is an important part of treatment. With the
help of an occupational therapist, you can learn easier ways to do your normal
activities, such as avoiding positions that strain your joints, using your
strongest joints and muscles while sparing weaker ones, and wearing braces or
supports for certain joints. Using grab bars in the bath, modified door knobs,
canes, walkers, and other devices can help you with tasks such as opening jars
or pulling up socks.
Medication
Doctors may recommend pain relievers combined with regimens of heat, rest, and
exercise; physical therapy; and controlled application of deep heat to soothe
affected joints.
Controlling inflammation is the primary goal of rheumatoid arthritis treatment. To reduce pain and inflammation in mild cases, your doctor will probably prescribe aspirin or another nonsteroidal anti-inflammatory drug (NSAID). Those that are available over-the-counter include aspirin, ibuprofen (Advil or Motrin), and naproxen sodium (Aleve). These are also available by prescription at higher doses. Other prescription NSAIDs include Voltaren, Oruvail, Anaprox, Relafen, and Indocin. NSAIDs have the potential for serious side effects such as stomach irritation, ulcers, and bleeding.
Another class of NSAIDs, called Cox-2 inhibitors, may be easier on the stomach but aren't shown to be any more effective in pain control. Celebrex is one example. Cox-2 inhibitors have been linked to an increased risk of heart attack, and side effects can include swelling and a worsening of high blood pressure.
For severe RA, your doctor may recommend steroids to ease the pain and stiffness of affected joints. Steroids can be given as injections directly into the inflamed joint or taken as a pill. Depending on the individual, results range from temporary relief to long-lasting suppression of symptoms. Potential side effects of long-term steroid use include high blood pressure, osteoporosis, and diabetes. But when used appropriately, steroids are often effective and quickly improve pain and inflammation.
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