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Treating Rheumatoid Arthritis

Doctors use a variety of approaches to treat rheumatoid arthritis. These are used in different combination and at different times during the course of the disease and are chosen according to the patient’s individual situation. No matter what treatment the doctor and patient choose, the goals are the same: to relieve pain, reduce inflammation, slow down or stop joint damage, and improve the person’s sense of well-being and ability to function.

People with rheumatoid arthritis need a good balance between rest and exercise, with more rest when the disease is active and more exercise when it is not. Rest helps to reduce active joint inflammation and pain and to fight fatigue. The length of time for rest will vary from person to person, but in general, shorter rest breaks every now and then are more helpful than long times spent in bed.

Exercise is important for maintaining healthy and strong muscles, preserving joint mobility, and maintaining flexibility. Exercise can also help people sleep well, reduce pain, maintain a positive attitude, and lose weight.

Some people find using a splint for a short time around a painful joint reduces pain and swelling by supporting the joint and letting it rest. Splints are used mostly on wrists and hands, but also on ankles and feet. Other ways to reduce stress on joints include self-help devices (for example, zipper pullers, long handled shoe horns); devices to help with getting on and off chairs, toilet seats, and beds; and change in the ways that a person carries out daily activities.

People with rheumatoid arthritis face emotional challenges as well as physical ones. The emotions they feel because of the disease-fear, anger, and frustration-combined with any pain and physical limitation can increase their stress level. Although there is no evidence that stress plays a role in causing rheumatoid arthritis, it can make living with the disease difficult at times. Stress may also affect the amount of pain a person feels. There are a number of successful techniques for coping with stress including regular rest periods, relaxation, or visualization exercises.

There is no scientific evidence that any specific food or nutrient helps or harms people with rheumatoid arthritis. However, an overall nutritious diet with enough, but not an excess, of calories, protein, and calcium is important. Some people may need to be careful about drinking alcoholic beverages because of the medications they take for rheumatoid arthritis.

Most people who have rheumatoid arthritis take medications. Some are used only for pain relief; others are used to reduce inflammation. Still others, often called disease-modifying antirheumatic drugs, are used to try to slow the course of the disease. The person’s general condition, the current and predicted severity of the illness, the length of time he or she will take the drug, and the drug’s effectiveness and potential side effects are important considerations in prescribing drugs for rheumatoid arthritis.

In patients with severe joint damage, several types of surgery are available. The primary purpose of these procedures is to reduce pain, improve the affected joint’s function, and improve the patient’s ability to perform daily activities. Surgery is not for everyone and patient and doctor should make careful consideration.

The most frequently performed surgery for rheumatoid arthritis is joint replacement and it is done primarily to relieve pain and improve or preserve joint function. Artificial joints are not always permanent and may eventually have to be replaced, an important consideration for young people.

Rheumatoid arthritis can damage and even rupture tendons, the tissues that attach muscle to bone. Tendon reconstruction, which is used most frequently on the hands, reconstructs the damaged tendon by attaching an intact tendon to it. This procedure can help to restore hand function, especially if the tendon is completely ruptured.

Synovectomy is a surgery where the doctor actually removes the inflamed synovial tissue. Synovectomy by itself is seldom performed now because not all of the tissue can be removed, and it eventually grows back. Synovectomy is done as part of reconstructive surgery, especially tendon reconstruction.

Regular medical care is important to monitor the course of the disease, determine the effectiveness and any negative effect of medication, and change therapies as needed. Monitoring typically includes regular visits to the doctor.