Rheumatoid arthritis (RA) is an autoimmune disease that
causes inflammation of the tissue that lines the inside of your joints. It’s a
chronic progressive disease that can be quite painful, and even debilitating.
It especially affects fingers, wrists, ankles, and feet.
Currently, there is no cure for rheumatoid arthritis. Treatment
focuses on reducing symptoms, maintaining joint function, and slowing
progression of the disease.
Rest and Exercise
With RA, keeping your muscles healthy and strong can help
maintain flexibility and mobility. During flare-ups, resting your muscles helps
reduce inflammation and pain. A careful balance of rest and exercise should
reduce your RA symptoms overall. Rest more when symptoms are worse, and exercise
more when they lessen.
Physical and Occupational Therapy
A physical or occupational therapist will observe your specific
problems and symptoms. Then they’ll offer ways to reduce your pain and swelling
and to improve your quality of life. They may suggest wearing a splint to
support painful joints. Or they may recommend using self-help devices to make
daily tasks easier and less painful. These self-help devices include:
- long-handled shoehorns
- extra-depth shoes with semi-rigid soles
- raised toilet seats
Drugs and Medication
Drug therapy is almost always the first line of treatment
used for RA. There are four major categories of RA drugs:
- nonsteroidal anti-inflammatory drugs (NSAIDs),
which reduce pain and inflammation in the long-term
- corticosteroids, which reduce severe pain and
inflammation in the short-term
- disease-modifying anti-rheumatic drugs (DMARDs),
which slow the progression of RA in various ways
- biologic agents (e.g., Humira, Enbrel), which
interrupt your body's inflammation process
Surgery is generally a last-resort treatment for RA. It’s
used if your joints become severely damaged or if drug therapy stops working.
There are several different types of surgery used in RA:
Total Joint Replacement, or Arthroplasty
In this type of surgery, the damaged parts of your joints
are removed completely and replaced with prosthetics made of metal or plastic.
Arthroplasty is a long-term solution. However, many joints, such as those in
the wrists and hands, can be complex and costly to replace.
Tendons are strands of tissue that connect muscles to bones,
enabling movement. RA can damage tendons and even cause them to rupture. This
type of surgery, most commonly used on hands, reattaches and repairs damaged
tendons. This restores movement and function.
This type of surgery removes inflamed synovial tissue. This
tissue forms the membranes surrounding the inflamed joints responsible for RA. Removing
this reduces pain and swelling. However, it’s impossible to remove all synovial
tissue, and it will also grow back after surgery. So synovectomy is a temporary
solution at best. It’s rarely done by itself and can be combined with tendon
reconstruction and arthroscopy.
Joint Fusion, or Arthrodesis
If total joint replacement is not an option, your doctor may
choose joint fusion. This type of surgery removes a damaged joint and fuses the
affected bones together, often using bone grafts taken from your pelvis. Joint
fusion limits movement but reduces pain and stops further bone damage. It’s
commonly used on wrists, ankles, fingers, toes, thumbs, or hips.
Although there is no cure for rheumatoid arthritis, it’s
possible to reduce its symptoms, manage your pain and restore your joint
function. Physical therapy, medication, and surgery as a last resort can help
you live a pain-free life.