There is no cure for rheumatoid arthritis (RA), so treatments focus on reducing symptoms, maintaining joint function, and slowing progression of the disease.
Rest and Exercise
Keeping muscles healthy and strong can help maintain flexibility and mobility in people with RA. However, during flare-ups, resting the muscles helps reduce inflammation and pain. A careful balance of rest and exercise—more rest when symptoms are worse, more exercise when they lessen—will reduce RA symptoms overall.
Physical and Occupational Therapy
A physical or occupational therapist will observe your individual problems and symptoms and offer solutions to help reduce pain and swelling and to improve your quality of life. These can include wearing a splint to support painful joints and using various self-help devices, such as grabbers, long-handled shoehorns, extra depth shoes with semi-rigid soles, and raised toilet seats, to make daily tasks easier and less painful.
Drugs and Medication
Drug therapy is almost always the first treatment used for RA. There are four major categories of RA drugs: nonsteroidal anti-inflammatory drugs (NSAIDs), which are used long-term to reduce pain and inflammation; corticosteroids, which are used short-term to reduce severe pain and inflammation; disease-modifying anti-rheumatic drugs (DMARDs), which slow the progression of RA in various ways; and biologic agents, which interrupt the body's inflammation process.
Surgery is generally a last-resort treatment for RA, used if joints become severely damaged or if drug therapy stops working. There are a few different types of surgery used in RA:
Total Joint Replacement (Arthroplasty).
In this type of surgery, the damaged parts of joints are removed completely and replaced with prosthetics made of metal or plastic. Arthroplasty is a long-term solution, but many joints, such as those in the wrists and hands, can be complex and costly to replace. Learn more about arthroplasty and find out about specific joint replacement surgeries like knee replacement and hip replacement.
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 the hands, reattaches and repairs damaged tendons, restoring movement and function.Learn more about tendon repair.
This type of surgery removes inflamed synovial tissue (the membrane surrounding joints whose inflammation is responsible for RA), reducing pain and swelling. However, it is impossible to remove all synovial tissue, and it will grow back after surgery, so synovectomy is at best a temporary solution. Synovectomy is rarely done by itself; it can be combined with tendon reconstruction and arthroscopy.
Joint Fusion (Arthrodesis)
If total joint replacement is not an option, a doctor may choose this type of surgery, in which a damaged joint is removed and the affected bones are fused together, often using bone grafts taken from the patient's pelvis. Joint fusion limits movement but reduces pain and stops further bone damage. It is commonly used on the wrists, ankles, fingers, toes, thumbs or hips.