Partnering with your healthcare team is the key to relieving symptoms and protecting your joints.
Breaking free of the pain and physical limitations of RA is possible, says rheumatologist Madelaine Feldman, MD. “RA does not have to be the debilitating and deforming disease it was in the past. Even though we can’t cure RA, we now have the potential to make you feel and function as if you don’t have it,” she notes. The key to unlocking that potential? Having a strong partnership with your doctor and working toward a common goal: remission, which means you have no or few painful joints, less stiffness and no signs of joint damage, says Dr. Feldman.
“As a team, you need to be dedicated to a treatment goal and be willing to make changes until you’re in remission or as close to it as possible. Don’t settle for the status quo or think, I’m better, I can live with this. We want you feeling your best and showing no signs of disease activity.”
That’s important since RA can damage more than your joints: It causes systemic inflammation that can affect any organ in your body. Staying motivated to work with your doctor, try other therapies and make healthy lifestyle changes will increase your odds of living without pain and permanent joint damage. So don’t be discouraged if what you’ve tried has not been effective. With so many options out there, you have every reason to keep trying until you find a therapy that works!
WHICH TREATMENT IS RIGHT FOR ME?
That depends on a lot, which is why you should never miss an exam or be shy about telling your rheumatologist anything. Knowing how you’re feeling and what you’re able to do, or not do, will help your doctor determine which therapy to try.
“Ask your doctor what the medication does and what the goals are,” says Dr. Feldman. “Having a positive attitude also helps. We know that negative emotions can trigger the immune system in the wrong way, so tell your doctor if you’re feeling hopeless or depressed.” Also, never skip a blood test, since your doctor uses the results to assess how well your body is responding to treatment and if you’re having any side effects.
Therapies include:
Medications that relieve symptoms
Examples include nonsteroidal anti-inflammatories (e.g., ibuprofen) and corticosteroids (e.g., prednisone). These are used to relieve symptoms; they do not stop joint damage, although some studies suggest early use of prednisone may help.
Medications that can help you fight RA
These can help you achieve remission! Not only can they help control pain and inflammation, they can also slow or even prevent further joint damage.
Options include:
- DMARDs: Short for diseasemodifying antirheumatic drugs, DMARDs “turn down” an overactive immune system. Several types are available, including methotrexate. Most are taken as pills (methotrexate can also be given by injection).
- Biologics: These are genetically engineered to block immune system signals that trigger inflammation. Because of their complex structure, biologics must be given by injection or intravenous infusion.
- JAK inhibitors: This is the latest class of RA medication. JAK inhibitors have been developed to block specific molecules involved in immune system signaling. This medication is taken as a pill.