Working closely with your care team to find the right therapy can help you break free of joint pain.
You may not realize it, but you have the key to conquering RA. “You’re an important member of the team, says rheumatologist Madelaine Feldman, MD. “Not only do you help your doctor evaluate how well controlled your disease is, you also make choices that keep your body at its fullest potential.” The first step? Partnering with your doctor and working toward a common goal: remission, which means you have no or few painful joints, less stiffness and no ongoing signs of joint damage.
“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 be happy with 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, because RA can damage more than just your joints: It causes bodywide infammation that can also affect organs like the heart, lungs and eyes.
Don’t be discouraged if the therapies you’ve tried have not been effective — new options are available, with more on the way, and one of those may be your key to relief!
WHICH MEDICINE IS RIGHT FOR YOU?
That depends on a lot, which is why you should never miss an exam or be shy about telling your rheumatologist exactly how you’re feeling. Knowing the activities that you are able to do, or not do, will help your rheumatologist 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 stressful 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. There are two basic types of treatments that rheumatologists use to treat RA:
Medications that relieve symptoms
Examples include nonsteroidal anti-inflammatories, such as ibuprofen and naproxen, as well as short-term use of steroids like prednisone. These are used to relieve symptoms; they do not stop RA 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 control pain and inflammation, they can also prevent or slow 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 (your doctor will explain how).
- 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.