Rheumatoid Arthritis

While there are no known cures for RA, specialised and dedicated RA clinics aim to alleviate symptoms, prevent further joint destruction, and help patients regain lost muscle strength and mobility.

NSAIDs (non-steroidal anti-inflammatory drugs) like diclofenac acid, or COX-2 inhibitors, are often prescribed to reduce pain, swelling and stiffness that result from rheumatoid arthritis. However, these drugs will only reduce the symptoms and will have no effect on the progression of the disorder. Reducing pain and swelling are important as they make you more comfortable.

Depending on the severity and progression of the disorder, DMARDs (or disease-modifying antirheumatic drugs) are often prescribed. These include hydroxychloroquine (Plaquenil), methotrexate, sulphasalazine and leflunomide (Arava). Low dose steroids may be used. Steroids can also be injected directly into a joint to relieve pain and swelling. However, steroids cannot be used in the long term, especially in high doses because they have significant side-effects.

There is now a new group of drugs called biologic agents which can control the disease quickly and effectively. They are given as injections and are very expensive. Not all rheumatoid arthritis patients are suitable for or need such drugs. Your doctor is the best judge on which drugs to use.

Once the inflammation is under control, it is necessary to rebuild the muscles and ligaments weakened by the arthritis. Exercise helps to rebuild muscle strength which can aid to stabilise the joint. While some sports which stress the joints excessively are not suitable, recovering patients should aim to keep fit as much as possible. It is important not to exercise the acutely swollen and painful joints. Your physiotherapist is the best person to ask for advice.

Sometimes surgery is necessary to correct joint deformity or to replace a completely destroyed joint.