Rheumatoid arthritis (RA) is a chronic autoimmune and inflammatory disease in which the immune system attacks healthy cells in the body by mistake. This causes painful inflammation in the affected parts of the body. RA mainly affects the joints and can attack multiple jointsTrusted Source at the same time. It can also affect other tissues and may cause problems in some organs, including the heart, eyes, and lungs.
The disease most often affects the knee, hand, and wrist joints. RA causes the lining of an affected joint to become inflamed and damages the joint tissue. The tissue damage can result in chronic pain, deformity, and instability. RA affects around 1.5 million people in the United States. There is no cure for RA, but a person may effectively manage the disease with medications and other management strategies.
People have individual experiences with RA, so the best medication for RA pain may differ for each person. This article explores over-the-counter (OTC) medications, prescription medications, and alternative treatments for RA.
Nonsteroidal anti-inflammatory drugs (NSAIDs) are available over the counter. These medications may help reduce inflammation from RA and alleviate pain. NSAIDs include ibuprofen, and naproxen. As with any medication, NSAIDs may cause side effects. A person is more likely to experience side effects if they take higher doses over a long period.
Side effects of NSAIDs may include:
– stomach ulcers
– allergic reactions
Rarely, NSAIDs can affect circulation, the heart, the kidneys, and the liver. This may cause serious problems such as stroke, heart failure, or heart attack.
The treatment goal for RA is to prevent Trusted Sourceirreversible damage to the joints and minimize pain. A doctor will assess a person’s best options for medication based on their overall health, age, the severity of the disease, and various other factors. Prescribed medication may include:
These medications, such as prednisone and cortisone, can reduce inflammation and pain and can help delay slow damage to the joints. A doctor may prescribe corticosteroids if NSAIDs do not produce results. When someone has RA, a doctor may inject the steroid directly into the joint or prescribe oral or topical forms. Corticosteroids may relieve RA symptoms. However, the results differ between individuals and according to the severity of the disease.
Corticosteroids may cause side effects, some of which are serious. Doctors may prescribe a low dose for 3 months or less, as the risk of side effects increases with longer use of higher doses.
Side effects may include:
-shortness of breath
-osteonecrosis, or bone death
-changes in blood sugar levels
-increased likelihood of infections
-high blood pressure
-bruising and poor wound healing
Disease-modifying antirheumatic drugs (DMARDs)
A doctor may prescribeTrusted Source DMARDs, such as methotrexate, for moderate to severe RA, alone or with other treatments. These drugs affect the way the immune system works. People with RA have an overactive immune system, and DMARDs disrupt this system, helping delay disease progression. This could help prevent permanent damage to the joint tissue.
A person may have to try different types of DMARDs to find one that suits them best The drugs are most effective if a person uses them in the early stages of RA, and it may take time for them to deliver benefits. A person with RA usually takes DMARDs for life.
Side effects of traditional or nonbiologic DMARDs may include:
-increased risk of infections
Biologic treatments are another type of DMARD.
When infection or another threat occurs, the body producesTrusted Source an inflammatory substance called tumor necrosis factor-alpha (TNF-alpha). Biologics, such as TNF-alpha inhibitors, suppress this substance, which helps prevent inflammation in the joint tissue.
These biologic treatments can also help reduce pain, swelling, tenderness, and stiffness. Types of biologics include adalimumab (Humira) and infliximab (Remicade).
Side effects may include:
-heightened risk of infections
-demyelinating diseases, such as multiple sclerosis (MS) or Guillain-Barré syndrome (GBS)
-congestive heart failure
-Janus kinase (JAK) inhibitors
JAK inhibitors are also a type of DMARD.
The immune system sends and receivesTrusted Source messages using proteins called cytokines. These proteins attach to receptors on the JAK-STAT pathway. When this occurs, it can lead to an abnormal immune response.
JAK inhibitors block cytokines from attaching to receptors, which slows the immune system’s response. When this occurs, the immune system does not cause as much inflammation, which can help reduce the severity of RA symptoms.
Side effects may include:
-increased risk of infection
-cytopenias, or low white blood cell and platelet count
A person should speak with their doctor to ensure they are receiving appropriate treatment for RA. That said, some alternative or complementary measures may also help to reduce RA-related pain and fatigue.
The Arthritis Foundation recommends:
-daily movement, such as walks, balanced with rest
-eating a balanced diet
-taking omega-3 fish oil or turmeric supplements with the guidance of a healthcare professional
-using topical products, such as creams or gels
-trying stress reduction therapies, such as massage and meditation
-using hot and cold treatments
There are a variety of OTC and prescription medications available to treat RA.
The best medication for people with RA will differ from one person to another. A doctor can assess each person’s needs and help them find the most effective treatment plan. This can depend on the severity of the disease, a person’s overall health, weight, age, and tolerance for medications.
Lifestyle changes and alternative or complementary measures may also help alleviate RA symptoms. However, people should speak with a healthcare professional for further advice.