Treatment and Management of Rheumatoid Arthritis
How is rheumatoid arthritis diagnosed?
It is often difficult to diagnose rheumatoid arthritis (RA). A specialist in RA (known as a rheumatologist) is usually required to establish the diagnosis.
The diagnosis of RA is made based on the careful analysis of many factors. A thorough history and physical examination are essential. Also, there are certain laboratory studies that can be helpful when considering the diagnosis. It is important to note that a diagnosis cannot be made based on any specific blood test. Some blood tests are helpful for ruling out other diseases that may have similar symptoms. X-rays are often helpful when considering the diagnosis of RA and to look for any signs of joint destruction.
How is rheumatoid arthritis managed?
The management of rheumatoid arthritis has dramatically improved over the past 25 years. Early recognition of the disease is essential to allow for early treatment. It is important to recognize that there is no cure for RA, but it can be managed.
Medications and physical therapy are important in the management of RA. In addition, because RA is a chronic disease, people often require medical therapy for many years to keep the disease under control.
There are many medication options for people with rheumatoid arthritis. Anti-inflammatory medications, including non-steroidal anti-inflammatory drugs (such as ibuprofen) and corticosteroids (such as prednisone), are often helpful in relieving the pain associated with RA and improving joint swelling and stiffness.
Specific disease-modifying anti-rheumatic drugs (known as DMARDs) may be helpful. Examples include methotrexate, sulfasalazine, azathioprine, and leflunomide. These work by modifying the body’s immune system and reducing the inflammation.
In addition to DMARDs, more potent agents, known as biologic agents, have been developed. These target even more specific aspects of the immune system. Biologic agents, such as infliximab, etancercept, and adalimumab, tend to be used in more advanced cases of RA.
Each DMARD and biologic agent has its own side effect and toxicity profile and often requires regular blood testing and clinical monitoring to ensure safety.
In addition to medical therapy for RA, many people benefit from physical therapy and rehabilitation. Under the guidance of rehabilitation therapists, people with RA often learn how to appropriately rest, exercise, strengthen, and maintain joint and muscle function.
This information has been approved by Marc Cohen, MD (April 2008).
