What Causes Rheumatoid Arthritis
The exact cause of rheumatoid arthritis is unknown. However, it is believed to be caused by a combination the following factors:
- Genetics
- The environment
- Hormones
Normally, the immune system protects the body from disease. In people who have rheumatoid arthritis, somethingpossibly infections, cigarette smoking, and physical or emotional stress, among other causestriggers the immune system to attack the joints .
Gender, heredity, and genes largely determine a person’s risk of developing rheumatoid arthritis. For example, women are about three times more likely than men to develop rheumatoid arthritis.
What Are Experimental Therapies For Ra
Experimental therapies are new treatments that show promise but arent yet proven for treating certain medical conditions, such as RA.
Researchers test these therapies in clinical trials to see how well they work. If the medicines are shown to be safe and effective in clinical trials, the Food and Drug Administration may approve them for use in the general public.
Natural Treatments For Rheumatoid Arthritis
There are some complementary medicine treatments that might help with your RA. Itâs a good idea to talk it over with your doctor first. Youâll still need to take your medicine and keep up with the other parts of your treatment plan.
Heat and cold. Ice packs can reduce joint swelling and inflammation. Put a cold compress or ice pack on the joint. Use the ice packs for 15 minutes at a time, with 30-minute breaks in between.
Heat compresses relax muscles and stimulate blood flow. Wrap a warm towel or pad around the area that hurts. Or try a warm bath or shower.
Relaxation. Try progressive muscle relaxation. This is when you tense or tighten one muscle group and then relax it. Take deep breaths as you do. Start with the muscles of your feet. Move slowly up your body, ending with the muscles of your face.
Sleep. A lack of shut-eye can make your joints hurt. Go to bed and get up at the same time each day. Try to get some exercise every day. Avoid nicotine, caffeine, and alcohol. And don’t forget to “unplug” your bedroom: Turn off TVs, computers, and phones.
Capsaicin. It’s an ingredient in hot peppers. Studies show that it can ease pain when you rub your joints with cream that’s got some in it. You may feel more pain at first, but it usually eases up.
Acupuncture. Studies show that acupuncture curbs pain, may lower the need for painkillers, and is good for helping affected joints stay flexible.
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When To Get Medical Advice
See a GP if you think you have symptoms of rheumatoid arthritis, so they can try to identify the underlying cause.
Diagnosing rheumatoid arthritis quickly is important, because early treatment can prevent it getting worse and reduce the risk of joint damage.
Find out more about diagnosing rheumatoid arthritis.
General Joint Pain And Stiffness
In addition to morning joint stiffness, you may also experience general joint stiffness throughout the day, especially after a period of inactivity.
Some of the first areas RA stiffness typically affects are the wrists and certain joints in the hands and feet, but its also possible to experience pain and stiffness in your knees or shoulders. Usually, both sides of your body will be affected.
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Common Rheumatoid Arthritis Drugs
Your doctor has choices to make within each class of RA medicine. Finding the right treatment for you, that is effective with the least RA medication side effects, may involve some trial and error. Here are 10 drugs commonly prescribed for RA:
Adalimumab is a biologic medication for injection under the skin. You will get the first dose in your doctors office. After that, the typical dose is self-administered once a week or every other week.
Celecoxib is an NSAID, specifically a type called a COX-2 inhibitor. It is a capsule you take once or twice a day, usually with food.
Etanercept is a self-administered biologic for once- or twice-weekly injection under the skin. Like Humira, you will get the first dose in your doctors office.
Hydroxychloroquine is a DMARD. It comes as a tablet you usually take once a day with food. For higher doses, your doctor may recommend splitting the dose to twice daily.
Indomethacin is an NSAID. It is available as a capsule, extended-release capsule, and a suspension. The ER capsule offers the most convenient dosing at once or twice daily with food.
Leflunomide is another DMARD you usually take once daily. Your doctor may have you take it more often during the first several days of treatment.
Methotrexate is a DMARD that is very effective for RA. It is available as either a tablet or injection under the skin. Doctors usually prescribe a weekly dose to decrease side effects.
Nsaids And Stomach Problems
NSAIDs, which block the inflammation of RA, can be present in both prescription drugs and over-the-counter drugs like ibuprofen. The most common side effects are stomach problems like heartburn and belching, but you can minimize these risks by taking the medication with food.
NSAIDs can cause cardiac, renal, and gastrointestinal issues, so patients should be mindful of this prior to starting them, says Ryan Matthew, MD, a rheumatologist at Ohio State University Wexner Medical Center in Westerville, Ohio.
There is also increased toxicity risk, he adds, so it is important to have a conversation with your doctor about the safest use and dosage.
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What To Expect During Infusion Therapy
The medication will be administered by injecting a needle attached to a small tube. This tube is connected to an IV bag with the solution. Once attached to your arm, the solution will slowly drip into your vein.
Each session can take several hours. However, at Infusion Associates, our staff is fully dedicated to making sure the experience is as comfortable as possible. You can bring a book or magazine, and receive infusions in a reclining chair. We also provide blankets, hot beverages such as coffee, tea, or hot cocoa and you can listen to music or watch a movie. You can also have the peace of mind that comes from having either a doctor or nurse practitioner monitoring the transfusion.
If Your Doctor Has Recommended Iv Therapy Let Infusion Associates Help You
At Infusion Associates, we provide medically-prescribed infusion therapy for patients with chronic conditions in a welcoming and friendly environment. Our team of healthcare professionals is fully committed to making the experience as comfortable as possible for you or your patients. We always inform patients of any potential side effects and answer all their questions before starting treatment. In addition, we have a Registered Pharmacist on-site to make the process as seamless as possible.
If you would like to refer a patient to us or want to inquire about the treatments we offer, you can contact us by calling us at or filling out this form.
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Affordability And Financial Assistance
RA therapies can be costly. In fact, biologic medicines are some of the most expensive drugs on the market, costing, on average, $10,000 to $30,000 a year. The most expensive can run more than $500,000.
If you cant afford your recommended medications, talk to your healthcare provider or pharmacist about ways to cut your costs.
Many organizations, such as Good Days, provide financial assistance to people with chronic illnesses. Drug companies may also offer discounts to patients in need. It also might help to check out websites like GoodRx and RxSaver for coupons and where to find the lowest prices in your area.
What Is The Most Common Way That Early Ra Is Treated According To Acr Guidelines
If a person has had an early RA diagnosis for less than six months and has met the criteria for a diagnosis of RA, they will be treated with a conventional synthetic disease-modifying anti-rheumatic drug . Almost always, the initial DMARD chosen is methotrexate, unless there is a specific reason not to use it. The continued treatment plan, even after six months, is still the same and always balances drug safety with the persons level of improvement.
It is important for a clinician to assess the patients disease activity and that there be a standard method to do so. Therefore, there are objective tools doctors use to measure disease activity. These tools are the:
- Disease activity score
- Health assessment questionnaire
- Routine Assessment of Patient Index Data 3
The DAS, also referred to as DAS 28, considers and scores the tenderness and swelling in 28 joints. A DAS of 3.3 indicates mild disease, while a score of 5.6 points or more indicates severe disease. This scale can be used to determine whether specific therapies are working. If, after treatment, the patient still has moderate-to-high disease activity, then the doctor can choose to add an additional therapy, such as a biologic medication.
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Physical And Occupational Therapy
Physical therapy and occupational therapy make a big difference to your daily life. They are key parts of any rheumatoid arthritis treatment plan.
Physical therapists can give you an exercise plan, teach you how to use heat and ice, do therapeutic massage, and encourage and motivate you.
Occupational therapists help you handle daily tasks — like cooking or using your computer — and show you easier ways to do those things. They can also check on whether any gadgets would help you.
What Are Effective Over
Most patients with Rheumatoid Arthritis will, at some point, use over-the-counter medications to control pain — most commonly, acetaminophen . Other OTC medications which can help with RA pain and inflammation include aspirin and non-prescription versions of ibuprofen or naproxen . In addition, some topical pain medications may also provide relief. These ointments and creams are generally divided into three categories:
Salicylates
Salicylates are derivatives of aspirin. In topical form, they are absorbed through the skin and exert a local, anti-inflammatory effect.
- Aspercreme
- Omega-3-fatty acids, found in fish oil capsules, may reduce inflammation.
- The same would be true for gamma-linoleic acid. Herbal preparations with possible benefits include ginger, Devil’s claw, and white willow.
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Medications To Reduce The Inflammation And Pain Of Rheumatoid Arthritis
Many people with RA also take medications to help manage pain. You might take these medications temporarily, during a flare-up, or every day depending on your condition and the treatment plan you discuss with your doctor. Pain-relieving options include:
- Nonsteroidal anti-inflammatory drugs . NSAIDs reduce inflammation and relieve pain. Your doctor might recommend over-the-counter NSAIDs, such as ibuprofen or naproxen sodium, or might prescribe stronger NSAIDs.
- COX-2 inhibitors. COX-2 inhibitors, such as celecoxib , also reduce inflammation and pain. Theyre intended to have fewer side effects and be safer for daily use than NSAIDs.
- Steroids.Steroids can reduce inflammation and help relieve pain. You can take steroids as an injection or tablet. Steroids can have serious side effects and are only meant for short-term use.
- help you adapt your movements
What Are The Potential Risks And Benefits Of Injectable Medications For Rheumatoid Arthritis
Biologic agents used to treat RA need to be injected. The biggest benefit of these drugs is that they are very effective.
- Biologics not only relieve symptoms but also halt damage to joints and generally provide quick relief.
- The biggest drawback of biological agents is cost. Patients can spend thousands of dollars a month using biologics.
- Other drawbacks include side effects, which may be severe because biologics suppress the immune system, enhancing the possibility of infections.
- In addition, patients may not like receiving injections.
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Corticosteroids For Treating Rheumatoid Arthritis
Corticosteroids, such as prednisone and prednisolone, are strong anti-inflammatory drugs that can be taken by mouth or injected, either into the bloodstream or directly into the joint.
These drugs are often used while waiting for DMARDs to take effect, and are sometimes also prescribed to enhance the effects of a DMARD. They can quickly reduce pain, stiffness, swelling, and tenderness of joints.
But corticosteroids are only used for short-term relief because they can cause a number of serious side effects in the long run, including:
What This Means For You
If you dont feel like treatment is helping you enough, speak up. Your number of tender and swollen joints and blood test results are only part of the equation.
Its also important to make sure your doctor understands your personal treatment goals. Work closely with your doctor to adjust your treatment as needed to reach your treatment goals. This is the crux of a treat-to-target strategy and effective .
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How Is Rheumatoid Arthritis Treated
The goals of rheumatoid arthritis treatment are to:
- Control a patient’s signs and symptoms.
- Prevent joint damage.
- Maintain the patients quality of life and ability to function.
Joint damage generally occurs within the first two years of diagnosis, so it is important to diagnose and treat rheumatoid arthritis in the window of opportunity to prevent long-term consequences.
Treatments for rheumatoid arthritis include medications, rest, exercise, physical therapy/occupational therapy, and surgery to correct damage to the joint.
The type of treatment will depend on several factors, including the person’s age, overall health, medical history, and the severity of the arthritis.
Azathioprine Cyclosporine Gold Salts And Hydroxychloroquine
Azathioprine
- Who should not use this medication: Pregnant or breastfeeding women should not use azathioprine additionally, people with the following conditions should not use this drug:
- Allergy to azathioprine
- Alcoholism
- Preexisting bone marrow or blood toxicities
Cyclosporine
- Who should not use this medication: People receiving psoralen-PUV-A or UV-B radiation should not take cyclosporine because of an increased cancer risk. Additionally, people with the following conditions should not take this drug:
- Allergy to cyclosporine
- Cancer
Gold Salts
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How Diet Affects Ra
Although there is no demonstrable link between diet and RA, studies have shown that the type of inflammation experienced in RA could be modulated by certain foods. Increased inflammation has been attributed to processed foods or foods cooked at higher temperatures.
It is recommended to increase consumption of foods that are considered to be anti-inflammatory, such as fruits, veggies, and cold water fish . As a result, inflammatory symptoms may improve and possibly lead to fewer flare-ups.
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What Is A Generic Drug
Generic drugs are the same medicine as the brand name but will cost less. Generics will have the same “dosage form, safety, strength, route of administration, quality, performance characteristics, and intended use. This means you can take the generic drug and still get the same benefits and effects as the brand-name drug.
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Rheumatoid Arthritis Drugs: Nsaids
NSAIDs work by blocking an enzyme that promotes inflammation. By reducing inflammation, NSAIDS help reduce swelling and pain. But they are not effective in reducing joint damage. These drugs alone are not effective in treating the disease. They should be taken in combination with other rheumatoid arthritis medications.
As with glucocorticoids, you should use them for brief periods — they can cause severe digestive tract problems. Which type, if any, your doctor prescribes may depend upon your medical history. If you have a history of liver, kidney, heart problems or stomach ulcers, it’s best to not take these drugs. Ask your doctor whether any new NSAIDS producing fewer side effects are available.
Examples of NSAIDs:
Is There A Cure For Rheumatoid Arthritis
There is no cure yet, however, we now know a great deal about what causes RA, and how to control it and prevent joint damage. This is achieved by the early implementation of disease-modifying antirheumatic drugs . These are essential to gain rapid control of the disease, in order to avoid joint erosions and long-term limitation of function.
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Prescription Medications For Ra Include:
- Corticosteroid drugs, also called oral steroids, are a common part of rheumatoid arthritis treatment regimen because they’re highly effective at reducing inflammation. The downside is that over time, the drug becomes less effective because your body adjusts to the anti-inflammatory effect. Decadron and methylprednisone are examples of oral steroids.Corticosteroids also come with the risk of bone thinning, bruising, weight gain, and high blood pressure.
- COX-2 inhibitors, such as Celebrex, are a newer class of NSAIDs that reduce pain and inflammation but without the risk of stomach complications. These drugs are used mainly by people with moderate to severe rheumatoid arthritis.
- Disease-modifying anti-rheumatic drugs work differently than corticosteroid drugs. Instead of acting quickly but without a lasting effect, DMARDs slowly modify the disease. So slowly, in fact, that it may take several months for you to feel their effects. That’s why doctors often prescribe DMARDs within three months of your diagnosisso you’ll get the benefits as quickly as possible. DMARDs are also usually taken with an NSAIDthe NSAID treats the painful symptoms while the DMARD works to prevent joint damage. Methotrexate is among the most prescribed DMARDs.Many DMARDs come with serious side effects, usually involving blood-producing cells, the kidneys, and the liver. Regular tests are necessary when using a DMARD so your doctor can monitor any possible adverse effects.