How Cognitive Therapy Can Help
Because one of the most trying aspects of rheumatoid arthritis is learning to live with pain, many doctors recommend pain management training. They may call it âcognitive therapy.â
The goal is to improve your emotional and psychological well-being as you develop ways to relax, handle stress, and pace yourself. For instance, it may include activity scheduling, guided imagery, relaxation, distraction, and creative problem-solving.
What Rheumatoid Arthritis Medications Are In Development
Rheumatoid arthritis treatment is an active area of research. In fact, according to the Pharmaceutical Research and Manufacturers of America, more than 50 drugs for rheumatoid arthritis are in various stages of clinical testing. Many of these are new biologics. Others target histamine receptors and glucocorticoid receptors.
Rheumatoid Arthritis Pain Management
While the overall goal of rheumatoid arthritis therapy is to prevent disease progression and further joint damage, pain management is a necessary daily practice for patients, in order to maximize their quality of life.; Chronic pain can adversely affect a patients ability to work, participate in physical and social activities, and can generally interrupt day-to-day life.
Despite medications and aggressive forms of treatment, many rheumatoid arthritis patients experience ongoing pain and stiffness. The reality is, it may never completely go away. But there are specific things patients can do to manage pain and limit its impact on their lives.
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How Well Do The Drugs Work Are They Dangerous
All the drugs used to treat rheumatoid arthritis have been tested and have been proven useful in patients who have the disease. However, they all work on a different aspect of the inflammatory process seen in rheumatoid arthritis and their use as well as their side effects — depends on the current disease status of each patient and any associated medical problems that a patient may have. The effectiveness and the risks of drugs are considered when your rheumatologist plans your treatment.
If a drug is very effective in treating an illness but causes a lot of side effects, it is not an ideal treatment for long-term use. For example, high doses of corticosteroids can make people with rheumatoid arthritis feel dramatically better. However, high doses of corticosteroids may cause serious side effects when taken over many months or years. Steroids have many possible side effects, including weight gain, worsening diabetes, promotion of cataracts in the eyes, thinning of bones , and an increased risk of infection. Thus, when steroids are used, the goal is to use the lowest possible dose for the shortest period of time.
Testing for tuberculosis is necessary before starting anti-TNF therapy. People who have evidence of an earlierTB infection should be treated because there is an increased risk of developing active TB while receiving anti-TNF therapy.
Evening Primrose Oil Supplements
Some plant oils may reduce pain and stiffness associated with RA. Evening primrose oil contains an essential fatty acid called gamma-linolenic acid that may provide some relief.
A 2016 study found that taking evening primrose oil and fish oil may reduce inflammation and disease activity.
According to the National Center for Complementary and Integrative Health , however, more research is needed on the effectiveness of primrose oil.
Again, check with your doctor before taking evening primrose oil, as it may interact with some medications. Potential side effects include headache and an upset stomach.
Thunder god vine grows in China and Taiwan and is used in traditional Chinese medicine. Research has indicated that it may be effective for treating RA symptoms.
According to a 2015 study , thunder god vine was comparable to the standard RA drug methotrexate in relieving symptoms. The study found that taking both was even more effective.
A 2018 research review also suggested that thunder god vine supplements may help reduce inflammation. Still, more research is needed on long-term effects and safety.
Talk to your doctor and assess the benefits before trying thunder god vine, as it may have some serious side effects. These can include reduced bone mineral content, infertility, rashes, and hair loss.
Thunder god vine can also be poisonous if it isnt prepared correctly.
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Rheumatoid Arthritis Medications And Pregnancy
Research presented in September 2017 at the annual meeting of the American College of Rheumatology shows that as many as;half of women with RA stop taking their medication during pregnancy. But doing so can cause disease activity to increase, potentially impacting unborn babies.
Many RA medicines are considered safe to take during pregnancy, including TNF inhibitors, oral steroids, and NSAIDs. Please discuss with your doctor, because not all drugs are created equal.
Women with RA who become pregnant should discuss their medication options with their rheumatologist before making changes to their medication usage.
How Long Can I Safely Take Methotrexate
The American College of Rheumatology recommends that most people continue taking methotrexate even if their arthritis symptoms have disappeared. This usually means that the medication is working.;
Some people worry that taking methotrexate for too long may cause cancer. Research suggests that people who take methotrexate may have a higher risk for certain cancers compared to people who dont take methotrexate. However, its important to know that people with RA already have a higher risk for cancer, whether or not they are taking methotrexate. So its hard to say whether methotrexate is the cause.;
In general, the benefits of methotrexate outweigh the risks. In a study, researchers followed more than 5,600 patients with RA for 25 years, and those who took methotrexate for at least 1 year had a much lower risk of dying than those who did not take methotrexate or took it for only a short period of time .
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Articles On How To Treat Ra Pain
The main treatment goals with rheumatoid arthritis are to control inflammation, ease pain, and reduce disability linked to RA.
Treatment usually includes medications, occupational or physical therapy, and exercise. Some people need surgery to correct joint damage. Early treatment is key to good results. And with todayâs treatments, joint damage can often be slowed or stopped.
Methotrexate For Rheumatoid Arthritis: Is It Safe And How Does It Work
Methotrexate is a medication thats often used to treat rheumatoid arthritis , which can cause symptoms like red, painful, and swollen joints. If youve heard of methotrexate before, you probably already know its a medication thats taken long term to help lessen the symptoms of RA. But what about side effects? And how does it compare to other medications? Heres what you should know about this popular medication and why its still considered to be the first choice among rheumatoid arthritis treatments.
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When Ra Goes Untreated: Long
If RA is left untreated in the long-term, it can affect not just quality of life but the duration of it, too. Persistent inflammation can lead to a shorter lifespan, Pisetsky explains.
Uncontrolled RA can also increase your risk for heart disease, because RA-related inflammation not only affects the joints, but also the heart. This inflammation can also contribute to narrowing of your blood vessels, according to the AF, allowing plaque to build up.
People who have RA have as much as twice the risk of heart disease as the general population, according to the AF. According to study published in April 2018 in BMC Rheumatology, due to the link between RA and heart problems, it’s important to manage not just RA but heart disease risk factors such as high blood pressure, high cholesterol, smoking, diabetes, and being sedentary.
And the more advanced your RA, the greater your risk for heart damage, the American College of Rheumatology notes.
However, untreated RA can affect more than just your joints and your heart, leading to complications ranging from skin issues, to bone thinning, to eye complications, and beyond.
That said, following a regular treatment plan that helps slow the progression of your RA can help protect your joints, your heart, your overall health and well-being and your life.
Side Effects And Risks Of Nsaids
Like all medications, NSAIDs come with a risk for side effects and other risks.
Side Effects
Side effects are more common if you are taking high doses for long periods, are older, or have serious health conditions. OTC NSAIDs will have fewer side effects compared to stronger prescription NSAIDs.
Possible side effects of NSAIDs include:
- Gastrointestinal: Stomach aches, nausea, diarrhea, etc.
- Headaches
- Stomach ulcers: Can bleed and lead to anemia
- Liver or kidney problems;
- Heart and circulation problems including heart failure, heart attack, and stroke
The FDA advisory panel has deemed Celebrex as safe as other NSAIDs when it comes to its cardiovascular risks. The panel also recommended changing the labeling to reflect that it still poses a threat to heart health. Research on celecoxib shows it has a lower risk for GI problems, including bleeding and ulcers, compared to other NSAIDs.
If you experience severe side effects from NSAIDs, stop using the medication and let your doctor know.
Drug Interactions
Some kinds of NSAIDs interact negatively with other medications. This means they can affect how other medicines work and can increase the risk for side effects.
Medications that might interact with an NSAID include:
If you are not sure if a medication you take is safe to take with an NSAID, ask your doctor or pharmacist. There are some foods or drinks you might need to avoid with NSAIDs as well. Read the package labeling or ask your doctor or pharmacist if you are not sure.
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Does Acetaminophen Help In Rheumatoid Arthritis
The painkiller acetaminophen only has a weak anti-inflammatory effect. Research has shown that it hardly helps in the treatment of rheumatoid arthritis, and clearly relieves the pain less effectively than NSAIDs do.
If you take acetaminophen anyway, it’s important to use it correctly. Higher doses can lead to liver and kidney damage. So adults shouldn’t take more than 4 grams per day according to the package insert. This is the amount in, for example, 8 tablets containing 500 milligrams of acetaminophen each. Waiting at least six hours between two doses is also recommended. So two 500 mg tablets of acetaminophen every six hours over one day would be the maximum allowed amount.
When To Take A Biologic Drug
Most people should try a non-biologic RA drug for at least three months. If you do not feel better or move more easily after three months, you should talk with your doctor about options such as adding another non-biologic or starting a new biologic. The combination of non-biologics that is sometimes called triple therapy may be the most cost-effective.
If a non-biologic or a combination of non-biologics did not help you, theres a good chance that a biologic will give relief.
People react to drugs differently. If one biologic does not help, you can try another. But never take two biologic drugs at the same time.
In rare cases, your doctor may skip more common treatments and go straight to biologics. This may make sense if your RA is already advanced when it is first diagnosed. Check with your doctor about using this aggressive approach to treatment.
If you need a biologic, ask your doctor if a less expensive version of the biologic, called a biosimilar, is available. Biosimilars are analogous to generic versions of drugs, with similar effectiveness but reduced cost.
This report is for you to use when talking with your health-care provider. It is not a substitute for medical advice and treatment. Use of this report is at your own risk.
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Your Ra Is In Remission Now What
With aggressive treatment, RA can go into remission (no visible signs or symptoms. Learn if its possible to take less medication or even a drug holiday.;
Your RA is in Remission! Now What?
There is no cure for rheumatoid arthritis , but remission;can feel like it. Today, early and aggressive treatment with disease-modifying antirheumatic drugs and biologics makes remission more achievable than ever before. But how likely are you to reach remission, and how likely are you to sustain it? And when you reach it, do you stay on your medications or go;off;them?;
When remission in RA was first defined 1981, it was characterized as elimination of all disease. Thats a very hard target. Were more likely to be able to reach limited or small amount of disease, explains David T. Felson, MD, professor of medicine at Boston University and a practicing rheumatologist.;
With that in mind, the American College of Rheumatology and the European League Against Rheumatism developed criteria for defining remission so researchers could compare the effectiveness of different treatment regimens.;;
Definitions of Remissionin Rheumatoid Arthritis;
These criteria are used by scientists when conducting clinical trials. Your rheumatologist may use these or slightly different measures to determine if your disease is in remission:;
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One or fewer swollen joints;
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One or fewer tender joints;
The Odds of Remission;
Drug-free Remission;
Should You Take a Drug Holiday?;
Quick Links
What Causes Rheumatic Disease
Most of these conditions happen when your immune system goes awry and attacks your own tissues. Doctors arenât sure what causes this. Sometimes itâs in your genes. Other times itâs a result of something in the world around you, like cigarette smoke, pollution, or something that causes an infection. Gender also plays a role — rheumatic diseases seem to affect women more than men.
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Questions For Your Doctor
- How do I know if my joint pain is caused by rheumatoid arthritis?
- Does RA run in families?
- What medicines would work best for me, and what are the side effects?
- Is there anything I can do to prevent flare-ups of RA?
- What are the pros and cons of surgery to treat RA?
- Does RA affect my life expectancy?
Before Taking This Medicine
You should not use hydroxychloroquine if you are allergic to hydroxychloroquine or chloroquine.
High doses or long-term use of hydroxychloroquine may cause irreversible damage to your retina . This could progress to permanent vision problems. The risk of retinal damage is higher in people with pre-existing eye problems, kidney disease, or people who also take tamoxifen.
To make sure hydroxychloroquine is safe for you, tell your doctor if you have ever had:
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vision changes or damage to your retina caused by an anti-malaria medication;
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heart disease, heart rhythm disorder ;
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diabetes;
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porphyria ; or
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a genetic enzyme deficiency called glucose-6-phosphate dehydrogenase deficiency.
Tell your doctor if you are pregnant or plan to become pregnant. Malaria is more likely to cause serious illness or death in a pregnant woman. Having malaria during pregnancy may also increase the risk of miscarriage, stillbirth, premature delivery, and low birth weight.
It is not known whether hydroxychloroquine will harm an unborn baby. If you are pregnant, ask your doctor about the risks of traveling to areas where malaria is common .
It may not be safe to breastfeed while using this medicine. Ask your doctor about any risk.
Hydroxychloroquine is not approved for treating lupus or rheumatoid arthritis in anyone younger than 18 years old.
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Significance Of The Study
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Rheumatoid arthritis not only affects the joints but can also affect internal organs, thus causing permanent disability in many instances. Currently, there is no cure for this autoimmune disease, rather, symptoms are addressed on an individual basis. Here, we succinctly summarize the classic and current treatment options available for the management of patients suffering from this complex disease.
Mistake No : You Combine Otc And Prescription Nsaids
Rules for the safe use of NSAIDS pertain to over-the-counter versions, too. Advil and Aleve are commonly used over-the-counter NSAIDs. They contain ibuprofen and naproxen, respectively, but not at prescription strength. Because Advil and Aleve are readily available on drugstore shelves, people sometimes pick up the products and use them without being aware that they are NSAIDs and should not be combined with other NSAIDs.
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Is It Safe To Get The Covid
The short answer: Yes. Having rheumatoid arthritis is not a contraindication the vaccine. In fact, getting the vaccine when you have rheumatoid arthritis may be especially important, given the disease may put you at higher risk for COVID-19 or severe outcomes.
Many patients with autoimmune conditions who take medications that affect immune system function are concerned that certain vaccines could give them the virus. This could theoretically occur with vaccines like the MMR vaccine for measles and mumps, which is a live vaccine. That means it is a weakened form of the virus intended to cause a harmless infection that your immune system rapidly eliminates.
However, none of the COVID-19 vaccines currently authorized in the U.S. Pfizer, Moderna, and Johnson & Johnson are live vaccines. The COVID-19 vaccine cannot infect you with coronavirus. It is safe for people with rheumatoid arthritis, including those who take immunosuppressant medication.
According to the U.S. Centers for Disease Control and Prevention , the only contraindications to receiving the COVID-19 are:
- Severe allergic reaction after a previous dose or to a component of the COVID-19 vaccine.
- Immediate allergic reaction of any severity to a previous dose or known allergy to a component of the vaccine. See the ingredients in each vaccine here.
Rheumatoid Arthritis Diet Exercise Therapy Home Remedies And Alternative Medicine
Foods to avoid with RA
There is no special RA diet or diet“cure” for rheumatoid arthritis. One hundred years ago, it was touted that “night-shade” foods, such as tomatoes, would aggravate rheumatoid arthritis. This is no longer accepted as true. There are no specific foods or food groups that should be universally avoided by individuals with rheumatoid arthritis.
There is no evidence that gluten bothers rheumatoid arthritis. Nevertheless, for those who are definitely sensitive to gluten , the gluten-free diet can prevent poor intestinal absorption of important nutrients. Bowel inflammation can be detrimental for those with RA if they become deficient in nutrients, such as vitamin D and folate.
Foods that fight RA inflammation
Nevertheless, some home remedies may be helpful, although these are not considered as potent or effective as disease-modifying drugs. Fish oils, such as in salmon, and omega-3 fatty acidssupplements have been shown to be beneficial in some short-term studies in rheumatoid arthritis. This suggests that there may be benefits by adding more fish to the diet, such as in the popular Mediterranean diet. The anti-inflammatory effects of curcumin in dietary turmeric, an ingredient in curry, may be beneficial in reducing symptoms of rheumatoid arthritis.
Supplements for RA
Exercises and home remedies for RA
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