Publication date Sep 11, 2007
Rheumatoid arthritis makes your joints swollen and stiff. It can be very painful. But there are treatments that can reduce pain, protect your joints and help you lead an active life.
If you have rheumatoid arthritis, your joints are painful and swollen. It happens because of a problem with your immune system.
Your immune system protects you against diseases by attacking germs in your body. But, if you have rheumatoid arthritis, your immune system makes a mistake. As well as attacking harmful germs, it attacks your joints.
The symptoms of rheumatoid arthritis usually develop slowly over time. At first, you may notice that your joints feel a little stiff, especially in the mornings. The small joints of your hands or feet are usually affected first.
Eventually, your joints may become stiff and painful. The pain is often worse just after you've been sleeping or sitting still, and gets better as you get moving. The stiffness often gets better as you move around too.
You may also get swelling in your joints. Some people get swellings or lumps under their skin. These can happen on the back of your elbows or finger joints. You can have surgery to remove them if they bother you.
There are lots of treatments that can help with rheumatoid arthritis. There's no one standard treatment. So, there are lots of drugs, and combinations of drugs, that your doctor may suggest. Treatment won't cure your arthritis, but it can help with pain and protect your joints.
Drugs for rheumatoid arthritis work best if you start taking them as soon as you can. You may need to keep taking treatment for the rest of your life.
Drugs that protect your joints are called disease-modifying drugs. They may take a few months to start working. Most of them come as tablets. Some common ones are:
Your doctor may suggest you take several disease-modifying drugs together. Your treatment may vary over time depending on your symptoms.
All of these treatments can have side effects. Your doctor will explain these to you. You may need to go for check-ups to keep an eye out for side effects. If you do get problems, your doctor will be able to help you switch to a different combination of drugs.
If your treatment isn't helping, your doctor may recommend a type of disease-modifying drug called a tumour necrosis factor antagonist. They're given as an injection or a drip. Examples are:
Your doctor will talk to you about the side effects you can expect.
Low doses of steroids can help to reduce the pain and swelling of rheumatoid arthritis. They also help to protect your joints. These steroids aren't the same as the steroids used by bodybuilders. They're similar to chemicals your body makes naturally. Steroids can cause side effects if you take them for a long time. But you'll probably be given a fairly low dose. This should mean you're less likely to get side effects.
Rituximab (MabThera) is a fairly new treatment for rheumatoid arthritis. It's only suitable for people who haven't been helped by other drugs. It's usually given at the same time as methotrexate. It's given as a drip.
A lot of the drugs that protect your joints also help with pain. But it's a good idea to talk to your doctor about painkillers too.
Paracetamol is a simple painkiller. Be careful not to take too much. An overdose can be dangerous. Your doctor can prescribe stronger painkillers if you need them.
Drugs called NSAIDs help with pain and inflammation. Some examples are ibuprofen, diclofenac (Voltarol) and naproxen (Naprosyn and Synflex). You can buy low doses of ibuprofen yourself. You can also get stronger NSAIDs or larger doses from your doctor. If one NSAID doesn't work for you, another might.
NSAIDs can upset your stomach if you take them regularly. More rarely, they can cause stomach ulcers. Doctors sometimes suggest you take a drug to protect your stomach.
Taking high doses of NSAIDs regularly for a long time may slightly increase your risk of a heart attack or stroke. Some NSAIDs aren't recommended at all for people with heart problems. For others, doctors recommend you take the lowest dose that helps with your pain. The overall risk is fairly small. In a study where people took ibuprofen or diclofenac, for every 1,000 people regularly taking high doses, an extra three had a heart attack or stroke.
You may want to try other ways of coping with pain, as well as taking drugs. Some people find that a warm bath or shower helps. Wrapping an ice pack (or a bag of frozen vegetables) in a towel and putting it on the joint may also help.
Exercise can help with pain and stiffness, as long as you do something that doesn't stress your joints. Swimming can be good. A physiotherapist can help you find exercises that suit you.
You may hear people say that eating certain foods, or avoiding certain foods, can help with rheumatoid arthritis. But there's very little research on this. Some doctors think that eating more oily fish, such as salmon or mackerel, may help. But no-one knows for certain. It's important to remember this if you see adverts for supplements or diets, especially if they're expensive. There isn't any proof that they work.
One person's experience of rheumatoid arthritis may be very different to another's. So it's hard to say what will happen to you. But new treatments are helping people with rheumatoid arthritis stay mobile and active for longer.
For some people, the symptoms of rheumatoid arthritis are always fairly mild. However, most people go on to get more severe symptoms. You may find your symptoms flare up at times, and become more painful. A small number of people (about 1 in 20) get more severe damage to their joints. This can make everyday tasks difficult.
You may find having arthritis a daunting prospect. But treatments can really help. Drugs can help protect your joints and prevent pain. If your pain gets worse, talk to your doctor. There are extra treatments that will help.
It's also important to get support if you need it. Your family and friends may be able to help you. And your doctor will be able to tell you what kinds of help and support are available in your area.
This information does not replace medical advice. If you are concerned you might have a medical problem please ask your Boots pharmacy team in your local Boots store, or see your doctor.
© BMJ Publishing Group Limited ("BMJ Group") 2007. All rights reserved
This information does not replace medical advice.
If you are concerned you might have a medical problem please ask your Boots pharmacy team in your local Boots store, or see your doctor.