Treatment
There is no cure for RA. The goals of treatment are to:
- Relieve pain
- Reduce inflammation
- Slow down joint damage
- Improve functional ability
Medications
There are a variety of medicines to treat the pain and inflammation of RA. In some cases, medicines may be used in combination.
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Disease-modifying anti-rheumatic drugs (DMARDS)—to slow the course of the disease; used early in the course of the disease to prevent long-term damage:
- Methotrexate (eg, Rheumatrex)
- Hydroxychloroquine (eg, Plaquenil)
- Sulfasalazine (eg, Azulfidine)
- Leflunomide (eg, Arava)
- Cyclosporine (eg, Neoral)
- Penicillamine (eg, Cuprimine)
- Gold (eg, Ridaura)
- Minocycline (eg, Minocin)
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Immunosuppressive drugs (only used when other DMARDS are ineffective):
- Azathioprine (eg, Imuran)
- Cyclophosphamide (eg, Cytoxan)—rarely used
- Chlorambucil (eg, Leukeran)—rarely used
-
Over-the-counter medicines:
- Acetaminophen (eg, Tylenol)
- Nonsteroidal anti-inflammatory drugs (NSAIDs) including ibuprofen and naproxen
-
Biologic response modifiers—drugs that interfere with the autoimmune response; includes TNF-inhibitors, such as:
- Etanercept (eg, Enbrel)
- Infliximab (eg, Remicade)
- Adalimumab (eg, Humira)
- Golimumab (eg, Simponi)
- Certolizumab (eg, Cimzia)
Steroids
Low-dose corticosteroids (eg, prednisone ) are often used first. They may be tapered when other drugs start working. Avoid long-term steroid use. Corticosteroid injections to inflamed joints may also be used.
Rest and Exercise
Rest reduces active joint inflammation and pain and fights fatigue. Exercise is important for maintaining muscle strength and flexibility. It also preserves joint mobility.
Joint Care
Splints applied to painful joints may reduce pain and swelling. Devices that help with daily activities can also reduce stress on joints. Devices include:
- Zipper extenders
- Long-handled shoehorns
- Specially designed kitchen tools
Stress Reduction
Stress reduction can ease the difficulties of living with a chronic, painful disease. Participating in an exercise program or joining a support group are two strategies you can use to reduce stress. Cognitive behavioral therapy , a form of talk therapy, and meditation may also offer benefits in reducing your pain and improving your ability to cope with RA.
Surgery
Joint replacement and tendon reconstruction help relieve severe joint damage.
Lifestyle Measures
These may relieve stiffness and weakness and reduce inflammation:
- Maintain a balance between rest and exercise.
- Attempt mild strength training.
- Participate in aerobic exercise (eg, walking, swimming, dancing).
- Avoid heavy impact exercise.
- If you smoke, quit .
- Control weight.
- Participate in a physical therapy program.
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition. Copyright © 2026 EBSCO Publishing All rights reserved.
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