Once your diagnosis is confirmed, there are many treatments that can ease your pain and increase your movement. Non-medication therapies such as physiotherapy, occupational therapy, physical activity and relaxation techniques can all be helpful in the treatment of RA. There is, though, a range of prescription drugs that are used to help people manage the disease.

It's a good idea to keep a diary of to include a record of symptoms, questions for clinic appointments, medications, history and blood results. A list of all medication including supplements, over the counter drugs and prescribed drugs by your healthcare team should be included.

Outcomes in RA have improved by the recognition of the benefits of early diagnosis and treatment. This has resulted in new treatment strategies that aim to prevent, or at least reduce, joint damage. This is sometimes referred to as "treat to target".

Dozens of drugs are used to treat RA and many people are prescribed a combination of them. The general aim when treating RA is to reduce joint inflammation and prevent long-term damage to the joints.

Disease Modifying Anti-Rheumatic Drugs (DMARDS - pronounced dee-mards)

The mainstay of drug therapy for RA is Disease Modifying Anti-Rheumatic Drugs (DMARDs), which tackle the causes of inflammation (pain swelling and stiffness) in the joints. DMARDs are important because they help prevent damage to the joint.

Your doctor will recommend a therapy that is best suited to your type and stage of arthritis, other medical problems and medications. Sometimes these drugs are given by injection.

Taking any medication carries some risk, which must be balanced against the potential benefits. It is important to recognise that the risk of joint damage and permanent disability is much greater than the risk of side effects from DMARDs to control the disease. When properly monitored, the vast majority of side effects are rare, and most are reversible by adjusting the dose or switching medications.

Biologic Therapies

Biologic therapies are a newer group of disease-modifying drugs that may be used if other DMARDs aren’t working well enough. These are given either by injection or through a drip into a vein.

This also includes a category of medicines called biosimilars. These drugs are follow-on versions of original biological medicines. They are independently developed after the patent protecting the original product has expired. Biosimilar medicines are intended to have the same mechanism of action as the original biological medicines and are designed to treat the same diseases as the innovator’s product.

Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)

Non-steroidal anti-inflammatory drugs (NSAIDs - en-saids) are a class of medications used to treat the pain and inflammation of arthritis. They act by blocking the inflammation that occurs in the lining of your joints. Although NSAIDs reduce the day-to-day inflammation and can be very effective in controlling pain and stiffness, they don't tackle the long-term effects of the disease.

Steroids

Steroids (properly known as corticosteroids and sometimes referred to as cortisones) can be effective in reducing inflammation. Most people with RA who need steroids are prescribed prednisolone (brand names include Deltacortril, Predsol) usually only for a short time. 

Steroids are often prescribed in the early stages of treatment in combination with DMARDs and are also useful in bringing the disease under control when RA is active.

Steroid injections

Steroids can also be injected into an inflamed joint, or into muscles to treat soft tissue conditions, such as tennis elbow. They can be injected directly into the veins during an arthritis flare-up. Injecting doesn't usually cause the same side effects as tablet steroids.

Your doctor might recommend steroid injections if your joints are particularly painful or your ligaments and tendons have become inflamed.

Painkillers (Analgesics)

Painkillers are drugs used to help reduce pain and are also called analgesics. Painkillers come in varying strengths and types. Some are available over the counter, while stronger painkillers are by prescription only.

There are a number of different types of painkillers;

1. Simple Non-opiod Painkillers

The most common type of painkillers, usually available over the counter e.g. paracetamol, ibuprofen 

 2. Compound painkillers

A combination of drugs used in one tablet e.g. co-codamol, which includes paracetamol and a low dose of codeine

3. Opiod Analgesics

These are stronger painkillers containing a higher dose of opiod than the other painkillers e.g codeine, tramadol, morphine

Painkillers are usually taken by mouth or given by injection. However, slow release painkilling patches, known as opiod patches, are also available though not widely prescribed.

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