Question: What are the best treatments for rheumatoid arthritis?
Dr. Hibberd's answer:
The best treatments for rheumatoid arthritis usually involve the use of so-called disease-modifying antirheumatic drugs (DMARDs), as opposed painkillers, anti-inflammatories, or other meds that merely control symptoms.
The age of taking pain pills or anti-inflammatories alone — without stopping and controlling joint destruction — ended 10 years or more ago for people with rheumatoid arthritis. Most doctors feel that DMARDs and biologics are the first-line of treatment, with steroids and anti-inflammatories used as supporting treatments. In some cases, select surgical management — such as arthroscopic procedures and joint replacement — are needed.
Rheumatoid arthritis is an auto-immune disorder, where antibodies are formed that react with joint tissue lining to destroy joints and bones. This destructive process can now be prevented by early treatment, the earlier the better. In addition, many other organs are also damaged by rheumatoid disease.
While immune suppressants — in pill or injectable form — are now used to halt the disease process, some people are not able to use these due to adverse side effects, age, or other reasons. You will need to see a rheumatologist for supervision of immune suppressants, though your family physician or internist may be comfortable starting you on them in some cases.
Usually DMARDs are used for six weeks and then biologics are added, if needed. Some patients experience near-miraculous results with DMARDs and/or biologic treatments.
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