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For people with rheumatoid arthritis (RA), the following treatments can help to manage pain, inflammation, stiffness, and decreased functioning:
Heat improves blood circulation to the treated area. Applying heat via warm soaks, whirlpools, paraffin, or heating pads can be very soothing. Most doctors recommend that you apply the heat for about 10 minutes at a time, 3-4 times a day.
Cold can help decrease inflammation in an affected joint, thereby relieving pain and improving stiffness and movement.
Apply an ice pack for 20-30 minutes at a time, several times each day. Do not put the ice directly on the unprotected skin.
In this therapy, the affected joint is injected with a solution containing a corticosteroid medication such as:
Steroids can help decrease inflammation and therefore pain in the joint. Sometimes, your doctor will remove excess joint fluid from the joint just before injecting the steroid medicine.
Steroid injections often have to be repeated every several months. Most practitioners believe that you shouldn’t get more than three or four such injections in a year. More injections may cause damage to the joint cartilage.
Physical therapy can help you decrease pain and stiffness, increase muscle strength, develop flexibility, and improve stamina. Physical therapists can teach you exercises to do on your own, or you can attend regular physical therapy sessions.
Therapy and stress reduction techniques, like meditation, can ease the difficulties of living with a chronic, painful condition. In a 2009 study, people with RA were assigned to one of three treatment groups: cognitive behavioral therapy (CBT), meditation , or standard treatment. Those in the CBT and meditation groups reported an improvement in pain and their ability to cope with RA compared to those who received standard treatment.
If you are having trouble getting around, a cane or walker may help. In addition, a variety of devices are available to help you with tasks that RA can make difficult or impossible, such as buttoning or zipping your clothing, opening jars, opening doors, and other activities of daily living. Talk to your doctor about the kinds of assistance you need. He may recommend a consultation with an occupational therapist.
This is a treatment that involves filtering your blood through a medical device that removes antibodies. The rest of the blood is then returned to you. The procedure takes about 2 hours and is usually done weekly for 12 weeks. Most patients don’t notice improvement of their symptoms until around the 12-week mark. Side effects may include:
Some people with RA become depressed and anxious . Consider finding a support group where you can meet other people who have learned to cope with the challenges of RA. Sharing your own experiences and learning from the struggles and triumphs of others can be helpful.
References:
Arthritis Foundation website. Available at: http://www.arthritis.org/ .
Cecil RL, Goldman L, Bennett J. Cecil Textbook of Medicine. 21st ed. Philadelphia, PA: WB Saunders Company; 2000.
Conn HF, Rakel. Conn’s Current Therapy. 54th ed. Philadelphia, PA: WB Saunders Company; 2002: 720-721.
National Institute of Arthritis and Musculoskeletal and Skin Diseases website. Available at: http://www.niams.nih.gov/ .
¹4/16/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php : Zautra AJ, Davis MC, Reich JW, et al. Comparison of cognitive behavioral and mindfulness meditation interventions on adaptation to rheumatoid arthritis for patients with and without history of recurrent depression. J Consult Clin Psychol. 2008;76:408-421.
Last reviewed September 2009 by Jill D. Landis, MD
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.
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