Rheumatoid arthritis

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Diagnosis

Your healthcare provider may refer you to a physician who specializes in arthritis (rheumatologist). Rheumatologists diagnose people with rheumatoid arthritis based on a combination of several factors. They’ll do a physical exam and ask you about your medical history and symptoms. Your rheumatologist will order blood tests and imaging tests.

The blood tests look for inflammation and blood proteins (antibodies) that are signs of rheumatoid arthritis. These may include:

Erythrocyte sedimentation rate (ESR) or “sed rate” confirms inflammation in your joints.

C-reactive protein (CRP).

About 80% of people with RA test positive for rheumatoid factor (RF).

About 60% to 70% of people living with rheumatoid arthritis have antibodies to cyclic citrullinated peptides (CCP) (proteins).

Your rheumatologist may order imaging tests to look for signs that your joints are wearing away. Rheumatoid arthritis can cause the ends of the bones within your joints to wear down. The imaging tests may include:

X-rays.

Ultrasounds.

Magnetic resonance imaging (MRI) scans.

In some cases, your provider may watch how you do over time before making a definitive diagnosis of rheumatoid arthritis.

Treatment

There’s no cure for RA, but there are effective treatments that can help you manage it and prevent damage.

Rheumatoid arthritis (RA) can require both patients and doctors to adjust as they figure out the best ways to treat the symptoms and slow the progression of the condition.

Recently, advances in treatment strategies have resulted in ever-improving outcomes and quality of life for those with rheumatoid arthritis. Treat to Target is a treatment philosophy that rheumatologists use to effectively manage this disease.

The treat-to-target approach has resulted in fewer symptoms and higher remission rates for those with RA. The treatment strategy involves:

setting a specific testing goal that signals either remission or low disease state

testing acute phase reactants and performing monthly monitoring to assess progress of treatment and management plan

switching medication regimen promptly if progress isn’t made

Treatments for RA help to manage the pain and control the inflammatory response. In many cases, this can result in remission. Decreasing the inflammation can also help to prevent further joint and organ damage.

Treatments may include:

medications

alternative or home remedies

dietary changes

specific types of exercise

Your healthcare provider will work with you to determine the best treatment plan for your medical needs.

For many people, these treatments help them live an active life and reduce the risk of long-term complications.

Learn more about specific RA treatments and how to treat flares.

Rheumatoid arthritis medications

There are many types of medication for RA. Some of these medications help to reduce the pain and inflammation of RA. Others help to reduce flares and limit the damage that RA does to your joints.

The following over-the-counter medications help reduce the pain and inflammation during RA flares:

nonsteroidal anti-inflammatory drugs (NSAIDs)

corticosteroids

acetaminophen (reduces pain but not inflammation)

The following drugs work to slow the damage that RA can cause to your body:

Disease-modifying antirheumatic drugs (DMARDs). DMARDs work by blocking your body’s immune system response. This helps to slow down the progression of RA.

Biologics. These new generation biologic DMARDs provide a targeted response to inflammation rather than blocking your body’s entire immune system response. They are an effective treatment for people who don’t respond well enough to more traditional DMARDs.

Janus kinase (JAK) inhibitors. These are a newer subcategory of DMARDs that block certain immune responses. JAK inhibitors are drugs that your healthcare provider may use to help prevent inflammation and stop damage to your joints when DMARDs and biologic DMARDs don’t work for you.