How to treat or cure rheumatoid arthritis

Rheumatoid arthritis cannot yet be cured, but modern treatment can control it well. Many people reach remission or low disease activity, with little pain and good function. Early, steady treatment is the key to protecting the joints.

Treat to target The rheumatologist sets a goal of remission or low disease activity, checks progress every one to three months, and adjusts medicine until the target is reached.

Main treatment steps

1. Start a DMARD, usually methotrexate, as early as possible after diagnosis.
2. Add short-term steroids or NSAIDs to ease symptoms while the DMARD takes effect.
3. If control is not enough after about three months, combine DMARDs or add a biologic or targeted drug.
4. Continue the lowest effective dose long term, and review before reducing.

Supportive care

• Physiotherapy and occupational therapy to keep joints moving and protect them.
• Regular exercise, healthy diet, no smoking.
• Treatment of related problems, such as bone loss, anaemia and high cholesterol.
• Mental health support, since pain and fatigue affect mood.

Surgery Joint replacement, tendon repair or synovectomy may be considered for severe damage when medicines are not enough.

Is there a cure? Not currently. Stopping treatment usually brings the disease back, though some people on long remission can reduce doses under supervision.

Ayurvedic view (interpretive) Ayurvedic care may support diet and comfort but has limited evidence as a treatment for RA, so should only be an adjunct to medical treatment.

Urgent warning signs Fever with a very hot, swollen joint, chest pain, breathlessness, or severe infection signs on immune-suppressing medicine need prompt care. Call 112 in an emergency.

Remember See a rheumatologist early, and stay on treatment even when you feel well.