Because the newest medications have been studied only in selected, and often the healthiest, people, they may have side effects that are not yet well known. For example, new risks were discovered for infliximab a year or two after it was approved for use. Studies found that tuberculosis, although rare, was more common than expected among those receiving treatment. In addition, in a trial of infliximab treatment for congestive heart failure, a higher death rate was observed compared with those not receiving the drug. These findings have led to new recommendations about how patients should be screened before treatment begins. Because these medications take some time to start working, your doctor probably will advise you to take an NSAID, a corticosteroid or both during the early weeks or months of treatment with a DMARD.
Diet, Exercise and Rehabilitation Services Finding a balance between rest and exercise is crucial to managing rheumatoid arthritis. When your symptoms flare up - when your joints are sore, warm and swollen - take it easy and rest. You can continue to do range-of-motion exercises to keep your joints mobile, but be careful not to tire yourself or aggravate your joints. Avoid unnecessary walking, housework or other activities. When your joints feel better and when other symptoms, including fatigue and morning stiffness, are less noticeable, increase your activity. Weight-bearing exercises such as walking and lifting weights can strengthen weakened muscles without risking additional joint damage. If exercise produces more pain or joint swelling, cut back a bit.
Despite many claims, there are no dietary changes, supplements, herbs or other alternative therapies known to improve the symptoms of rheumatoid arthritis over a long period of time.
Having rheumatoid arthritis often means that you have to pay special attention to the way you move. An occupational therapist or physical therapist can offer suggestions and guidance as you manage ordinary tasks around your home and work. In addition, a therapist can provide special devices that can help you conserve energy and protect your joints during your daily activities. A splint, brace, sling or Ace bandage worn when your joints are especially tender can take the pressure off the joints and protect them from injury. A podiatrist may provide shoe inserts (orthotics) or even suggest surgery to improve pain and function in arthritic feet.
Surgery In some cases, surgery is needed to remove inflamed tissue, or to reconstruct or replace the affected joint. When rheumatoid arthritis causes significant destruction and pain in the hip or knee, arthroplasty, a surgical procedure to replace the joint, may be an effective option. Because rheumatoid arthritis may cause tendon damage, especially in the hand and wrist, surgical tendon repair may be recommended.
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