Treatments for rheumatoid arthritis can help reduce inflammation in the joints, relieve pain, prevent or slow down joint damage, reduce disability and enable you to be as active as possible.

Although there's no cure for rheumatoid arthritis, early treatment and support (including medicine, lifestyle changes, supportive treatments and surgery) can reduce the risk of joint damage and limit the impact of the condition.

Your treatment will usually involve care from your GP and several different specialists.

There are medicines available to help stop rheumatoid arthritis from getting worse and reduce your risk of further problems.

These are often divided into main 2 types: disease-modifying anti-rheumatic drugs (DMARDs) and biological treatments.

Relatedsearches

Disease-modifying anti-rheumatic drugs (DMARDs)

If you've been diagnosed with rheumatoid arthritis, you'll usually be offered a combination of DMARD tablets as part of your initial treatment.

These medicines ease the symptoms of the condition and slow down its progression.

DMARDs work by blocking the effects of the chemicals released when your immune system attacks your joints, which could otherwise cause further damage to nearby bones, tendons, ligaments and cartilage.

The DMARDs that may be used include:

• methotrexate
• leflunomide
• hydroxychloroquine
• sulfasalazine

Methotrexate is usually the first medicine given for rheumatoid arthritis, often with another DMARD and a short course of steroids (corticosteroids) to relieve any pain.

These may be combined with biological treatments.

Common side effects of methotrexate include:

• feeling sick
• loss of appetite
• a sore mouth
• diarrhoea
• headaches
• hair loss

The medicine can also affect your blood cells and liver, so you'll have regular blood tests to monitor this.

Less commonly, methotrexate can affect the lungs, so you may have a chest X-ray and possibly a breathing test when you start taking it. This is to provide a comparison if you develop shortness of breath or a persistent dry cough while taking it. But most people tolerate methotrexate well.

It can take a few months to notice a DMARD working. It's important to keep taking the medicine, even if you do not notice it working at the beginning.

It's important to take methotrexate as instructed by your doctor, and see your doctor if you have any side effects.

You may have to try 2 or 3 types of DMARD before you find the one that's most suitable for you.

Once you and your doctor find the most suitable DMARD, you'll usually have to take the medicine long term.

Relatedsearches

Medicine to relieve pain

n addition to the medicines used to control the progression of rheumatoid arthritis, you may also need to take medicine specifically to relieve pain.

Painkillers

In some cases, you may be advised to use painkillers, such as paracetamol or a combination of paracetamol and codeine (co-codamol), to relieve the pain associated with rheumatoid arthritis.

These medicines do not treat the inflammation in your joints, but they may be helpful in relieving pain in some people.

Non-steroidal anti-inflammatory drugs (NSAIDs)

In addition to, or instead of, painkillers such as paracetamol, your doctor may prescribe a non-steroidal anti-inflammatory drug (NSAID).

This may be a traditional NSAID, such as ibuprofen, naproxen or diclofenac. Or your doctor may prescribe a type called a COX-2 inhibitor, such as celecoxib or etoricoxib.

These medicines can help relieve pain while also reducing inflammation in the joints, although they will not stop rheumatoid arthritis getting worse over time.

Your doctor will discuss with you what type of NSAID you should take, and the benefits and risks associated with it.

Although uncommon, taking NSAIDs can increase the risk of serious stomach problems, such as internal bleeding.

This is because the medicines can break down the lining that protects the stomach against damage from stomach acids.

If you're prescribed NSAID tablets, you'll often be given another medicine to take with it, such as a proton pump inhibitor (PPI).

Taking a PPI reduces the amount of acid in your stomach, which reduces the risk of damage to your stomach lining.

Steroids

Steroids are powerful medicines that can help reduce pain, stiffness and inflammation.

They can be given as:

• a tablet (for example, prednisolone)
• an injection directly into a painful joint
• an injection into a muscle (to help lots of joints)

They're usually used to provide short-term pain relief – for example, while you're waiting for DMARD medicines to take effect or during a flare-up.

Steroids are usually only taken for a short time because long-term use can have serious side effects, such as:

• weight gain
• osteoporosis (weakening of the bones)
• easy bruising
• muscle weakness
• thinning of the skin