How is rheumatoid arthritis treated?

Written by Yang Ya Meng
Rheumatology
Updated on September 26, 2024
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Rheumatoid arthritis, also commonly referred to as internal rheumatoid arthritis, primarily has three major categories of treatment. The first category is anti-inflammatory and pain relief. The medications for anti-inflammatory pain relief include two types: the first type is non-steroidal pain relievers; for patients with very severe pain, a low dose of corticosteroids can be considered. The second category, which is also the most important treatment, involves the use of immunosuppressants. These immunosuppressants include drugs such as methotrexate and leflunomide. If the patient does not respond well to anti-inflammatory pain relief and immunosuppressants, treatment with biologics can also be considered.

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Written by Liu Li Ning
Rheumatology
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Rheumatoid arthritis hurts more at night or during the day?

The pain of rheumatoid arthritis is irregular. It can hurt at night or during the day, and it varies from person to person. The onset of rheumatoid arthritis is somewhat related to streptococcal infection. Clinically, it mainly presents as migratory swelling and pain in the large joints of the limbs, generally without leaving joint deformities. The onset of rheumatoid arthritis is related to streptococcal infection, so it requires treatment with penicillin antibiotics. During the acute phase, it is also recommended to use non-steroidal anti-inflammatory drugs to alleviate symptoms. Commonly used drugs include sustained-release capsules of diclofenac sodium, meloxicam, or etoricoxib.

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Written by Yang Ya Meng
Rheumatology
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Rheumatoid arthritis diagnostic tests

The diagnostic tests for rheumatoid arthritis include blood tests and X-ray examinations. Blood tests include a complete blood count, inflammatory markers, erythrocyte sedimentation rate, C-reactive protein, and screening for various antibodies such as rheumatoid factor, anti-O, anti-CCP antibodies, and anti-AKA antibodies. Additionally, if there is significant pain in the hand joints, an X-ray of the hand joints can be taken. The X-ray can show whether there is any destruction of bone, osteoporosis, or other manifestations of rheumatoid disease. Based on these tests, it is generally possible to diagnose the specific type of rheumatoid disease.

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Written by Guan Yu Hua
Orthopedic Surgery
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Difference between arthritis and rheumatoid arthritis

Arthritis is typically osteoarthritis, a chronic inflammation characterized primarily by degenerative changes in joint cartilage, followed by bone proliferation, making it a chronic disease. Early pathological changes include alterations in joint cartilage, such as subchondral bone extrusion, followed by changes in the muscles surrounding the periosteum and joint capsule. Early radiographic examinations can provide a definitive diagnosis. Its symptoms primarily manifest as pain. For rheumatoid arthritis, it generally presents as morning stiffness and joint swelling and pain more severe than in the surrounding area, which can essentially confirm a diagnosis. It usually affects large joints such as the knee, shoulder, or wrist joints, typically presenting as migratory pain. A definitive diagnosis can usually be made by testing for rheumatoid factor, with an anti-O level exceeding 500 units. Additionally, there may be a slight increase in white blood cells, accelerated erythrocyte sedimentation rate, and elevated C-reactive protein. Examination of the synovial fluid shows increased white blood cells and neutrophils. In such cases, using anti-rheumatic drugs might suffice, but it’s also crucial to ensure rest and local heat application. These two types of arthritis fundamentally differ.

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Written by Liu Li Ning
Rheumatology
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Can rheumatoid arthritis be cured through exercise?

Rheumatoid arthritis can be somewhat alleviated by exercise in terms of disease recovery. Rheumatoid arthritis primarily manifests as migratory swelling and pain in the major joints throughout the body. The onset of the disease is somewhat associated with streptococcal infections. In recent years, due to the widespread use of penicillin, rheumatoid arthritis has become very rare in clinical settings. Since the onset of rheumatoid arthritis is related to infections, long-acting penicillin is generally used for treatment if there is no accompanying carditis. Joint pain can be treated with non-steroidal anti-inflammatory drugs such as etoricoxib or sustained-release capsules of diclofenac sodium; if carditis is present, corticosteroids can be used. Patients with rheumatoid arthritis can engage in gentle aerobic exercises like swimming, yoga, jogging, Tai Chi, etc.

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Written by Liu Li Ning
Rheumatology
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Do you need to take X-rays for rheumatoid arthritis?

Rheumatoid arthritis requires imaging, especially of the affected joints. It is typically necessary to do this routinely. The main purpose is to check for any bone damage, primarily to differentiate it from rheumatoid arthritis. Because rheumatoid arthritis generally does not leave joint deformities, while rheumatoid arthritis, if not treated properly, can lead to bone destruction and in severe cases, joint fusion. In addition to imaging, rheumatoid arthritis also requires complete blood count, erythrocyte sedimentation rate, C-reactive protein, anti-streptolysin O, and echocardiography among other tests to comprehensively assess the condition and determine the treatment plan.