Can rheumatoid arthritis be cured?

Rheumatoid arthritis, where the immune system attacks the membranes that line your joints, is a chronic autoimmune disease that often causes pain, swelling, stiffness and eventually, the progressive destruction of your joints. While some conditions like osteoarthritis have to do with wear and tear over time, rheumatoid arthritis is driven by a dysfunction in your immune system.

Rheumatologist Brinda Basida, MD, explained the symptoms of rheumatoid arthritis to watch for, as well as how it’s diagnosed and treated.

Rheumatoid arthritis is about far more than joint pain

“While the stereotypical image of the disease is of painful, swollen hands and feet, rheumatoid arthritis is a systemic condition,” said Dr. Basida. “Someone living with RA may experience issues with fatigue, cardiovascular disease, osteoporosis, lung involvement and more.”

T cells, B cells and macrophages infiltrate the lining of your joints, forming a kind of tissue called ‘pannus’ that invades and destroys cartilage and bone. As inflammation worsens, so does the pain, swelling and joint damage that RA is most known for.

What causes someone to develop rheumatoid arthritis?

“Frustratingly, we’re not yet sure the exact cause of RA,” said Dr. Basida. “However, we do know there are risk factors that can make you more likely to develop it.”

If you are born female or have a family history of the condition, you’re more likely to develop RA. It’s also much more likely to develop in middle age, although children and young teens can get a related condition called juvenile idiopathic arthritis. Those who are overweight or who have dealt with a gum infection called periodontal disease have a higher risk as well.

Finally, smoking raises your risk for developing RA. Those who continue to smoke after RA develops also tend to experience a worsening of the condition.

How is rheumatoid arthritis diagnosed?

“RA is diagnosed using a combination of factors,” said Dr. Basida. “Generally, a diagnosis is supported using the 2010 ACR/EULAR classification criteria, which assigns points across four different aspects of the disease, including joint involvement, how long your symptoms have lasted, how certain blood markers change in concentration during times of inflammation, and blood tests that look for those antibodies attacking your own healthy tissues.”

When working to diagnose rheumatoid arthritis, your provider may order X-rays or an MRI alongside blood tests to rule out other causes like lupus.

“Early diagnosis is critical when it comes to treating RA,” added Dr. Basida. “If we can get treatment moving within the right window of opportunity, we have the chance to prevent the joint damage from progressing in most patients.”

How is rheumatoid arthritis treated?

Treatment follows a treat-to-target strategy, meaning the doctor and patient set a goal, monitor progress and adjust treatment accordingly. In the case of RA, the goal is for inflammation and symptoms to be reduced or low disease activity within 6 months.

“First line therapy is a medicine called methotrexate, which we consider an anchor drug,” said Dr. Basida. “This is often combined with short-term use of glucocorticoids, known commonly as steroids, to treat the inflammation. Up to 40% of patients will see improvement just using methotrexate.”

For those whose response to methotrexate isn’t enough, other targeted medication may be used to help suppress an overactive immune system or calm inflammation.

With ongoing treatment, Dr. Barisa estimates that 75-80% of people living with RA will be able to experience remission or low disease activity.

Can rheumatoid arthritis be cured?

“There is currently no cure for rheumatoid arthritis,” said Dr. Basida. “However, with early diagnosis and modern treatment strategies, the disease can be effectively controlled in the majority of patients, preventing irreversible joint damage and disability.”

Some patients have been able to remain in remission without ongoing use of medication, but so far these patients are the exception. Most will need ongoing therapy and treatment.

How can I manage rheumatoid arthritis symptoms at home?

“There are some evidence-based recommendations for self-care,” said Dr. Basida. “The first is regular exercise, which is sometimes the hardest for those dealing with pain and swelling to commit to. There’s a saying that ‘motion is lotion.’ To keep yourself moving is to help improve pain and physical function. Your doctor can work with you on what kind of exercise would be best for you, as well as how often you may need to exercise and how intensely.”

Other ways to help care for RA symptoms at home include:

• Using warm compresses, ice packs or other ways of applying gentle heat or cold to treat inflammation and soothe pan.
• Sticking to a healthy diet. The Mediterranean diet, which is recommended for cardiac health, is also known to reduce inflammation for many living with RA. The diet focuses on fresh vegetables, fruits, fish and lean proteins, nuts, olive oil and whole grains.
• Acupuncture and massage therapy may help you feel more comfortable and reduce pain. Speak with your doctor first.
• Quitting smoking is known to help improve health on almost every level.
• You may want to supplement with omega-3 vitamins as part of your anti-inflammatory therapies. If you can take your omega-3s by eating foods like nuts and fish, this is more effective.
• Using splints, braces or other assistive devices may be helpful, especially when the disease is in its early stages.
• Pace out activities to avoid ‘overdoing it,’ which can worsen inflammation.
• Occupational therapy can help you develop ways to lessen your symptoms during your daily routine.

“While all these methods are helpful, none of them can replace the kind of treatment you receive from a rheumatologist,” said Dr. Basida. “Medical therapy for rheumatoid arthritis is the only way to prevent the disease from progressing.”