Severe Rheumatoid Arthritis (Treatment Options)

There is still no cure for systemic inflammatory disease called rheumatoid arthritis (RA). But it is manageable and treatable condition. Currently, the best thing we can do is to prevent it from getting worse, control its inflammatory process, and reduce the risk of its complications. And in severe RA, surgical treatment options may be suggested if other medications fail to work.

Once diagnosed, RA is a lifelong disorder of the abnormality immune system that causes inflammation in the joints. It can lead to a number of signs and symptoms. But the primary symptoms are pain, redness, swelling and increased heat in the affected joints.

Certain medications, particularly when given and started early, will be so helpful to improve the prognosis and outlook of the disease. Though this issue is still debatable, some experts believe that the first 2 years after the symptom onset are so crucial to cope with the disease.

Patients with RA who get and take appropriate treatments in the early stage of the disease are more likely to become easier to treat and control the disease.

On the other hand, if the disease is poorly controlled in the first years, there will be greater chance for RA complications to occur and the disease is more difficult to treat.

Some patients think that taking pain medication for RA is enough for coping. This option may be helpful enough to improve the symptom (especially for joint pain), but it only treats the symptom – not the disease itself!

DMARDs and biologic-agent medications are the common choices to aggressively treat and control the inflammatory process of RA. They can target the main cause of the disease, the over-active ‘abnormality’ of the body immune system.

Even these medications may make the disease go into remission, too. For in-depth information about the crucial initial treatments for RA and how DMARDs & biologic agents work, see this post!

Chronic RA that comes and goes can lead to damage to the joint, causing disability in severe cases.

The good news, the use of surgery for RA is declining (see more in here). But to restore the function of the affected joint, sometimes surgery may be required – particularly true if other medications fail to work.

Surgical option may also be suggested to help ease the joint pain. The following are some procedures of surgery for RA.

Repairing joints of the hands

These include:

1. Carpal tunnel syndrome is one of common RA complications. In severe case, surgery may be required to cut a ligament in the wrist, release carpal tunnel, and relieve pressure on a nerve!
2. Surgery to help release and treat inflamed tissues that line the joints of the fingers.
3. If there is a severe abnormal bending, surgery may be suggested to remove tendons in the fingers.

Joint replacement

In a few cases, severe RA may cause serious joint damage and surgery may be needed to replace part or even all of a joint (such as joints of shoulder, knee, or hip). This procedure is called ‘arthroplasty’ (joint replacement), a major operation that can involve a couple of weeks in the hospital and months for rehabilitation.

In arthroplasty, the specialist removes the damaged part or all of a joint – and then he will insert prosthesis (artificial part of joint, made of plastic or/and metal) that has a limited lifespan.

In addition, joint fusion may be suggested if you cannot take a joint replacement. It can help realign or stabilize a joint, too!