Joint swelling is a common symptom of rheumatoid arthritis (RA), an inflammatory autoimmune disease that occurs when the immune system mistakenly attacks the body’s own cells and tissues. RA can cause swelling in any joint, but the condition commonly affects the joints of the hands, wrists, and knees.

In people with RA, swollen joints are often accompanied by other symptoms, including joint pain, morning stiffness, and a limited range of motion in the affected areas. These symptoms can make it difficult to accomplish basic daily activities, such as opening doors, or to participate in certain kinds of physical activities.

There is no known cure for RA itself, but effective treatments can help relieve joint swelling and manage pain and discomfort. They can even stop the progression of the disease to help prevent permanent joint damage.

How To Manage Swollen Joints in RA

Managing joint swelling generally involves a combination of medication and self-management remedies. As always, your doctor is your best resource when it comes to finding the best treatment for your rheumatoid arthritis.

Medications

Your doctor may prescribe or recommend different types of drugs, alone or in combination, to manage joint swelling caused by RA.

Disease-Modifying Antirheumatic Drugs (DMARDs)

DMARDs work to improve swollen joints by altering the underlying RA itself. By slowing down the progression of the disease, DMARDs may help to improve RA symptoms like joint swelling.

Conventional DMARDs include:

• Trexall and Rheumatrex (methotrexate)
• Azulfidine (sulfasalazine)
• Arava (leflunomide)
• Plaquenil (hydroxychloroquine)

Another form of DMARDs, called biologic DMARDS or biologics, include:

• Rituxan (rituximab)
• Humira (adalimumab)
• Remicade (infliximab)
• Orencia (abatacept)
• Actemra (tocilizumab)
• Kevzara (sarilumab)
• Enbrel (etanercept)
• Cimzia (certolizumab pegol)
• Simponi (golimumab)

A newer form of DMARDs, called targeted synthetic DMARDs, include:

• Xeljanz (tofacitinib)
• Olumiant (baricitinib)
• Rinvoq (upadacitinib)

According to a 2019 study, a combined treatment of DMARDs and biologics “could lead to better improvement of the disease symptoms and decrease the severity and activity of the disease.”

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

NSAIDs are used to reduce mild to moderate pain and inflammation that accompany swelling. NSAIDs target the symptoms of RA, rather than the RA itself.

Common over-the-counter NSAIDs include Advil (ibuprofen) and Aleve (naproxen).

Steroids

Also known as corticosteroids, steroid drugs such as prednisone are effective at reducing inflammation to relieve joint swelling, stiffness, and pain. Steroids can be taken orally or injected into the affected joint.

Joint Aspiration

In some cases, your doctor may recommend draining excess fluid from a swollen joint through a procedure known as joint aspiration. Removal of the fluid, done through a needle or syringe, can help restore health to the joint.

Massage

Massage therapy can help reduce swelling and pain. If professional massages aren’t accessible, consider self-massage. With a little help on hard-to-reach areas, you can massage any swollen joint on your body at home.

Occupational Therapy and Assistive Devices

Consulting an occupational therapist can help you find ways to improve and maintain your utility at the workplace while you cope with swollen joints. They can share ways to protect your hands and maintain joint function by reducing the pressure exerted on them while doing daily tasks.

For example, an occupational therapist may recommend ergonomic tools, which are devices designed to improve comfort and reduce the risk of injury. Examples include:

• Spring-loaded scissors
• Wider-diameter pens
• Mounted jar openers
• Saw-handled (instead of flat-handled) knives

Heat or Cold Therapy

Applying heat or cold to the affected joint may help relieve some of the pain from swelling. Some myRAteam members find that hot and cold compresses work well as part of their regimen: “I take baths with Epsom salt and alternate heat with ice packs. This helps me a lot,” said one member.

“I have a heating pad with vibration,” shared another. “I use it in the evening for about half an hour on each joint and the following morning, I’m not so stiff and in pain.”

Elevation, Support, or Compression

For swelling, particularly in the feet or ankles, myRAteam members recommend compression socks, braces, orthotics, and periods of elevation to help.

“I have found orthotics for my shoes helped me a lot. I can't walk any distance without them. I also wear support stockings and they help a lot for the circulation in my legs. My ankles and legs still swell, but not as bad as they used to,” one member wrote.

“My ankles and feet are swollen up ... about all I can do is just get off my feet when it happens,” another member shared. “Elevating my feet and Epsom salt soaks help.”

Anti-Inflammatory Diet

An anti-inflammatory diet may have an impact on inflammation and swelling. To manage your swollen joints, avoid foods and ingredients that are believed to have inflammatory effects, such as refined carbohydrates, fried foods, sweetened beverages (like soda), and red meat. Read more about adopting an anti-inflammatory diet for RA.

Join the Community

On myRAteam, you'll have access to the social network for people living with RA and their loved ones. Currently, there are more than 144,000 members on the network.

What techniques do you use for managing joint swelling with RA? Share your thoughts in a comment below, or start a conversation by posting on myRAteam.