Living with rheumatoid arthritis (RA) can feel overwhelming, but today’s treatments offer more hope. From medications that slow disease progression to therapies that ease symptoms, treatments for RA have become more effective than ever. Whether you’ve just been diagnosed or are looking into new treatments, learning about your options can help you take charge of your condition.

Although there’s no cure yet for RA, modern treatments can significantly reduce pain, improve mobility, and protect your joints from long-term damage. The journey often begins with safer, low-risk therapies, progressing to more intensive options when needed. Your treatment plan will depend on how severe your symptoms are, your lifestyle, and your overall health.

Here’s a detailed look at the medications, surgical options, and lifestyle changes available to effectively manage RA.

Nonsteroidal Anti-Inflammatory Drugs

Nonsteroidal anti-inflammatory drugs (NSAIDs) are often the first line of defense for managing mild to moderate pain and inflammation. They work by blocking the production of prostaglandins, which are chemicals in the body that trigger inflammation. While NSAIDs do not stop RA progression, they provide short-term relief, particularly during flares.

Common over-the-counter NSAIDs include:

• Aspirin
• Ibuprofen
• Naproxen

Some prescription NSAIDs for RA include:

• Celecoxib (Celebrex)
• Diclofenac sodium and misoprostol (Arthrotec)
• Fenoprofen calcium (Nalfon)
• Indomethacin
• Meloxicam (Mobic)

Potential side effects of NSAIDs include stomach ulcers or irritation, an increased risk of bleeding, or sometimes elevated blood pressure with long-term use and higher doses.

Glucocorticoids

Glucocorticoids, commonly called corticosteroids, are powerful anti-inflammatory medications that can quickly reduce swelling and pain in RA. They work by slowing down the immune system and lowering the levels of substances that cause inflammation. Common glucocorticoids include:

• Prednisone
• Dexamethasone
• Methylprednisolone

Glucocorticoids are typically used for short-term symptom control during RA flares or as bridge therapy while waiting for slower-acting disease-modifying antirheumatic drugs (DMARDs) to take effect. They can be administered orally (by mouth), intravenously (into the vein), or directly injected into the affected joints.

Long-term use of glucocorticoids can lead to significant side effects, including osteoporosis (a condition that makes bones weak), weight gain, high blood sugar, and increased risk of infections. To lessen this risk, doctors often prescribe the lowest effective dose for the shortest duration possible.

Disease-Modifying Antirheumatic Drugs

DMARDs are the foundation of RA treatment. They slow disease progression, reduce inflammation, and prevent joint damage. These drugs are grouped into three main categories: conventional DMARDs, biologic DMARDs, and targeted DMARDs.

Conventional Disease-Modifying Antirheumatic Drugs

Conventional DMARDs are well-established treatments taken orally, but some may also be injected. Examples include:

• Hydroxychloroquine (Plaquenil) — Taken orally as a pill; typically mild but effective for RA
• Leflunomide (Arava) — Taken orally as a pill
• Methotrexate — A first-line treatment that can be taken orally or injected
• Sulfasalazine (Azulfidine) — Taken orally as a pill and often combined with other DMARDs

Biologic DMARDs

Biologic DMARDs are advanced treatments made from living cells. They target specific parts of the immune system, like proteins that cause inflammation. These are typically injectable medications, but some are available as a pill.

Tumor Necrosis Factor Inhibitors

Tumor necrosis factor (TNF) inhibitors block a protein called tumor necrosis factor-alpha, which is overproduced in people with RA and leads to joint inflammation and damage. By targeting this specific protein, TNF inhibitors reduce pain, swelling, and stiffness while preventing further joint damage. Examples include:

• Adalimumab (Humira)
• Certolizumab pegol (Cimzia)
• Etanercept (Enbrel)
• Golimumab (Simponi)
• Infliximab (Remicade, Renflexis, Renflectra, Avsola)

These medications are usually given by subcutaneous injections (under the skin) or intravenously. TNF inhibitors have worked well for many people with moderate to severe RA who have not had relief from conventional DMARDs alone.

Non-TNF Biologics

Non-TNF biologics target other immune system pathways involved in RA when TNF inhibitors are not effective. These drugs focus on blocking different proteins or cells responsible for inflammation. The following non-TNF biologic agents are FDA approved for RA:

• Abatacept (Orencia)
• Anakinra (Kineret)
• Rituximab (Rituxan)
• Sarilumab (Kevzara)
• Tocilizumab (Actembra)

Biologics are given either subcutaneously or intravenously. Most are taken every few weeks, depending on the medication.

JAK Inhibitors

JAK inhibitors, a type of targeted DMARD, are pills that block Janus kinase pathways, which play a role in immune system activity and inflammation. These are often used when other DMARDs aren’t effective and are a convenient alternative for patients who prefer oral medications over injections. Examples include:

• Baricitinib (Olumiant)
• Tofacitinib (Xeljanz)
• Upadacitinib (Rinvoq)

Potential side effects of DMARDs include an increased risk of infections, liver problems, and, rarely, certain cancers. Your doctor will monitor your health closely while on these medications.

Biosimilars

Biosimilars are nearly identical versions of biologic drugs. They’re a more affordable option while still being just as effective. They are FDA-approved and work the same way as biologics. For example, biosimilars for adalimumab (Humira) such as Amjevita and Cyltezo provide the same benefits as the original medication while reducing costs. Ask your doctor if a biosimilar is a suitable option for your treatment plan.

Surgery for Severe Joint Damage

Surgery is less common today thanks to earlier diagnosis and effective treatments. However, it may be necessary in cases of severe joint damage. Common surgical procedures for RA include:

• Joint replacement (arthroplasty) — Damaged joints, often hips or knees, are replaced with prosthetics to restore function and reduce pain.
• Joint fusion (arthrodesis) — Joints in the wrists, ankles, or fingers are fused to stabilize and reduce pain. This limits motion but can provide relief in severely damaged joints.
• Synovectomy — Inflamed tissue lining the joints is surgically removed, which can ease pain and swelling.
• Tendon repair — RA can cause tendons to rupture, and surgery restores joint movement and prevents deformity.

Lifestyle Changes To Support RA Treatment

Although medications play a significant role in RA management, lifestyle changes can complement treatment and improve quality of life.

Diet

A balanced diet with fresh fruits, vegetables, whole grains, and unsaturated fats can help reduce inflammation. Following an anti-inflammatory diet or avoiding foods like red meats and nightshade vegetables may help some individuals. Some examples of nightshade vegetables include tomatoes, potatoes (not sweet potatoes), peppers (including bell peppers, chili peppers, and paprika), and eggplant.

Exercise

Regular low-impact exercise helps maintain joint flexibility, reduce stiffness, and prevent conditions like osteoporosis and heart disease. Consult a physical therapist to create a safe, effective exercise plan.

Weight Management

Excess weight adds strain to strain to joints and can worsen RA symptoms. Maintaining a healthy weight can reduce disease severity and improve balance and joint support, making daily activities easier.

Complementary and Alternative Therapies

While not replacements for medication, complementary therapies such as the following are explored by some people with RA:

• Acupuncture — May help relieve pain for some individuals
• Herbal supplements — Popular but not always supported by strong scientific evidence
• Ayurvedic medicine — A traditional approach that some people find helpful
• Massage therapy — May ease muscle tension and stiffness
• Mindfulness and mediation — Help manage stress, which can exacerbate RA symptoms

Always consult your doctor before trying alternative treatments, as they may interact with your medications or cause side effects.

Is There a Cure for Rheumatoid Arthritis?

Despite the ongoing research, there’s no cure for RA yet. However, treatments today are more effective than ever, making it possible to live a full, active life with RA. By working closely with your healthcare team, you can develop a personalized plan that addresses your needs and improves your quality of life.

Talk With Others Who Understand

On myRAteam, the social network for people with rheumatoid arthritis and their loved ones, more than 206,000 members come together to ask questions, give advice, and share their stories with others who understand life with RA.

Are you living with RA and considering any of these treatments? What treatments have you used for your RA? Share your experience in the comments below, or start a conversation by posting on your Activities page.