The good news is that there are many options to treat RA.
Everyone reacts differently to various medicines and treatments. What yields life-changing results in one person might not be a good fit for someone else. That’s why finding the right treatment for your rheumatoid arthritis (RA) might take a few tries. Luckily, you have plenty of other options if your rheumatoid arthritis treatment is not working.
What is the goal of treating rheumatoid arthritis?
Of course, the ultimate goals of treatment for RA are to help you feel better, perform everyday tasks with minimal pain, and enjoy a better quality of life. RA symptoms like joint pain and stiffness can really take a toll on your life and hold you back, so limiting those symptoms is key.
The other main goal of treatment is to control inflammation, which can help lower the risk of joint damage and other complications long term. Rheumatoid arthritis creates inflammation in the joints. This stems from the immune system mistakenly attacking the joint tissue. This constant inflammation fuels symptoms, but it also erodes the joints.
What are signs your rheumatoid arthritis treatment isn't working?
If you have been sticking to your RA treatment as prescribed, you should start to see results in weeks or months, depending on the treatment. Your RA treatment might not be working if you’re still having inflammation. You’ll know you’re having inflammation if you’re still feeling a lot of pain, redness, and swelling in the joints.
It’s possible that your treatment may reduce your pain and stiffness but not eliminate it. Whether or not you think it’s working might be subjective. If pain and stiffness are affecting your ability to do daily tasks, your work, or your hobbies, it might be time to talk to your doctor.
What are the next steps?
The first thing to do if you think your rheumatoid arthritis treatment is not working is to talk to your doctor. Be prepared to talk about:
- Symptoms you’ve been experiencing
- Any side effects you’ve had
- How symptoms and side effects are affecting your life
You and your doctor may then talk about how to tweak your treatment regimen, which may mean switching to a different type of therapy. Usually, your doctor will start you on the mildest treatment option. This can help find the right balance between efficacy, cost, side effects, and risks.
If you’re still having inflammation or pain on your current treatment, your doctor may suggest moving up the treatment ladder. For example, more advanced treatments for rheumatoid arthritis include:
- Biologics: These are therapies that target the specific parts of the immune system that are fueling disease activity. Biologics come in injection or infusion form.
- JAK inhibitors: These are oral medicines that block janus kinases (JAK). These are involved in the overproduction of cytokines (inflammatory proteins) in people who have rheumatoid arthritis. Blocking JAKs helps control that inflammation to reduce symptoms and the risk of joint damage.
Whether or not biologics or JAK inhibitors are right for you will be a discussion between you and your rheumatologist. There are many other types of treatments available, and it’s worth the effort to find the right one for you.
Dr. Navarro-Millan is a rheumatologist at the Hospital for Special Surgery.
- Rheumatoid arthritis: causes, symptoms, treatments and more. Atlanta, GA: Arthritis Foundation. (Accessed on August 5, 2021)
- Treatments. Atlanta, GA: American College of Rheumatology. (Accessed on August 5, 2021)
- Treatment of rheumatoid arthritis in adults resistant to initial conventional nonbiologic DMARD therapy. Waltham, MA: UpToDate, 2021. (Accessed on August 5, 2021)