As rheumatoid arthritis is a chronic, progressive inflammatory disorder of joints, the symptoms continue to worsen unless inflammation of joints is minimized or stopped. The treatment for rheumatoid arthritis features a combination of medications and non-drug approaches. Drug approaches involve a large variety of medications that are used single or in combination.  Hydrotherapy, physical therapy, relaxation therapy, occupational therapy, heat and cold treatments are the non-drug approaches.

The treatment for rheumatoid arthritis focus on reducing pain and inflammation, managing the symptoms, decreasing the progression of disease, minimizing or preventing joint damage and deformities, improving and maintaining joint function and preserving range-of-motion and mobility of joints. Commonly used medications such as non-steroidal anti-inflammatory drugs, analgesics and steroids are helpful to ease the stiffness and pain.

Non-steroidal anti-inflammatory drugs (NSAIDs) including naproxen, diclofenac, ibuprofen and piroxicam can effectively reduce stiffness, pain and inflammation. COX-2 inhibitors including celecoxib (Celebrex) are the newer generation of NSAIDs. The pain-relievers such as paracetamol/acetaminophen, tramadol and opioids can help to manage the joint pain which may ease the movements of joins.

Use of corticosteroids is another effective treatment option for rheumatoid arthritis. These drugs are used to reduce the extreme inflammation which is accompanied by stiffness and severe pain. In addition to this, there are other medications such as disease-modifying drugs including penicillamine, methotrexate, sulfasalazine, gold tablets and leflunomide, newer disease modifying drugs including infliximab, and etanercept used for the treatment for rheumatoid arthritis.

TNF-alpha inhibitors are considered as one of the significant options of treatment for rheumatoid arthritis. TNF-alpha (tumor necrosis factor) is a cytokine (cell protein) which can trigger the inflammation in rheumatoid arthritis. TNF inhibitors such as adalimumab (Humira), infliximab (Remicade) and etanercept (Enbrel) may help to block the action of cytokine and prevent the inflammation of joints. Thus TNF inhibitors can help to stop the progression of this disease. Generally, these medications are suggested to take with methotrexate.

Etanercept (Enbrel) prevents the action of TNF and helps to reduce the inflammatory and immune responses. It is given in the form of subcutaneous injection twice in a week. People with Etanercept should undergo regular blood tests as this medication can cause adverse effects on blood cells.

Infliximab (Remicade) also blocks the action of tumor necrosis factor. It is generally used in combination with methotrexate. It is specifically useful in the patients whose rheumatoid arthritis is not improving only with methotrexate. Infliximab is injected intravenous every 6-8 weeks. In addition to this, adalimumab (Humira) can help to relive inflammation and prevent worsening of joint damage by blocking the action of TNF.

These medications can cause some side-effects including irritation of injection site (etanercept and adalimumab), lymphoma, blood disorders, worsening congestive heart failure (infliximab), demyelinating diseases as well as increased risk of infection. You are not supposed to take these medications, if you have an active inflammation.