Treatment Options

Pharmaceutical Drugs

Depending on diagnosis, the treatment protocol will vary. In some cases it is recommended to start with anti-inflammatory medications such as Nonsteroidal Anti-inflammatory Drugs (NSAIDs), which can include over-the-counter medications like Tylenol. At times patients may be prescribed corticosteroids in an attempt to calm the inflammation.

Other first line prescription strength treatments are called Disease-Modifying Antirheumatic Drugs (DMARDs) - (for example methotrexate or leflunomide). If the disease activity is uncontrolled with these therapies - or if the disease activity is very high early in the disease journey - biologics/biosimilars or biologic-like treatments such as  targeted synthetic DMARDs (Otezla/ampremilast) or Janus kinase inhibitors (Olumiant/baricitinib, Xeljanz/tofacitinib, and Rinvoq/upadacitinib) will likely be prescribed.

Things patients who use/have used these types of treatments want you to know:

• It takes time. Unlike some of the over-the-counter options that typically target pain and may bring temporary relief, DMARDs and biologics can take weeks or months to start working.
• Discuss side effects. Talk to the medical professional who prescribes the treatment to ask them about what possible side effects to expect and notify them if they become intolerable for you. Many patients experience few side effects and often say the pros of feeling better far outweigh the side effects - but everyone must decide what is right for themselves.  Also if you are on these medications and plan to start a family, make sure to discuss this with your healthcare provider.
• It's possible you will be on what is called combination therapy. This means you may be on more than one of these treatments simultaneously. This may be short-term until your disease is under control or may be needed long-term depending on how much damage was done before treatment began.
• There are many types of biologics/biosimilars and other DMARDs that target different things (TNF inhibitors, IL-1, IL-6, IL-17, IL-12 and IL-23, B-cell inhibitors, and more). What works for one patient - even within the same diagnosis - may not work well for another. This is normal, as our diseases are very unique to the individual. Don't get discouraged! Often you'll find the first or second option can be life-changing. This is why AiArthritis is working so hard for research into precision medicine.
  
  

Non-Pharmacologic

Working collaboratively with your doctor to ensure appropriate treatment is crucial. This often includes a whole body approach, including nutrition, exercise, mobility devices, mental support, relaxation, and alternative pain management.

Pain management

• Physical therapy (to help with flexibility, improve mobility, and increase muscle strength), while occupational therapy helps you find ways to adapt to your everyday environment.
• Assistive devices like splints, walking sticks, jar openers - anything that makes your life easier to participate!
• Massage therapy can aid in pain reduction, relaxation of sore muscles, and alleviation of stress or anxiety, but some patients also have reported they find massages to be painful.
• Cannabis, where legal, can be helpful for managing pain. CBD is non-psychoactive (but can have some slight effects, always start with small doses) and THC is the psychoactive part of the plant. Always check with local municipalities for laws and regulations before beginning to use CBD or THC.

Healthy Diet

Eating a well-balanced diet can help you feel better by increasing vitamins, lowering inflammation, and promoting good gut health. However, it is not suggested to manage an AiArthritis disease with diet alone. Anti-Inflammatory Diets include food with healthy fats, omega-3 fatty acids, and avoiding processed foods (canned or jars food, for example) or "eating clean". Some find symptom improvement through various elimination diets, particularly if an allergy is identified. Probiotics and prebiotics found in foods like yogurt can help maintain good gut health. To learn more about anti-inflammatory dietary changes, click the link to download our resource.

Exercise or Physical Movement

One thing that makes our type of arthritis different than the more common osteoarthritis is severe stiffness after rest. That means moving can help joints feel better. When possible, even light weights can help strengthen muscles, which will provide more support for your body. When disease activity is high, areas of the body hurt - like the feet, hands, back, or hips - and fatigue can be debilitating. Don't push yourself if your disease is flaring, but rather try less impactful movement activities, if possible. Learn more from our YouTube Playlist about Exercise featuring information from our Go With Us! to Conferences program.

Rest

This includes learning to conserve energy/balance rest and activity. Sometimes it may seem like we need a lot of rest and that is okay. Prioritizing balance is so important with our diseases.

Mental Support

These can include meditation, deep breathing exercises, cognitive behavioral therapy, as well as visualization of pleasant imagery. To learn more about how mental health affects those with AiArthritis disease, check out this Mental Health episode of our AiArthritis Voices 360 Talk Show.