How is Rheumatoid Arthritis Diagnosed?

Diagnosing rheumatoid arthritis involves identifying persistent joint inflammation while ruling out other conditions that cause similar symptoms, such as osteoarthritis, lupus or gout. A rheumatologist usually evaluates the pattern of joint pain, morning stiffness lasting more than 30 minutes, swelling and tenderness in multiple joints, particularly those of the hands, wrists and feet.

To confirm the diagnosis and find out how active the disease is, your doctor may order blood tests and imaging scans. These tests look for autoimmune antibodies, check inflammation, and show if there is any joint damage.

How is Rheumatoid Arthritis Treated Based on Severity?

Early treatment of rheumatoid arthritis helps reduce inflammation and prevent irreversible joint destruction. The table below shows how RA is treated based on severity:

Clinical Severity Treatment Approach
Mild Rheumatoid Arthritis DMARDs, NSAIDs, physiotherapy and lifestyle changes.
Moderate Rheumatoid Arthritis Combination DMARDs, corticosteroids and rehabilitation.
Severe Rheumatoid Arthritis Biologic medicines or targeted synthetic DMARDs with multidisciplinary care.
Advanced Joint Damage Surgery along with medical treatment and rehabilitation.

Types of Rheumatoid Arthritis and Their Treatment

Mentioned below are the types of rheumatoid arthritis along with their treatment:

Type of Rheumatoid Arthritis Treatment
Seropositive Rheumatoid Arthritis Early DMARD therapy (such as methotrexate), biologic medicines or targeted synthetic DMARDs, along with physiotherapy and regular disease monitoring.
Seronegative Rheumatoid Arthritis DMARDs, NSAIDs for symptom relief, physiotherapy and regular follow-up. Treatment may be adjusted if antibody status changes over time.

Topical Treatments for Rheumatoid Arthritis

Topical treatments can help ease mild joint pain and stiffness in people with rheumatoid arthritis, especially when the pain is localised. These treatments do not prevent joint damage, but they can offer temporary relief and are often used with oral medicines and physiotherapy. 

Some of the topical treatments for rheumatoid arthritis are:

  1. Capsaicin Cream Capsaicin cream works by reducing pain signals from nerve endings. Regular application may help relieve joint pain, although a temporary burning sensation can occur after use.

  2. Counterirritant Creams and Gels Creams and gels containing ingredients such as menthol or methyl salicylate can create a cooling or warming sensation that may provide short-term relief from joint discomfort.

  3. Topical Lidocaine Lidocaine creams or patches may be used in selected patients to temporarily relieve localised joint pain, particularly when other treatments are unsuitable.

Other Treatments for Rheumatoid Arthritis

Along with medicines, doctors may recommend physiotherapy, occupational therapy or surgery to help reduce pain, improve joint function and maintain mobility. The choice of treatment depends on the severity of rheumatoid arthritis, the extent of joint damage and the patient's response to medicines.

Physiotherapy and occupational therapy can help you move better and make everyday tasks easier. Surgery might be an option if joint damage is severe and other treatments are no longer working well.

Oral Medications for Rheumatoid Arthritis Treatment

Oral medicines are commonly prescribed to reduce inflammation, control the immune response and slow joint damage. Some of the effective medicines for rheumatoid arthritis prescribed by doctors include:

  1. MethotrexateMethotrexate is the DMARD doctors prescribe most often and is usually the first treatment for rheumatoid arthritis. It helps manage inflammation and slows down how quickly the disease gets worse.

  2. SulfasalazineSulfasalazine reduces joint inflammation and may be prescribed alone or in combination with other DMARDs to improve symptom control.

  3. LeflunomideLeflunomide suppresses the overactive immune response responsible for joint inflammation and may be used when methotrexate is not suitable.

  4. JAK InhibitorsMedicines such as tofacitinib, baricitinib and upadacitinib are oral targeted therapies that block specific immune pathways involved in rheumatoid arthritis. They may be recommended for patients who do not respond adequately to conventional DMARDs.

  5. HydroxychloroquineOften prescribed for mild rheumatoid arthritis or combined with other DMARDs to manage joint inflammation and reduce stiffness. 

Note: Oral medicines for rheumatoid arthritis should only be taken under the supervision of a rheumatologist. Regular blood tests may be required to monitor liver function, kidney function and blood cell counts during treatment.

Ayurvedic and Alternative Treatments for Rheumatoid Arthritis

Some of the Ayurvedic and alternative treatments for rheumatoid arthritis include:

  • Herbal Remedies: Ayurvedic practitioners may recommend herbs such as ashwagandha, ginger, garlic and Boswellia (Indian frankincense) to help support joint health and reduce inflammation.

  • Yoga and Meditation: Gentle yoga and meditation may improve joint flexibility, reduce stiffness and help manage stress associated with rheumatoid arthritis.

  • Herbal Oil Massage: Massage with Ayurvedic herbal oils may help relieve joint pain and stiffness and improve mobility in some individuals.

Note: Alternative treatments should only be used after consulting a qualified healthcare professional.

Home Care for Managing Rheumatoid Arthritis

Some home care tips below can support rheumatoid arthritis treatment and help improve joint function. These include:

  • Try to exercise regularly by choosing low-impact activities that are gentle on your joints.

  • You can use hot or cold packs to help ease pain and stiffness.

  • Take physiotherapy sessions at home for better recovery.

  • Protect your joints during daily activities.

  • Work towards keeping a healthy body weight.

Latest Treatment for Rheumatoid Arthritis in India

Recent progress in rheumatoid arthritis treatment has given more choices to people who do not get enough relief from standard disease-modifying antirheumatic drugs (DMARDs). Newer biologic medicines like sarilumab, which blocks the interleukin-6 (IL-6) receptor, have helped patients with moderate to severe rheumatoid arthritis, even when methotrexate or tumour necrosis factor (TNF) inhibitors have not worked well.

Biosimilars of these biologic drugs are also becoming more common, providing similar results at a lower cost. Researchers are also looking into targeted synthetic DMARDs and other new therapies to improve outcomes and keep treatments safe. 

For people who stay in remission, there are ongoing studies about whether it is safe to reduce or stop treatment, but more research is needed before this becomes a standard practice.

How Long Does Rheumatoid Arthritis Treatment Take?

The table below shows the approximate duration required for the specific treatments of rheumatoid arthritis:

Treatment Approximate Time to Show Effect
NSAIDs Within a few hours to a few days for pain and inflammation relief.
Corticosteroids Usually within 24 to 48 hours during acute flare-ups.
Conventional DMARDs 6 to 12 weeks, with full benefits in about 3 to 6 months.
Biologic Medicines 2 to 8 weeks, with maximum benefit after 3 to 6 months.
JAK Inhibitors 2 to 4 weeks, with full response in about 2 to 3 months.
Long-Term Rheumatoid Arthritis Management Lifelong treatment with regular monitoring and medication adjustments as needed.

Rheumatoid Arthritis Treatment Side Effects

Some rheumatoid arthritis treatments may cause side effects, including:

  • Nausea

  • Stomach irritation

  • Increased risk of infections

  • Liver function changes

  • Kidney function changes

  • Mouth ulcers

  • Hair thinning

  • Injection-site reactions

  • Changes in blood cell counts

Lifestyle Changes for Managing Rheumatoid Arthritis

The following healthy habits may help manage rheumatoid arthritis and improve quality of life:

  • Try to be active most days of the week.

  • Work towards keeping your weight in a healthy range.

  • Eat anti-inflammatory food.

  • Add omega-3 fatty acids to your diet.

  • Quit smoking.

  • Try to drink alcohol only in moderation.

  • Aim to get enough restful sleep each night.

  • Find healthy ways to cope with stress.

  • Stick to the treatment plan your doctor recommends.

  • Remember to see your doctor for regular check-ups.

Factors That Can Worsen Symptoms of Rheumatoid Arthritis

Some factors can worsen rheumatoid arthritis symptoms or trigger flare-ups, including:

    • Emotional or physical stress

    • Smoking

    • Infections

    • Missing prescribed medicines

    • Lack of sleep

    • Physical inactivity

    • Obesity

    • Joint overuse

Rheumatoid Arthritis Treatment Cost

Rheumatoid arthritis treatment costs in India vary depending on the severity of the disease, treatment type, city and hospital. A consultation with a rheumatologist may cost around ₹500 to ₹2,000. Conventional DMARDs may cost ₹150 – ₹500 per month, while biologic medicines and targeted therapies can cost ₹30,000 – ₹1.5 lakh or more per month. Physiotherapy sessions usually cost between ₹500 and ₹1,500 each. Joint replacement surgery can range from ₹1.5 lakh to ₹6 lakh.

Does Health Insurance Cover Rheumatoid Arthritis Treatment in India?

Yes, health insurance covers rheumatoid arthritis treatment in India. It usually covers costs of hospitalisation, joint replacement surgery, and pre & post-hospitalisation expenses, depending on the policy terms and conditions. Additionally, outpatient treatment expenses are also covered if your plan includes OPD cover.

However, rheumatoid arthritis is considered a specified disease and is usually covered after a waiting period of up to 2 years. In case rheumatoid arthritis is a pre-existing condition, a PED waiting period of up to 3 years has to be served before coverage starts. 

To ensure adequate coverage for rheumatoid arthritis, selecting a health insurance plan with a sum insured amount of at least ₹15 lakh to ₹20 lakh is often advised.

Disclaimer: Health Insurance coverage is subject to specific policy terms, underwriting guidelines, and regulatory changes. Always verify coverage details with your insurance provider before purchasing.

FAQs

  • Q1. Can rheumatoid arthritis symptoms go into remission?

    Ans: Yes, rheumatoid arthritis can go into remission with prompt and regular therapy. This results in reduced or well-controlled inflammation and discomfort.

  • Q2. What is the best treatment for rheumatoid arthritis?

    Ans: Methotrexate is one of the disease-modifying antirheumatic medications (DMARDs) that doctors often begin using to treat rheumatoid arthritis. They may recommend biologic medications or targeted therapy if the illness is more severe.

  • Q3. When are biologic medicines used for rheumatoid arthritis?

    Ans: Your doctor may suggest biologic medications if you have moderate to severe rheumatoid arthritis and conventional DMARDs are ineffective or your symptoms persist.

  • Q4. Is surgery necessary for rheumatoid arthritis?

    Ans: Surgery is usually considered for rheumatoid arthritis only when severe joint damage causes persistent pain, deformity or difficulty performing daily activities despite medical treatment. Joint replacement surgery is one of the most common procedures for rheumatoid arthritis.

  • Q5. Can exercise help manage rheumatoid arthritis?

    Ans: Yes, doing regular stretching, physiotherapy, and gentle exercises can help manage rheumatoid arthritis by keeping you mobile, strengthening your muscles, maintaining joint flexibility, and reducing stiffness.

  • Q6. What foods should people with rheumatoid arthritis avoid?

    Ans: There is no specific rheumatoid arthritis diet, but limiting processed foods, sugary drinks, and excessive alcohol intake while eating a balanced diet rich in fruits, vegetables, whole grains, and omega-3 fatty acids may help support overall health.

  • Q7. Can rheumatoid arthritis become worse over time?

    Ans: Yes, if not treated properly, rheumatoid arthritis can slowly damage your joints and make it harder to move. Seeing your doctor regularly and taking your medicines as prescribed can help slow down the disease and prevent problems.

  • Q8. Can rheumatoid arthritis cause problems outside the joints?

    Ans: Rheumatoid arthritis affects more than simply your joints. Your skin, eyes, heart, lungs, and blood vessels may also be affected.

  • References

    • https://www.healthline.com/health/remedies-rheumatoid-arthritis

    • https://www.careinsurance.com/health-insurance/rheumatoid-arthritis

    • https://chicagoarthritis.com/how-long-do-rheumatoid-arthritis-medications-take-to-work/

    • https://www.mayoclinic.org/diseases-conditions/rheumatoid-arthritis/diagnosis-treatment/drc-20353653

    • https://www.healthline.com/health/types-rheumatoid-arthritis

    • https://my.clevelandclinic.org/health/diseases/4924-rheumatoid-arthritis#management-and-treatment

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