Medication

• According to the Mayo Clinic, the American College of Rheumatology (ACR) updated its recommended treatments for people with rheumatoid arthritis in 2008. For people with a mild form of the disease that has been present for shorter than 2 years, they recommend hydroxychloroquine or minocycline, disease-modifying antirheumatic drugs (DMARDs) that limit the damage in the joints. These drugs are slow-acting, sometimes taking months before any effect is noticed and are often compared with other drugs such as ibuprofen initially to limit pain. For people without a poor prognosis, the ACR recommends the DMARD sulfasalazine and for people with unknown prognosis the DMARD methotrexate or the immunosuppressants leflunomide which works by calming the immune system. If a person has a poor prognosis, the ACR suggests combining a DMARD with a TNF-alpha inhibitor, which acts an anti-inflammatory by blocking proteins that cause stiffness and swollen joints.
  
  

Surgery

• If medications fail to work, your doctor may want to perform surgery on your damaged joints. It can reduce your pain or correct a deformed joint. In total joint replacement, the surgeon replaces the damaged joint material with plastic and metal parts. Sometimes your doctor will loosen the tendons around a joint to allow for greater mobility. Also, the surgeon may remove the lining of the joint if it is too inflamed. However, surgery does come with some side effects, such as the risk of infection, bleeding or increased pain.
  
  

Alternative Treatments

• Some people are more interested in seeking out alternative treatments for rheumatoid arthritis. According to the Mayo Clinic, some studies show that plant oils that contain gamma-linolenic acid can help with pain. But taking these oils, which come from evening primrose and black currant can cause abdominal issues and may interfere with other medications. Another option is fish oils which contain omega-3 fatty acids. Once again, some studies by the Mayo Clinic suggest fish oils are helpful, but more information is needed. Movement therapy, such as tai chi or yoga, can also help keep your joints limber.