Rheumatoid Arthritis
Treatment Options
Treatment at
UPMC
There is no treatment to cure rheumatoid arthritis (RA). The goals
of treatment are to:
- relieve pain
- reduce inflammation
- slow down joint damage
- improve functional ability
Treatments include:
Medications
- anti-inflammatory medications:
non-buffered aspirin
acetaminophen (Tylenol)
nonsteroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen and
naproxen (Advil, Aleve)
Cox-2 inhibitors - celecoxib (Celebrex)
steroid drugs (prednisone)
- disease-modifying antirheumatic drugs (DMARDS) -- to slow
the course of the disease:
methotrexate (Rheumatrex)
hydroxycholoquinone (Plaquenil)
sulfasalazine (Azulfidine)
leflunomide (Arava), cyclosporine (Neoral)
penicillamine (Cuprimine)
gold (Ridaura) -- gold can also be given as an injection
- immunosuppressive drugs (only used when other drugs are ineffective):
azathioprine (Imuran)
cyclophosphamide (Cytoxan)
chlorambucil (Leukeran)
- biologic response modifiers -- drugs that interfere with
the autoimmune response associated with RA
etanercept (Enbrel)
infliximab (Remicade)
Steroids
When less potent pain relievers are ineffective, corticosteroid
injections to the inflamed joint may be given. Because cortisone injections
can be harmful to the tissue and bones, they are reserved for patients
with more pronounced symptoms.
Rest and Exercise
Rest helps reduce active joint inflammation and pain, and fight fatigue.
Exercise is important for maintaining muscle strength and flexibility,
as well as preserving joint mobility.
Joint Care
Splints applied to painful joints may help reduce pain and swelling.
Devices that assist in activities of daily living can also reduce stress
on joints, such as:
- zipper extenders
- long-handled shoehorns
- specially designed kitchen tools
Stress Reduction
Stress reduction can ease the difficulties of living with a chronic,
painful disease. Exercise programs, support groups, and open communication
with health care providers can all help to reduce stress.
Surgery
Several types of surgery can help alleviate severe joint damage.
Arthroscopic surgery can clean out the bone and cartilage fragments
that cause the pain and inflammation. Joint replacement and tendon reconstruction
are other surgical alternatives.
Lifestyle Measures
The following measures may relieve stiffness and weakness and reduce
inflammation:
- Maintain a balance between rest and exercise.
- Attempt mild strength training.
- Aerobic exercise (walking, swimming, dancing).
- Avoid heavy impact exercise.
- Stop
smoking.
- Control your weight.
- Get physical therapy.
Treatment at UPMC
This condition is typically treated by experts specializing in:
For information about complementary medicine approaches to this condition,
visit UPMC's Center
for Integrative Medicine.
Call UPMC toll-free 1-800-533-UPMC (8762) to find a doctor and schedule
an appointment.
At UPMC, treatment for those with arthritis and joint problems is available
through the UPMC Arthritis Network. Services of the UPMC Arthritis Network
include a wide range of care, from the services of rheumatologists
in a medical practice; to multidisciplinary
arthritis centers; to the UPMC
Arthritis Center, a tertiary care facility that accepts self-referrals
and physician referrals from throughout the western Pennsylvania region.
The network offers care at urban and community locations.
The network comprises physicians and other health care professionals
who specialize in the treatment of:
Care by a Rheumatologist in a Medical Practice
The UPMC Arthritis Network includes rheumatologists who treat patients
on an outpatient basis through a medical practice. To find a rheumatologist
in a network-affiliated medical practice near you and make an appointment,
call 1-800-533-UPMC (8762) or call the practice directly by consulting
the list that follows.
UPMC Arthritis and Internal Medicine Associates
3500 Fifth Ave., Suite 401
Pittsburgh, PA 15213
412-682-2434
UPMC Margolis Rheumatology Associates
339 Sixth Ave., fifth floor
Pittsburgh, PA 15222
412-560-8888
UPMC Arthritis Network Centers
An arthritis center in the UPMC Arthritis Network is a site where
specialty and multidisciplinary care are available. In addition to treatment
from an arthritis specialist, the services of occupational therapists,
physical therapists, social workers, and nurse-educators are available.
On a regular basis, physicians at UPMC Arthritis Network centers attend
UPMC-sponsored continuing medical education programs. These programs
ensure that the physicians are aware of the most up-to-date treatment
methods. Patients may be referred to a center by their physicians, or
patients may self-refer by calling for an appointment.
The UPMC Arthritis Network centers are:
UPMC Arthritis Center
Liliane S. Kaufmann Building
3471 Fifth Ave., Suite 900
Pittsburgh, PA 15213
412-648-6970
Doris Palmer Arthritis Center of UPMC St. Margaret
200 Medical Arts Building
200 Delafield Road, Suite 4040
Pittsburgh, PA 15215
412-784-1466
The UPMC Arthritis Center, in the Oakland section of Pittsburgh,
is unique in this list. It can provide tertiary care services -- that
is, very specialized care with the most advanced technological support.
In addition, the center maintains a collection of information resources
for patients. The collection includes educational materials, newsletters
of groups active in arthritis treatment and research, and other resources.
The UPMC Arthritis Center accepts physician referrals and self-referrals
from inside and outside the UPMC Arthritis Network.
Other UPMC Arthritis Network Locations
UPMC Arthritis Network care is available throughout the Pittsburgh
region, at the locations cited in the list that follows.
UPMC Shadyside
5230 Centre Ave.
Pittsburgh, PA 15232
412-647-8762
(Inpatient care only)
UPMC Downtown
339 Sixth Ave., fifth floor
Pittsburgh, PA 15222
412-560-8888
Weirton Medical Center
601 Colliers Way
Weirton, WV 26062
304-797-6480
These sites differ from UPMC Arthritis Network centers in that arthritis
consultation may not be offered on a full-time basis and only selected
multidisciplinary support may be available.
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