Table of ContentsView AllTable of ContentsTreatment AssessmentActivities That May Worsen RA SymptomsQuestions to AskMedicationsOther TipsConsidering Surgery
Table of ContentsView All
View All
Table of Contents
Treatment Assessment
Activities That May Worsen RA Symptoms
Questions to Ask
Medications
Other Tips
Considering Surgery
Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease that primarily affects the joints but can also cause damage in other parts of the body. There is currentlyno cure for RA, but medication is often recommended as part of an overall treatment plan to help control symptoms. It’s important to note that some RA medications can take several months to be effective. Fortunately, severaltreatment optionsare available if a medication isn’t working effectively as it should.
Charday Penn / Getty Images
How to Tell If Your Treatment Isn’t Working
The main goals of RA treatment are to reduce symptoms, like pain and inflammation, and to maintain or improve joint mobility.However, up to 20% of people with RA don’t get sufficient relief from medications.If your current RA treatment plan is no longer helping you achieve those targets, it may need to be adjusted.
Here are a few signs to watch for:
Sometimes, your body may no longer react to certain medications as it once did. This can especially happen with biologics, an RA drug class. Your immune system may see the drug as an invader and develop antibodies to work against it, making it less effective or ineffective.In other cases, a worsening condition could also be the reason for a medication no longer working well.
Your healthcare provider should also monitor you for signs indicating it’s time to change treatment strategies. In addition to monitoring your symptoms and tracking your responses to medications, they may order additional blood tests, X-rays, and physical exams.
When to See a Healthcare ProviderNew or worsening RA symptoms are a sign to consult your healthcare provider. Keep an eye out for:Sharp or constant painChange in symptomsIncrease in inflammation that doesn’t get better with medication or restA sudden inability to participate in daily activities
When to See a Healthcare Provider
New or worsening RA symptoms are a sign to consult your healthcare provider. Keep an eye out for:Sharp or constant painChange in symptomsIncrease in inflammation that doesn’t get better with medication or restA sudden inability to participate in daily activities
New or worsening RA symptoms are a sign to consult your healthcare provider. Keep an eye out for:
Certain activities may worsen your RA symptoms. Consult your healthcare provider to learn more about what activities to avoid.
Some of these may include:
Questions to Ask Your Healthcare Provider
Reevaluating your RA treatment plan with your healthcare provider may feel intimidating, but speaking up early is important.
Your healthcare provider will want to hear directly from you as they assess your medical history. Be honest about your pain levels and treatment plan preferences, and ask questions about the process.
For example, consider asking:
Keep in mind that your healthcare provider will take into account several factors when writing your RA prescriptions, including your age, RA severity, and overall health. They may suggest changing your dosage, adding another medication to your routine, or switching medications altogether.
Is It Common to Change Treatments?Occasional changes to an RA treatment plan are normal. Treatment is not one size fits all, and medications can affect people differently. Keep in mind that it’s usually recommended to give RA drugs a couple of months to take effect (unless there are severe side effects or another reason to stop treatment early). Most disease-modifying antirheumatic drugs (DMARDs) and biologics take three to six months to be fully effective. Always consult your healthcare provider before making any treatment adjustments.
Is It Common to Change Treatments?
Occasional changes to an RA treatment plan are normal. Treatment is not one size fits all, and medications can affect people differently. Keep in mind that it’s usually recommended to give RA drugs a couple of months to take effect (unless there are severe side effects or another reason to stop treatment early). Most disease-modifying antirheumatic drugs (DMARDs) and biologics take three to six months to be fully effective. Always consult your healthcare provider before making any treatment adjustments.
Rheumatoid Arthritis Medications
RA medications fall under the followingfive categories:
DMARDs and biologics can take several weeks or months to establish a clinical effect.Analgesics, NSAIDs, and corticosteroids have a short onset of action but do not prevent joint damage or alter the course of the disease. There’s no way to predict how someone will respond to an RA treatment.
Sometimes your body may no longer react to certain medications as it once did. This can especially happen with biologics. Your immune system may see the drug as an invader and develop antibodies to work against it, making it less effective or ineffective.In other cases, a worsening condition could also be the reason for a medication no longer working well.
Figuring out which medications are best for your situation often requires trial and error. Expect to work closely with your healthcare provider during this adjustment period.
Other Steps You Can Take to Manage RA Symptoms
There are several other ways to help you manage your symptoms, in addition to medication.
Some of these may include the following:
Remember that home remedies and lifestyle adjustments aren’t meant to take the place of medications and supervised medical care. RA is a progressive disease that can lead to permanent joint damage. It’s important to take your medication as prescribed to prevent flares. Always check with a healthcare provider before changing or adding to your current routine.
When to Consider Surgery
Severe cases of RAmay require surgery to repair or replace a damaged joint, though it’s mostly considered a last resort.
Before recommending surgery, your healthcare provider may suggest trying minimally invasive procedures like laser therapy, which some studies have shown to be successful in improving pain and joint function for RA patients.
They’ll also review your symptoms, treatment history, and X-ray results to ensure you’re a good candidate for surgery. This usually means:
Summary
Rheumatoid arthritis (RA) is a chronic, progressive autoimmune condition that causes pain, stiffness, and joint inflammation. Most RA patients use medications to help control symptoms, but sometimes a drug may no longer be as effective as it once was.
If you notice current symptoms getting worse or new symptoms appearing, it’s time to talk to your healthcare provider about adjusting your RA treatment plan. In addition to other RA management techniques, like exercise and diet, several types of RA medications are available to help get you on the right track to feeling better again. Your healthcare provider is there to help you find the most effective medications to help control your symptoms and improve your quality of life.
25 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Solomon DH, Bitton A, Katz JN, et al.Treat to target in rheumatoid arthritis: Fact, fiction or hypothesis?.Arthritis Rheumatol. 2014;66(4): 775–782. doi:10.1002/art.38323Arthritis Foundation.Why don’t drugs work for some RA patients?Johns Hopkins Arthritis Center.Rheumatoid arthritis signs and symptoms.Kosmac M, Toplak N, Simonini G, et al.Anti-drug antibodies are associated with diminished drug levels and treatment failure (abstract).Arthritis Rheum.2012;64:2598.Arthritis Foundation.Rheumatoid arthritis: Causes, symptoms, treatments, and more.Arthritis Foundation.Understanding rheumatoid arthritis flares.Centers for Disease Control and Prevention.Rheumatoid arthritis.Arthritis Foundation. Best exercises for Rheumatoid Arthritis.Arthritis Foundation. 6 self-care tips for RA.Kyburz D, Finckh A.The importance of early treatment for the prognosis of rheumatoid arthritis.Swiss Med Wkly. 2013;143:w13865. doi:10.4414/smw.2013.13865Fraenkel L, Bathon JM, England BR, et al.2021 American College of Rheumatology guideline for the treatment of rheumatoid arthritis.Arthritis Rheumatol. 2021;73(7):1108-1123. doi:10.1002/art.41752Pisetsky DS.Advances in the treatment of rheumatoid arthritis. Costs and challenges.North NCMJ. 2017;78(5). doi:10.18043/ncm.78.5.337Arthritis Foundation.DMARDS.Curtis JR, Singh JA.The use of biologics in rheumatoid arthritis: Current and emerging paradigms of care.Clin Ther. 2011;33(6):679–707. doi:10.1016/j.clinthera.2011.05.044Crofford LJ.Use of NSAIDs in treating patients with arthritis.Arthritis Res Ther. 2013;15(Suppl 3):S2. doi:10.1186/ar4174van Laar M, Pergolizzi JV Jr, Mellinghoff HU, et al.Pain treatment in arthritis-related pain: beyond NSAIDs.Open Rheumatol J. 2012;6:320-330. doi:10.2174/1874312901206010320Johns Hopkins Arthritis Center.Rheumatoid arthritis treatment.Cooney JK, Law RJ, Matschke V, et al.Benefits of exercise in rheumatoid arthritis.J Aging Res. 2011;2011:681640. doi:10.4061/2011/681640Skoczyńska M, Świerkot J.The role of diet in rheumatoid arthritis.Reumatologia. 2018;56(4):259-267. doi:10.5114/reum.2018.77979National Center for Complementary and Integrative Health.What the science says about complementary approaches for rheumatoid arthritis.Arthritis Foundation.Rheumatoid arthritis self-care.Chang K, Yang SM, Kim SH, Han KH, Park SJ, Shin JI.Smoking and rheumatoid arthritis.Int J Mol Sci. 2014;15(12):22279-95. doi:10.3390/ijms151222279Rheumatoid Arthritis Support Network.RA surgery: How successful is surgery in treating rheumatoid arthritis.Chia WC, Chang CH, Hou WH.Effects of laser therapy on rheumatoid arthritis: A systematic review and meta-analysis.Am J Phys Med Rehabil. 2021;100(11):1078-1086. doi:10.1097/PHM.0000000000001711American College of Rheumatology.Joint replacement surgery.
25 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Solomon DH, Bitton A, Katz JN, et al.Treat to target in rheumatoid arthritis: Fact, fiction or hypothesis?.Arthritis Rheumatol. 2014;66(4): 775–782. doi:10.1002/art.38323Arthritis Foundation.Why don’t drugs work for some RA patients?Johns Hopkins Arthritis Center.Rheumatoid arthritis signs and symptoms.Kosmac M, Toplak N, Simonini G, et al.Anti-drug antibodies are associated with diminished drug levels and treatment failure (abstract).Arthritis Rheum.2012;64:2598.Arthritis Foundation.Rheumatoid arthritis: Causes, symptoms, treatments, and more.Arthritis Foundation.Understanding rheumatoid arthritis flares.Centers for Disease Control and Prevention.Rheumatoid arthritis.Arthritis Foundation. Best exercises for Rheumatoid Arthritis.Arthritis Foundation. 6 self-care tips for RA.Kyburz D, Finckh A.The importance of early treatment for the prognosis of rheumatoid arthritis.Swiss Med Wkly. 2013;143:w13865. doi:10.4414/smw.2013.13865Fraenkel L, Bathon JM, England BR, et al.2021 American College of Rheumatology guideline for the treatment of rheumatoid arthritis.Arthritis Rheumatol. 2021;73(7):1108-1123. doi:10.1002/art.41752Pisetsky DS.Advances in the treatment of rheumatoid arthritis. Costs and challenges.North NCMJ. 2017;78(5). doi:10.18043/ncm.78.5.337Arthritis Foundation.DMARDS.Curtis JR, Singh JA.The use of biologics in rheumatoid arthritis: Current and emerging paradigms of care.Clin Ther. 2011;33(6):679–707. doi:10.1016/j.clinthera.2011.05.044Crofford LJ.Use of NSAIDs in treating patients with arthritis.Arthritis Res Ther. 2013;15(Suppl 3):S2. doi:10.1186/ar4174van Laar M, Pergolizzi JV Jr, Mellinghoff HU, et al.Pain treatment in arthritis-related pain: beyond NSAIDs.Open Rheumatol J. 2012;6:320-330. doi:10.2174/1874312901206010320Johns Hopkins Arthritis Center.Rheumatoid arthritis treatment.Cooney JK, Law RJ, Matschke V, et al.Benefits of exercise in rheumatoid arthritis.J Aging Res. 2011;2011:681640. doi:10.4061/2011/681640Skoczyńska M, Świerkot J.The role of diet in rheumatoid arthritis.Reumatologia. 2018;56(4):259-267. doi:10.5114/reum.2018.77979National Center for Complementary and Integrative Health.What the science says about complementary approaches for rheumatoid arthritis.Arthritis Foundation.Rheumatoid arthritis self-care.Chang K, Yang SM, Kim SH, Han KH, Park SJ, Shin JI.Smoking and rheumatoid arthritis.Int J Mol Sci. 2014;15(12):22279-95. doi:10.3390/ijms151222279Rheumatoid Arthritis Support Network.RA surgery: How successful is surgery in treating rheumatoid arthritis.Chia WC, Chang CH, Hou WH.Effects of laser therapy on rheumatoid arthritis: A systematic review and meta-analysis.Am J Phys Med Rehabil. 2021;100(11):1078-1086. doi:10.1097/PHM.0000000000001711American College of Rheumatology.Joint replacement surgery.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Solomon DH, Bitton A, Katz JN, et al.Treat to target in rheumatoid arthritis: Fact, fiction or hypothesis?.Arthritis Rheumatol. 2014;66(4): 775–782. doi:10.1002/art.38323Arthritis Foundation.Why don’t drugs work for some RA patients?Johns Hopkins Arthritis Center.Rheumatoid arthritis signs and symptoms.Kosmac M, Toplak N, Simonini G, et al.Anti-drug antibodies are associated with diminished drug levels and treatment failure (abstract).Arthritis Rheum.2012;64:2598.Arthritis Foundation.Rheumatoid arthritis: Causes, symptoms, treatments, and more.Arthritis Foundation.Understanding rheumatoid arthritis flares.Centers for Disease Control and Prevention.Rheumatoid arthritis.Arthritis Foundation. Best exercises for Rheumatoid Arthritis.Arthritis Foundation. 6 self-care tips for RA.Kyburz D, Finckh A.The importance of early treatment for the prognosis of rheumatoid arthritis.Swiss Med Wkly. 2013;143:w13865. doi:10.4414/smw.2013.13865Fraenkel L, Bathon JM, England BR, et al.2021 American College of Rheumatology guideline for the treatment of rheumatoid arthritis.Arthritis Rheumatol. 2021;73(7):1108-1123. doi:10.1002/art.41752Pisetsky DS.Advances in the treatment of rheumatoid arthritis. Costs and challenges.North NCMJ. 2017;78(5). doi:10.18043/ncm.78.5.337Arthritis Foundation.DMARDS.Curtis JR, Singh JA.The use of biologics in rheumatoid arthritis: Current and emerging paradigms of care.Clin Ther. 2011;33(6):679–707. doi:10.1016/j.clinthera.2011.05.044Crofford LJ.Use of NSAIDs in treating patients with arthritis.Arthritis Res Ther. 2013;15(Suppl 3):S2. doi:10.1186/ar4174van Laar M, Pergolizzi JV Jr, Mellinghoff HU, et al.Pain treatment in arthritis-related pain: beyond NSAIDs.Open Rheumatol J. 2012;6:320-330. doi:10.2174/1874312901206010320Johns Hopkins Arthritis Center.Rheumatoid arthritis treatment.Cooney JK, Law RJ, Matschke V, et al.Benefits of exercise in rheumatoid arthritis.J Aging Res. 2011;2011:681640. doi:10.4061/2011/681640Skoczyńska M, Świerkot J.The role of diet in rheumatoid arthritis.Reumatologia. 2018;56(4):259-267. doi:10.5114/reum.2018.77979National Center for Complementary and Integrative Health.What the science says about complementary approaches for rheumatoid arthritis.Arthritis Foundation.Rheumatoid arthritis self-care.Chang K, Yang SM, Kim SH, Han KH, Park SJ, Shin JI.Smoking and rheumatoid arthritis.Int J Mol Sci. 2014;15(12):22279-95. doi:10.3390/ijms151222279Rheumatoid Arthritis Support Network.RA surgery: How successful is surgery in treating rheumatoid arthritis.Chia WC, Chang CH, Hou WH.Effects of laser therapy on rheumatoid arthritis: A systematic review and meta-analysis.Am J Phys Med Rehabil. 2021;100(11):1078-1086. doi:10.1097/PHM.0000000000001711American College of Rheumatology.Joint replacement surgery.
Solomon DH, Bitton A, Katz JN, et al.Treat to target in rheumatoid arthritis: Fact, fiction or hypothesis?.Arthritis Rheumatol. 2014;66(4): 775–782. doi:10.1002/art.38323
Arthritis Foundation.Why don’t drugs work for some RA patients?
Johns Hopkins Arthritis Center.Rheumatoid arthritis signs and symptoms.
Kosmac M, Toplak N, Simonini G, et al.Anti-drug antibodies are associated with diminished drug levels and treatment failure (abstract).Arthritis Rheum.2012;64:2598.
Arthritis Foundation.Rheumatoid arthritis: Causes, symptoms, treatments, and more.
Arthritis Foundation.Understanding rheumatoid arthritis flares.
Centers for Disease Control and Prevention.Rheumatoid arthritis.
Arthritis Foundation. Best exercises for Rheumatoid Arthritis.
Arthritis Foundation. 6 self-care tips for RA.
Kyburz D, Finckh A.The importance of early treatment for the prognosis of rheumatoid arthritis.Swiss Med Wkly. 2013;143:w13865. doi:10.4414/smw.2013.13865
Fraenkel L, Bathon JM, England BR, et al.2021 American College of Rheumatology guideline for the treatment of rheumatoid arthritis.Arthritis Rheumatol. 2021;73(7):1108-1123. doi:10.1002/art.41752
Pisetsky DS.Advances in the treatment of rheumatoid arthritis. Costs and challenges.North NCMJ. 2017;78(5). doi:10.18043/ncm.78.5.337
Arthritis Foundation.DMARDS.
Curtis JR, Singh JA.The use of biologics in rheumatoid arthritis: Current and emerging paradigms of care.Clin Ther. 2011;33(6):679–707. doi:10.1016/j.clinthera.2011.05.044
Crofford LJ.Use of NSAIDs in treating patients with arthritis.Arthritis Res Ther. 2013;15(Suppl 3):S2. doi:10.1186/ar4174
van Laar M, Pergolizzi JV Jr, Mellinghoff HU, et al.Pain treatment in arthritis-related pain: beyond NSAIDs.Open Rheumatol J. 2012;6:320-330. doi:10.2174/1874312901206010320
Johns Hopkins Arthritis Center.Rheumatoid arthritis treatment.
Cooney JK, Law RJ, Matschke V, et al.Benefits of exercise in rheumatoid arthritis.J Aging Res. 2011;2011:681640. doi:10.4061/2011/681640
Skoczyńska M, Świerkot J.The role of diet in rheumatoid arthritis.Reumatologia. 2018;56(4):259-267. doi:10.5114/reum.2018.77979
National Center for Complementary and Integrative Health.What the science says about complementary approaches for rheumatoid arthritis.
Arthritis Foundation.Rheumatoid arthritis self-care.
Chang K, Yang SM, Kim SH, Han KH, Park SJ, Shin JI.Smoking and rheumatoid arthritis.Int J Mol Sci. 2014;15(12):22279-95. doi:10.3390/ijms151222279
Rheumatoid Arthritis Support Network.RA surgery: How successful is surgery in treating rheumatoid arthritis.
Chia WC, Chang CH, Hou WH.Effects of laser therapy on rheumatoid arthritis: A systematic review and meta-analysis.Am J Phys Med Rehabil. 2021;100(11):1078-1086. doi:10.1097/PHM.0000000000001711
American College of Rheumatology.Joint replacement surgery.
Meet Our Medical Expert Board
Share Feedback
Was this page helpful?Thanks for your feedback!What is your feedback?OtherHelpfulReport an ErrorSubmit
Was this page helpful?
Thanks for your feedback!
What is your feedback?OtherHelpfulReport an ErrorSubmit
What is your feedback?
