Rheumatoid arthritis treatment: clear steps to control pain and protect joints

Rheumatoid arthritis (RA) is treatable — the goal is to stop inflammation early, protect your joints, and keep you moving. Treatment mixes medicines, monitoring, and everyday habits. Below you’ll find practical options and actions you can take now so you can talk to your rheumatologist with confidence.

Medical treatments that work

Start with DMARDs (disease-modifying antirheumatic drugs). Methotrexate is the most common first choice. It slows damage and is often paired with folic acid to reduce side effects. If methotrexate isn’t right, doctors consider leflunomide or sulfasalazine.

If hydroxychloroquine isn’t helping or you need a stronger plan, there are clear alternatives. Modern care often moves to biologics — like TNF inhibitors (etanercept, adalimumab) or IL-6 blockers — or to JAK inhibitors (tofacitinib, baricitinib). These target immune pathways more precisely and can make a big difference for people who don’t respond to standard DMARDs.

Short-term corticosteroids and NSAIDs can ease pain and flare symptoms, but they’re not a long-term solution. Use them while the DMARDs take effect or during flares, and discuss risks with your doctor.

Practical steps you can take now

Ask your doctor about starting DMARDs as soon as possible — early treatment lowers the risk of permanent joint damage. Before starting biologics or some DMARDs, you’ll likely get baseline tests: CBC, liver function, TB and hepatitis screening. Keep up with monitoring labs as directed.

Vaccinations matter. Get flu and pneumococcal vaccines and review live vaccine timing with your provider if you’re starting biologics or JAK inhibitors.

Move safely. Low-impact exercise, strength training, and range-of-motion work protect joints and reduce stiffness. A physical therapist can show safer ways to lift, carry, and exercise so you don’t stress damaged joints.

Small daily habits add up: quit smoking (it makes RA worse), manage weight, and aim for consistent sleep. These steps lower inflammation and improve medication response.

If you’re a young person moving from pediatric to adult care, plan the transition early. Bring a medical summary, list of meds, and questions to your first adult rheumatology visit. Our site has a guide on smooth pediatric-to-adult transitions that can help make that change easier.

Track symptoms with a simple diary: joint pain, morning stiffness length, and flare triggers. That record makes clinic visits far more productive and helps your doctor adjust treatment fast.

Finally, talk about pregnancy, infection risk, and long-term monitoring. Some DMARDs affect pregnancy planning and require stopping before conception. Your rheumatologist will help time treatments and tests so you stay safe and in control.

Want deeper reading? Check our article "Top Hydroxychloroquine Alternatives: 2025 Rheumatologist Guide to DMARDs & Biologics" for detailed options and what to expect when switching meds.

If you’re unsure about your current plan or seeing more flares, book a rheumatology review. Early action gives you the best shot at long-term joint health and a better quality of life.