Rheumatoid arthritis is a very common disease where the joints swell and get inflamed and the person suffers from pain and stiffness. Normally such condition cannot be cured. The general approach for treatment includes physical therapy and use of medicines.
The medicines aim at managing the pain and trying to retard or stop the progress of the disease. Medications include analgesics in the mild condition to Disease Modifying Anti-inflammatory drugs or DMARDs for treatment in advanced stages.
One of the commonest medicines used are the NSAIDs or Non-Steroidal Anti-inflammatory Drugs. They are more popular because apart from reducing pain they are also able to reduce inflammation and swelling. However, unlike DMARDs they are not able to slow down or stop the progression of rheumatoid arthritis. Instead they are generally used along with other rheumatoid arthritis medicines like methotrexate and biologic DMARDs.
How do NSAIDs Help?
Pain from rheumatoid arthritis results in the release of a hormone like chemicals called prostaglandins. These are released from the damaged tissues and they are the ones that send the message to trigger inflammation. So the person experiences swelling and pain in the affected area. NSAIDs act on these and block prostaglandins and in turn block the Cox-1 and Cox-2 enzymes. This helps in reducing the swelling, pain and also the stiffness associated with rheumatoid arthritis.
Prostaglandin also protects the linings of kidney and stomach. So use of NSAIDs may also have some side effects. So the person may suffer from stomach ulcer, internal bleeding or even damages to the kidneys. Though all NSAIDs can cause such condition, the degree varies. It can be said that more the Cox-1 enzymes are blocked the more will be the degree of damage. So emphasis is being given on developing Cox-2 inhibitors as they are less likely to cause as much damage as Cox-1 inhibitors.
Precautions for Using NSAIDS
Use of NSAIDs has been associated with increase in the chances of heart attack. The people said to be at risk are those having high cholesterol levels, diabetes and the regular smokers. Those people having high blood pressure run the risk of further increase in pressure and heart attacks.
The NSAIDs also reduce blood flow to the kidney and effects its functioning. This is why regular kidney function tests should be done to monitor the condition of this vital organ. In some cases, people with asthma have shown sensitivity to NSAIDs. So it is often recommended that people with asthma should not take NSAIDs.
Commonly Used NSAIDs
There is a large variety of over-the-counter and prescription NSAIDs available to the physicians which are effective in the treatment of rheumatoid arthritis. Apart from the commonly used medicines like Aspirin, Diclofenac, Ibuprofen, etc. there are other NSAIDs also. Here is an overview of some of them.
This non-steroidal drug is generally a Cox-2 inhibitor which acts to relieve swelling and pain. Apart from treatment of rheumatoid arthritis this medicine is also used for treating acute pain and menstrual pain. It is usually administered orally and its effect may start showing from about two weeks’ time.
The side effects of this drug are like those of other NSAIDs. So there is a chance of stomach upset and formation of gas. Allergic reactions are rare and heavy damage to the body is generally not seen. However, continuous treatment over a long period is not recommended and taking it before or after heart bypass surgery should be avoided.
This is another of the NSAIDs which is used as a pain reliever in various conditions. It is used in arthritis for reducing swelling, stiffness of the joints and pain. It is normally taken as an oral medicine and two weeks may be needed for showing its effects. Since this drug can cause stomach upsets including ulcer, the minimum effective dose should be given and prolonged use should be avoided. Common side effects of this drug are stomach upset, diarrhea, nausea and dizziness.
This drug is used for treatment of mild to moderate pain in various conditions. Like other rheumatoid arthritis drugs it also reduces swelling and stiffness shown in arthritis.
Oral use of this drug can show result in two to three weeks. The common side effects of this drug include stomach upset, diarrhea, gas formation, constipation, vomiting, nausea, headache and dizziness. Serious side effects are rare and are like that of most of the other NSAIDs.
This non-steroidal drug can treat conditions of swelling, pain and stiffness associated with various conditions like arthritis, gout, tendonitis and bursitis. The maximum use should be limited to 200mg per day in adults and the results will take approximately four weeks to show. Its side effects are stomach upset, headache, heartburn, dizziness and drowsiness. Serious conditions resulting from side effects and allergies are like the other NSAIDs.
This drug is used for short term treatment and aims at reducing moderate to severe pain. Such medication is used in case of adults only and normally it precedes or follows some surgical procedures. Apart from decreasing swelling and pain, it also reduces fever. Result is normally seen within five days.
But if it fails to do so after five days, the physician should be consulted for the next step. The general side effects are similar to those of the other NSAIDs but among the serious side effects one may experience easy bleeding and bruising, change in urine amount and signs of infection and meningitis. However, there is no reason to panic as these are the rarest of effects.
This drug is used to treat chronic varieties of arthritic pain and swelling. Taking it regularly may cause stomach upset, nausea, etc. If such symptoms show, then this medicine can be taken with an antacid or simply with food or a glass of milk. For better effect use this medication regularly at the same time of the day and the results will start showing from the third week.
Naproxen is used as a pain reliever in various conditions ranging from headaches and muscle aches to dental pain, menstrual cramp and tendonitis.
In case of rheumatoid arthritis and other diseases like gout and bursitis, this proves useful in reducing swelling and stiffness besides pain. Two weeks will be required to show its effect.