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Sellers, BS Pharmacy, PharmD — By Caitlin Geng on July 22, 2022Rheumatoid arthritis (RA) is a chronic autoimmune and inflammatory disease in which the immune system attacks healthy cells in the body by mistake. This causes painful inflammation in the affected parts of the body. RA mainly affects the joints and can attack multiple joints at the same time. It can also affect other tissues and may cause problems in some organs, including the heart, eyes, and lungs. The disease most often affects the knee, hand, and wrist joints. RA causes the lining of an affected joint to become inflamed and damages the joint tissue. The tissue damage can result in chronic pain, deformity, and instability. RA affects around 1.5 million people in the United States. There is no cure for RA, but a person may effectively manage the disease with medications and other management strategies. People have individual experiences with RA, so the best medication for RA pain may differ for each person. This article explores over-the-counter (OTC) medications, prescription medications, and alternative treatments for RA. To discover more evidence-based information and resources for RA, visit our dedicated hub. OTC medications Share on PinterestPER Images/StocksyNonsteroidal anti-inflammatory drugs (NSAIDs) are available over the counter. These medications may help reduce inflammation from RA and alleviate pain. NSAIDs include ibuprofen, and naproxen. As with any medication, NSAIDs may cause side effects. A person is more likely to experience side effects if they take higher doses over a long period. Side effects of NSAIDs may include:headachesstomach ulcersindigestiondiarrheanauseadizzinessdrowsinessallergic reactions Rarely, NSAIDs can affect circulation, the heart, the kidneys, and the liver. This may cause serious problems such as stroke, heart failure, or heart attack. Learn more about OTC anti-inflammatory medications here. Prescription medications The treatment goal for RA is to prevent irreversible damage to the joints and minimize pain. A doctor will assess a person’s best options for medication based on their overall health, age, the severity of the disease, and various other factors. Prescribed medication may include: Corticosteroids These medications, such as prednisone and cortisone, can reduce inflammation and pain and can help delay slow damage to the joints. A doctor may prescribe corticosteroids if NSAIDs do not produce results. When someone has RA, a doctor may inject the steroid directly into the joint or prescribe oral or topical forms. Corticosteroids may relieve RA symptoms. However, the results differ between individuals and according to the severity of the disease. Corticosteroids may cause side effects, some of which are serious. Doctors may prescribe a low dose for 3 months or less, as the risk of side effects increases with longer use of higher doses. Side effects may include:dizzinessblurred visionshortness of breathirregular heartbeatnumbnessosteoporosisosteonecrosis, or bone deathmood changeschanges in blood sugar levelsincreased likelihood of infectionsglaucomacataractshigh blood pressurebruising and poor wound healing Disease-modifying antirheumatic drugs DMARDs A doctor may prescribe DMARDs, such as methotrexate, for moderate to severe RA, alone or with other treatments. These drugs affect the way the immune system works. People with RA have an overactive immune system, and DMARDs disrupt this system, helping delay disease progression. This could help prevent permanent damage to the joint tissue. A person may have to try different types of DMARDs to find one that suits them best The drugs are most effective if a person uses them in the early stages of RA, and it may take time for them to deliver benefits. A person with RA usually takes DMARDs for life. Side effects of traditional or nonbiologic DMARDs may include:headacheliver damagenauseavomitingdiarrheamouth ulcersincreased risk of infectionsimmune-related disorders Biologic treatments Biologic treatments are another type of DMARD. When infection or another threat occurs, the body produces an inflammatory substance called tumor necrosis factor-alpha (TNF-alpha). Biologics, such as TNF-alpha inhibitors, suppress this substance, which helps prevent inflammation in the joint tissue. These biologic treatments can also help reduce pain, swelling, tenderness, and stiffness. Types of biologics include adalimumab (Humira) and infliximab (Remicade). Side effects may include:skin reactionsheightened risk of infectionslymphomademyelinating diseases, such as multiple sclerosis (MS) or Guillain-Barré syndrome (GBS)lupuscongestive heart failure Janus kinase JAK inhibitors JAK inhibitors are also a type of DMARD. The immune system sends and receives messages using proteins called cytokines. These proteins attach to receptors on the JAK-STAT pathway. When this occurs, it can lead to an abnormal immune response. JAK inhibitors block cytokines from attaching to receptors, which slows the immune system’s response. When this occurs, the immune system does not cause as much inflammation, which can help reduce the severity of RA symptoms. Side effects may include:thrombosisincreased risk of infectioncytopenias, or low white blood cell and platelet countweight gain Learn more about the best medications for RA here. Alternative treatments A person should speak with their doctor to ensure they are receiving appropriate treatment for RA. That said, some alternative or complementary measures may also help to reduce RA-related pain and fatigue. The Arthritis Foundation recommends:stopping smokingdaily movement, such as walks, balanced with resteating a balanced diettaking omega-3 fish oil or turmeric supplements with the guidance of a healthcare professionalusing topical products, such as creams or gelstrying stress reduction therapies, such as massage and meditationusing hot and cold treatments Learn more about alternative treatments for RA here. Summary There are a variety of OTC and prescription medications available to treat RA. The best medication for people with RA will differ from one person to another. A doctor can assess each person’s needs and help them find the most effective treatment plan. This can depend on the severity of the disease, a person’s overall health, weight, age, and tolerance for medications. Lifestyle changes and alternative or complementary measures may also help alleviate RA symptoms. However, people should speak with a healthcare professional for further advice. Last medically reviewed on July 22, 2022Rheumatoid ArthritisMedically reviewed by Alisha D. Sellers, BS Pharmacy, PharmD — By Caitlin Geng on July 22, 2022 Latest newsWhat sets 'SuperAgers' apart? Their unusually large neuronsOmega-3 may provide a brain boost for people in midlifeSeasonal affective disorder (SAD): How to beat it this fall and winterCDC: Monkeypox in the US 'unlikely to be eliminated in the near future'Why are more women prone to Alzheimer's? New clues arise Related CoverageCan cryotherapy help with rheumatoid arthritis pain?Medically reviewed by Debra Rose Wilson, Ph.D., MSN, R.N., IBCLC, AHN-BC, CHT Using cryotherapy to treat pain is not a new idea. 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