Not long ago there was some debate as to whether early, aggressive therapy made any difference to the outcome of patients with inflammatory arthritis, including rheumatoid arthritis. Treatment tended to be based on the idea of first and second line drugs, beginning with non steroidal anti inflammatory drugs and progressing to disease modifying anti rheumatic drugs such as gold and other relevant substance. Most rheumatologists are now convinced that accurate diagnosis and appropriate intervention with drugs and physiotherapy in the early stage of the disease are crucial, because the longer inflammation lasts, the more damage is caused.
This means patients are now more likely to be prescribed one or more disease modifying drugs early on. Doctors argue that once inflammation is suppressed, patients will not deteriorate and should actually improve. Patients also seem less likely to suffer side an effect from these drugs is they are treated sooner rather than later. Disease modifying anti rheumatic drugs play a key role in the treatment of rheumatoid arthritis. They may also be used in some other types of rheumatic diseases, such as ankylosing spondylitis or the arthritis linked with psoriasis. The lower disease activity and inflammation, thereby reducing pain, swelling and stiffness of joints, and they are often effective in cases where anti inflammatory drugs are not.
However, they have potentially more damaging side effects than the non steroidal ones. They also tend to be slow acting and it may take weeks or even months for the full benefit to be felt. As they are not analgesics you may have to carry on with pain killers or with anti inflammatory drugs. Corticosteroids, often shortened to steroids, are hormones, some are produced naturally in the body, others manufactured synthetically. Those used in the treatment of arthritis are derived from, or a synthetic variants of, the natural corticosteroid hormones formed in the outer part of the adrenal glands.
When present in large amounts, steroids reduce inflammation and suppress immune responses, which is why they are used for patients with rheumatoid arthritis and other types or rheumatic disease. Always tell your doctor and pharmacist about any medicines you are currently taking, both prescribed and over the counter. They will be able to offer invaluable advice on which drugs are the most appropriate for your particular circumstances. Paracetamol is an effective pain killer, but does not relieve inflammation. It is a preferred treatment for osteoarthritis because it has fewer side effects than aspirin. Overdosing can result in serious liver and kidney damage.
