How Do Doctors Measure Arthritis Pain


The most important drugs used in arthritis therapy include:

Basic medication:
Basic drugs (also known as “Disease Modifying AntiRheumatic Drugs”, DMARDs for short) are usually prescribed first after diagnosis. They can curb the excessive immune system, slow or even stop the progression of rheumatoid arthritis, and the destruction of joints and bones. So they not only alleviate the symptoms, but ideally also lead to remission. Used for long-term therapy, they control the course of the disease.

The treatment can take place as monotherapy, which consists of only one drug, or as combination therapy, in which several drugs (including biologics) are used.

It should be noted that all basic medications only show their effect after some time (usually several weeks). In order to effectively relieve the symptoms during this time, the doctor usually also prescribes a low-dose cortisone preparation at the beginning of treatment and, if the patient is in severe pain, a non-steroidal anti-inflammatory drug (NSAID).

Withdrawal of the basic medication:
Some patients want to stop taking the basic drug after a while. If the patient is in sustained remission for six to twelve months, the basic drug can be tapered (dose reduction) and discontinued in rare cases. However, stopping therapy for rheumatoid arthritis does not work forever, but at most for a few years.

In many patients, the disease worsens after stopping the medication. A change in treatment is more successful if the patient has received a combination therapy consisting of a basic drug and a biological and only the basic drug slips away. Biologics are highly effective preparations that can keep rheumatism in check on their own.

After stopping the medication, the patient must attend regular check-ups with the attending physician in order to detect a possible relapse (relapse) at an early stage.

Cortisone is a hormone that the body produces itself. Since it has an anti-inflammatory effect, cortisone preparations are also used in rheumatism therapy. After the diagnosis, the doctor usually prescribes the short-term intake of cortisone in addition to a basic drug. Usually a low dose in tablet form is sufficient. This is gradually reduced after a while and the cortisone preparation is finally discontinued. If the symptoms are very severe, the doctor can also inject cortisone directly into the patient's painful joint.

Non-Steroidal Anti-Inflammatory Drugs (NSAIDs):
The non-steroidal anti-inflammatory drugs are named because they do not contain cortisone (steroid). Their active ingredients ibuprofen or diclofenac eliminate pain and reduce inflammation. However, NSAIDs only help to alleviate symptoms; they have no influence on the course of the disease. In addition, the following applies: Painkillers may only be taken for four consecutive days and for a total of ten days a month without a doctor's agreement, otherwise the pain preparation can damage the stomach and cause gastric mucosal inflammation or a gastric ulcer.

For around 20 years there has been a new class of drugs that are used in the treatment of rheumatoid arthritis and are very successful, so-called biologics. They consist of genetically engineered proteins and can specifically inhibit certain messenger substances that promote inflammation and thus stop the inflammatory processes. This reduces pain and swelling in the joints.

Biologics are usually prescribed together with basic medication; this combination therapy is usually even more effective than the basic medication alone.

Homeopathic Remedies:
Homeopathic remedies can support rheumatism therapy, but should never be used as the sole treatment method. There is no clear scientific evidence that homeopathy works. If you would like to take homeopathic preparations in addition to conventional medical therapy, discuss this with your doctor.