I was diagnosed with seronegative RA 3.5 years ago, and it primarily affects my hands. I’ve got two small kids, so I’ve chosen a pretty aggressive course of treatment to manage symptoms, maintain mobility, and prevent long term damage. It’s my understanding that beginning therapies sooner than later is ideal to keep your joints in good shape for as long as possible.

I initially was started on hydroxychloroquine, which I tolerated well and was effective at managing mild flares for about 2.5yrs. I utilized occasional rounds of prednisone for particularly stubborn flares, as well as cortisone injections for a couple unresponsive joints. I also saw an acupuncturist regularly (which I highly recommend), and deployed ibuprofen strategically.

I also started seeing hand OT, which was very useful - I strongly recommend getting set up with an OT who works specifically with hands and is knowledgeable about inflammatory arthritis because the exercises and management are different than for osteoarthritis. I’d suggest making “acute care”, “recovery”, and “management” plans with the hand therapist. I have an arsenal of splints, exercises, gadgets, and tricks they’ve given me that are all useful depending on the circumstance.

My RA has worsened somewhat in the last year, so I’ve changed up my meds but I still utilize cortisone injections as well as acupuncture, hydrotherapy, and compression gloves or sleeves for individual fingers or the whole hand. I also follow an anti inflammatory diet and try to be mindful about not pushing my hands too far. It’s all been an exercise in trial and error and it evolves over time - communicating any significant changes to your rheumatologist in a prompt fashion will help them create a good plan for you.

But really my best advice is to take a multifaceted approach to pain and symptom management - meds + PT/OT + alternative therapies + lifestyle modifications tailored to your specific needs is the way to go. Meds will help reduce or prevent flares/joint damage, while the rest will help support the joints and facilitate recovery over time. No amount of PT will prevent a flare for me personally, but knowing how to manage when I’m having one and how to regain mobility when one is over has helped enormously!