Typically, doctors prescribe arthritis medications to help control the disease. There are several categories of arthritis medications, including NSAIDs (nonsteroidal anti-inflammatory drugs), analgesics (pain medications), DMARDs (disease-modifying anti-rheumatic drugs), biologics, and corticosteroids.
While no one really likes to take medication, people with arthritis tend to be compliant with doctor's orders. They want to manage their disease and follow treatment recommendations, hoping the prescribed medications will be effective. Because arthritis can be a chronic disease, some people often stay on their medications for years.
Not every arthritis patient will be prescribed the same medication or combination of medications. It takes patience, as well as trial and error, to determine what works best for you. You may make many medication changes before you and your doctor decide on the best treatment regimen for you.
How will you know your medications are not working and it's time for a change? Essentially, you will be dissatisfied with how you are feeling. You will feel that your arthritis symptoms are not yet controlled and that they interfere with your daily routine. But, there is a question that's even more difficult to answer: How do you know your medications are working?
Know Why You Take Each Medication
Each medication has an indication, meaning, a reason it is prescribed. You should know its intended role, how it works in the body, and what you should expect from taking it. For example, analgesic medications are taken to decrease arthritis pain. NSAIDs are prescribed to reduce inflammation. DMARDs are used to slow disease activity and prevent disease progression. Knowing how a drug works will help you determine if it is working.
Assess How You Are Feeling
Judge how you feel after taking the medication compared to how you felt before taking it. Do you feel better overall? Have specific symptoms decreased in intensity? Do you feel that the medication is doing what it is supposed to do (e.g., pain medications should decrease your pain)? Only you know how you feel. Only you can judge the effectiveness of the drug subjectively.
Track Pain Levels
Keeping a symptom diary will allow you to track trends. By writing down how you feel each day, using a pain scale, or an iPhone app to help you rate your pain level, it's easy to look back over a period of time and see if you are doing better, worse, or the same. You can share the information with your doctor, too, so decisions about treatment plans can be adjusted, if necessary, based on your symptom trends.
Evaluate Your Activity Level
In the same manner you evaluate your symptoms, you should assess your activity level. Have you been more active since taking the medication? Has your ability to keep up with usual daily activities increased? Are you experiencing less fatigue? Are you able to socialize more? Judge how taking medication is affecting home, work, and leisure activities.
Blood Tests Help Monitor Progress
Certain blood tests, such as an erythrocyte sedimentation rate or C-reactive protein, can measure inflammation. While the tests detect nonspecific inflammation, they still are useful by offering trends. With periodic testing, you can observe if your results increase or decrease. A consistently elevated sedimnetation rate or CRP would suggest that medications are not controlling inflammation.
Be Aware of Side Effects or Drug Interactions That May Interfere
If you determine that your arthritis medication is not helpful, consider whether you are having side effects that may be interfering. For example, if a medication causes you to feel dizzy, you will hardly realize its true benefit. Discuss any ill effects with your doctor to determine if it is due to the arthritis medication or the medication in combination with others you take.
Review Drugs Periodically With Your Doctor
It's fairly easy to get into a rut with your medication regimen. If you have taken a drug for a long time, you may fail to detect diminishing effectiveness. Old habits die hard. Using myself as an example, I took a particular arthritis drug for 17 years. I was taken off of the medication at one point, for a reason unrelated to its effectiveness, and I never went back on the drug. There was no apparent difference in my arthritic condition, whether I took it or not. Periodically, review all of your drugs with your doctor and re-evaluate if they are working for you.
Don't Stop a Drug on Your Own
If you feel one or more of your medications is not working for you, talk to your doctor. Don't make a decision to stop taking it on your own. Some drugs can have serious adverse effects if stopped suddenly. Always be open and honest with your doctor about what your are doing or what you intend to do. Decide with your doctor if a dosage adjustment is warranted or whether switching to another medication is the best course of action.