What is the typical initial therapy for rheumatoid arthritis?

The typical initial therapy for rheumatoid arthritis includes the use of NSAIDs and methotrexate. Methotrexate is considered a cornerstone of treatment for rheumatoid arthritis due to its ability to modify the disease course, reduce inflammation, and slow down joint damage.

NSAIDs can provide symptomatic relief from pain and inflammation, making them an important part of the initial treatment as well. However, they do not modify the disease or prevent long-term joint damage. The combination of NSAIDs for immediate symptom relief and methotrexate for long-term disease management addresses both the immediate needs of the patient and the underlying progression of the disease.

While corticosteroids can also be used to manage inflammation and provide relief, they are typically not the first-line therapy due to potential side effects with long-term use. Physical therapy is beneficial for maintaining joint function and mobility but does not serve as initial pharmacological therapy for the disease. Therefore, the combination of NSAIDs and methotrexate is the standard approach for initial treatment of rheumatoid arthritis, making this the correct response.