What Are Rheumatoid Nodules?

Since nodules don’t generally cause any medical problems, they usually don’t need to be treated. Depending on where they are, though, they can sometimes limit range of motion. If they’re on your feet, your shoes can rub them, causing irritation.

A change in medication, such as stopping methotrexate (MTX) in favor of something else, may reduce the size of a nodule, but it’s complicated. “The situation is different if a patient has nodules before [RA] treatment or develops nodules after treatment,” says Pisetsky. “If the patient already had nodules, I would not stop MTX. I would consider stopping MTX only if the patient develops nodules after the onset of treatment, but I would make this determination in the context of the overall treatment response.”

Surgery may be an option. Pisetsky notes that he’s cautious about surgery “because at a site that is inflamed, I worry about wound healing.” But he’s seen many people who have had success with it.

Depending on many factors, it’s possible that the disease-modifying antirheumatic drugs (DMARDs) taken for rheumatoid arthritis may shrink nodules. Talk to your doctor. If you have a large nodule that’s very bothersome and surgery is not an option for you, your doctor may try injecting it with a steroid medication to shrink it.

Additional reporting by Deborah Shapiro.