 Hi, I am Dr. Vijay Rao. I am a consultant working in the rheumatology department in Manipal Hospital's Bangalore. The first and foremost treatment is immediately in the form of steroids which is given, the safest route is an injection which is given on the muscle. It works pretty much instantly and lasts in the body for 4 to 6 weeks. In some people this alone might not be enough then we will have to give steroids in the form of tablets for about 3 to 4 weeks. But the main treatment is in the form of tablets what we call as disease modifying drug therapy that has to be taken minimum for 2 years and these treatments start working only after 45 days to 60 days and they should not be stopped until the rheumatologist says. You will not see instant relief with that. It takes about 3 months for about 90% improvement but has to be gradually increased the dosages over 6 months and gradually tapered over the next 2 years and stopped. Sudden stoppage will definitely bring back symptoms within a week's time. We sometimes use advanced treatments called biological agents which work on particular chemicals in the body achieving a better cure, control and lesser side effects. But these are reserved for patients who have not responded to tablets and for more severe disease because it's expensive and we don't use it up front.