Alternative Treatments for Rheumatoid Arthritis

If you have rheumatoid arthritis (RA), alternative healing methods can be helpful additions to medications and a physician’s care. Find out which treatments have been scientifically proven as safe and effective for pain, swelling and stiffness. Plus, learn the do’s and don’ts of using alternative therapies for RA. And then test your inflammation IQ with our quiz…

Rheumatoid arthritis (RA) is an inflammatory autoimmune disease – a condition in which the immune system, which normally protects the body by fighting infections and diseases, instead targets the body.

RA is different from other types of arthritis, such as osteoarthritis, a wear-and-tear condition that commonly occurs as people age. In RA, the immune system attacks the tissues that line the joints, causing pain, swelling and stiffness and affecting their ability to work properly.

Over time, RA may damage bone and cartilage within joints, weaken muscles and tendons, and lead to joint destruction.

RA occurs more frequently in women than in men and often begins in middle age. It can affect any joint in the body, most often the wrist and fingers. And it usually occurs in a symmetrical pattern – for example, if one hand is affected, usually the other will be, too.

Some people with RA may have other health issues, such as anemia, dry eyes or mouth, and heart or lung problems. As an autoimmune disease, RA may be accompanied by occasional fevers and an overall feeling of fatigue or weakness.

Treatment for RA combines a variety of approaches and is aimed at relieving pain, reducing joint swelling, slowing or preventing joint damage, and improving physical function and well-being. Conventional medicines include nonsteroidal anti-inflammatory drugs (NSAIDs), disease-modifying anti-rheumatic drugs (DMARDs), biological response modifiers and corticosteroids.

Other treatments include physical therapy, modified exercise programs, and devices that ease physical stress on the joints (such as splints). People with RA are also encouraged to make lifestyle changes such as balancing activity with rest, eating a healthy diet and reducing emotional stress.
Despite the use of conventional treatments, however, people with RA may continue to have symptoms or difficulties with side effects. Many patients add alternative remedies to control pain and inflammation, improve physical function, or cope with the disease or side effects of treatment.

Here’s a look at the some of the top alternative remedies, and the evidence suggesting they may work:

Mind-Body Therapies
Mind-body methods – such as meditation, relaxation and tai chi – are among the most commonly used alternative treatments in the United States. They’ve been studied for a variety of pain-related conditions, and results from clinical trials suggest they may be beneficial additions to RA treatment regimens.

Psychological therapies incorporating mind-body techniques such as relaxation, imagery, and biofeedback may help improve physical and psychological symptoms associated with RA. Research reviews suggest that these therapies – when added to conventional medical treatments – could have beneficial effects on pain, physical function, psychological state and ability to cope. They may be especially helpful for people who’ve had RA for a shorter duration.

A study funded by the federal government found that a type of meditation called mindfulness-based stress reduction had positive effects on the psychological aspects of RA (such as depression and coping ability), although it didn’t relieve symptoms.

A few small studies have been conducted on tai chi for RA. In general, tai chi hasn’t been shown to be effective for joint pain, swelling and tenderness, but it may improve mood, quality of life, and overall physical function. Some people have reported soreness when first learning tai chi, but most studies have found that it’s relatively safe for people with RA.
Dietary Supplements
Although no herbal or nutritional supplement has shown clear treatment benefits, there is preliminary evidence for a few – particularly fish oil and gamma-linolenic acid.

Fish oil contains high amounts of omega-3 fatty acids – substances the body needs to perform a number of important functions. The body can also use omega-3s to make substances that reduce inflammation.

Interest in the use of fish oil for RA stems from observations that groups of people who consumed large amounts of foods rich in omega-3s have lower rates of inflammatory diseases. Types of fish high in omega-3s include herring, mackerel, salmon and tuna. Supplements are available as capsules or bottled oils.

Fish oil supplements may be useful in relieving tender joints and morning stiffness, and studies have also found that fish oil could reduce the need for NSAIDs and other conventional RA medicines.

While some species of fish can contain high levels of mercury, pesticides or polychlorinated biphenyls (PCBs), filtered fish oil supplements don’t appear to contain these substances. In high doses, fish oil may interact with certain medicines, including blood thinners and drugs used for high blood pressure. Products made from fish liver oil (such as cod liver oil) can contain dangerously high amounts of vitamins A and D.

Gamma-linolenic acid (GLA) is an omega-6 fatty acid found in the oils of some plant seeds, including evening primrose (Oenothera biennis), borage (Borago officinalis) and black currant (Ribes nigrum). In the body, GLA can be converted into substances that reduce inflammation.

Some well-designed studies suggest that GLA may relieve symptoms such as joint pain, stiffness and tenderness; in some cases, it led to a decreased need for NSAID medication.

GLA appears to be safe for most adults. However, some borage oil preparations contain chemicals called pyrrolizidine alkaloids, which can harm the liver.
Research on other supplements for RA symptoms is still in the early stages. For example:

In animal studies, extracts of the spice turmeric (Curcuma longa) containing the chemical curcumin were found to protect joints from inflammation and damage. There may be a potential role for curcumin in preventing or slowing RA disease, but studies in people are needed to confirm this.

Varieties of boswellia (Boswellia serrata, Boswellia carterii, also known as frankincense) produce a resin that has shown anti-inflammatory and immune-system effects in laboratory and animal studies. But no rigorous clinical trials in people with RA have been conducted.

Laboratory studies have identified anti-inflammatory compounds in ginger (Zingiber officinale), but additional research is needed to determine if the herb has an effect on RA.

There’s also evidence that substances found in green tea might be useful in treating both RA and osteoarthritis.

Other Alternative Treatments for RA
These therapies may also be effective in easing RA symptoms:

Acupuncture has been used and studied for a variety of pain conditions, but very little research has focused on RA. Larger and more rigorous studies are needed.

Balneotherapy is the technique of bathing in heated tap or mineral water for health purposes. Preliminary research on using this therapy for RA has been conducted in areas where it’s most popular, such as Europe and Israel’s Dead Sea region. Although some benefits have been reported, there’s not enough reliable evidence to draw conclusions.

Some people with RA may try following special diets – such as vegetarian and vegan diets, the Mediterranean diet, and periods of fasting – to control symptoms. While a few studies suggest that decreasing or eliminating consumption of meat, dairy, or foods likely to cause allergies may be helpful in some cases, others don’t. One drawback is that special diets may be difficult for people to follow over time. In addition, some diets could put people at risk for nutritional deficiencies.

Do’s and Don’ts
If you have RA and are thinking about using alternative therapies, keep the following points in mind:

Don’t replace proven conventional treatments for RA with alternative treatments.

Be aware that some alternative therapies – particularly dietary supplements – may interact with conventional medical treatments. Also, consider the possibility that what’s on the label may not be what’s in the bottle. Some tests of dietary supplements have found that the contents didn’t match the dose on the label, and some herbal supplements have been found to be contaminated.

Women who are pregnant or nursing should consult their health care provider before using any alternative therapy.

Tell all your health care providers about any alternative practices you use. Give them a full picture of what you do to manage your health. This will help ensure coordinated and safe care.

Excerpted from “Rheumatoid Arthritis and CAM” by the National Center for Complementary and Alternative Medicine, a division of the National Institutes of Health.
For more on this condition, visit our Rheumatoid Arthritis Health Center .

What’s Your Inflammation IQ?
Inflammation has become a hot topic over the last few years. The latest scientific research indicates that inflammation is behind more than 80% of the conditions we suffer from – everything from arthritis to heart disease. Dr. Mark Hyman, author of The UltraSimple Diet, agrees that inflammation leads to a host of health problems. Fighting it can get you on track to a healthier, happier life.