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Rheumatoid Arthritis

separator Complementary and Alternative Treatments for Rheumatoid Arthritis

Rheumatoid arthritis (RA) is an inflammatory disease that causes pain, swelling, stiffness and loss of function in the joints. It's an autoimmune disease in which the body's immune system attacks the tissues lining the joints.

The disease can act differently in different people. For some people, RA appears and then goes away after a while and may never return. For others, it may be mild. For still others, there may be severe flare-ups and periods of remission. And for some people, the disease affects them all the time, causing pain relentlessly.

The most common features of RA include

  • Tender, warm, swollen joints
  • Symmetrical pattern affecting the joints (for example, if one hip is affected, the other one probably is too)
  • Fatigue, occasional fevers
  • Pain that's worse in the morning
  • Symptoms that can last for many years

Common Western treatments for RA

There's no known cure for RA, but there are many ways to treat the symptoms. Doctors generally recommend that people with RA try to do gentle exercises regularly, get plenty of rest, maintain a healthy weight, take part in activities that can reduce the stress of having a chronic illness, eat a healthy diet and in general take good care of themselves.

There are also many medications that can treat the symptoms of RA. The most common ones include

  • NSAIDs, which treat pain and inflammation
  • DMARDs, which treat pain and inflammation and can help slow disease progression
  • Steroids, which relieve pain and inflammation

The side effects of these medications can be troubling for some people, however. NSAIDs can cause stomach irritation and, in some cases, heart problems. Steroids increase appetite, weaken muscles, cause mood changes and increase risk of high blood pressure, to name a few of he effects. And DMARDs can increase the risk of infection, cause hair loss and kidney and/or liver damage.

Complementary and alternative treatments for RA

If you're interested in exploring CAM therapy for RA, it's important first of all that you continue with the treatment your doctor has already prescribed for you. Never make the decision on your own to stop treatment. CAM therapies can be used in conjunction with your current regimen. It's a good idea to talk with your doctor if you do pursue CAM therapies.

Many times, people who have RA become interested in complementary and alternative medicine (CAM) because their own treatments may not be working as well as they'd like, or they're interesting in relieving the side effects of their current medications. They may also want to find ways to relieve the stress that comes with having a chronic illness. In general, people turn to CAM therapies when their RA symptoms are interfering with their daily activities and they feel as though what they're currently doing to treat their RA isn't enough.

One philosophy that many CAM practitioners believe in is that there's an emotional component to the disease process. Since autoimmune diseases cause the body's immune system to turn on itself, the practitioners reason that in the bigger picture, the actual person may be angry with himself and attacking himself emotionally, which can cause the autoimmune response in the body.

Patients having their first encounters with CAM practitioners may be surprised when they find that not only does the practitioner take a medical history, but he or she is also likely to ask many questions about the patient's emotional life—family relationships, relationships with friends, satisfaction with work, etc. The practitioners often believe that this kind of information is just as valuable when it comes to formulating a treatment plan.

The most common types of CAM for RA include

  • Acupuncture and other Chinese medicine practices
  • Supplements
  • Dietary changes
  • Herbal medicine

Dietary changes

Dietary changes that take a CAM approach focus on decreasing inflammatory foods and promoting foods that reduce inflammation. Many CAM practitioners believe that the typical Western diet can strongly contribute to the inflammation that's a hallmark of RA. These foods include saturated fats, which are primarily derived from animal fats, and the omega 6 fats, which come from corn, soy, and other polyunsaturated oils, such as butter, and which are especially harmful when they're hydrogenated.

The thinking is that these harmful fats promote cascades—chemical reactions—that flood the body with substances that cause it to react in an inflammatory way. The solution is to focus on eating more omega 3 fats, which can block the dangerous chemical cascades. These foods primarily come from a plant-based diet and include

  • Seeds
  • Nuts
  • Vegetables
  • Fruit
  • Whole grains
  • Dried beans
  • Fatty fish, such as salmon

When you eat a variety of fruits and vegetables, you're getting plenty of color in your diet. The natural color in foods is made by substances called flavonoids. Flavonoids themselves have anti-inflammatory properties, and if you eat a lot of them on a regular basis, they build up in your connective tissue.

There's also a theory that some people develop RA because they're allergic to some foods, or highly sensitive, if not allergic. There's anecdotal evidence that in some cases, people with RA who eliminate gluten in their diets (gluten is found in wheat) experience an improvement in their symptoms. If the allergy/sensitivity theory is correct, there could be any number of foods that might cause this inflammatory response, and patients are often urged to explore that possibility.

Herbs and supplements

While there hasn't been a lot of research done on the effectiveness of most herbs and supplements for RA, there are some that CAM practitioners believe are beneficial. They include:

  • Extracts of turmeric, which is called curcumin and is believed to have anti-inflammatory properties
  • Glucosamine sulfate and condroitin sulfate, which acts like an NSAID
  • Fish oil, which actually has been subjected to clinical trials and shown to have anti-inflammatory properties. If you're interested in taking fish oil supplements for RA, make sure you're getting 3,000 milligrams of EPA per day in your dosage.

Acupuncture and other Chinese medical practices

The goal of acupuncture is to balance and harmonize the body's natural flow of energy. The theory in Chinese medicine is that when energy flow is blocked and stagnant, illness can result. Acupuncturists place tiny needles into points on the body that stimulate and enhance the flow of energy.

The Chinese medical perspective sees joint inflammation as a buildup and imbalance of heat, so the acupuncturist's goal is to place needles in such a way that the heat "moves on." Most of the time, people with RA who get relief from acupuncture will need to continue to see their acupuncturists for treatments periodically. But every person is different, and only your own acupuncturist can determine the best course of treatment for you.

Another Chinese medical practice that can provide relief for RA is hydrotherapy. This can consist of simple soaking in a very hot bath, or naturopathic hydrotherapy, which uses applications of hot and cold water to improve blood flow and remove toxins.

Mind/body practices are also beneficial

If you're physically able to exercise (talk with your doctor about the safety of this for you), you might want to try gentle yoga classes, t'ai chi or qigong. These modalities can help improve strength and flexibility, and they can play a big role in stress reduction as well.

Give CAM therapies time to take effect

Western medications tend to provide relief fairly quickly. CAM therapies, on the other hand, generally need more time. If you make dietary changes, for example, you'll need to stick with them over a period of months before you're likely to see an improvement. The same is true of supplements and sometimes, of acupuncture.

But the benefits can be wonderful. For example, an anti-inflammatory diet is beneficial not just for RA, but for the prevention of heart disease. The practices of yoga, t'ai chi or qigong can help strengthen your body and relieve stress whether you have RA or not. In essence, the side effects of most CAM therapies are beneficial and promote general overall health.

Who's a good candidate for CAM RA treatments?

Most CAM practitioners will say that just about anybody who has RA is a good candidate for complementary therapies. And the sooner you try them, the better, because CAM therapies work best to prevent and stop progression of the disease. Once joint damage has become severe, CAM therapies may not be as effective as they might have been earlier on.

Finding a CAM practitioner

If you're interested in finding an acupuncturist, one of the best ways is through word of mouth. If you don't know of anyone who's had acupuncture, you can find a licensed practitioner near you by going to the Web site of the National Certification Commission for Acupuncture and Oriental Medicine (http://www.nccaom.org/) and click on the "Find a Practitioner" tab at the top.

To find a naturopathic doctor, who can advise you on dietary changes, supplements and other CAM treatments, visit the American Association of Naturopathic Physicians (http://www.naturopathic.org/) and click on the "Find a ND" tab.

Source:
National Center for Complementary and Alternative Medicine; National Institute of Arthritis and Musculoskeletal and Skin Disease; HealthTalk Interactive Web Broadcast, 8 February 2007



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