Treatments
Alternative Therapies
In a study of patients with rheumatoid arthritis at our Center, it was found that 66% of patients had tried some form of alternative medicine. The most commonly preferred were acupuncture, Ayurveda, herbs, and homeopathy.
- Always discuss your use of alternative medications, herbs, etc with your rheumatologist/ doctor
- Always use only licensed and well-qualified practitioners
- Remember that even herbs can have side effects and interact with medications you take
- Remember that often not enough research has been done into ‘natural’ therapies and hence all their side effects are not known.
- Traditional medicines which your doctor gives you have known side effects and are usually safe to take under proper supervison
- There is no evidence that any of the alternative forms of medicine can prevent joint damage such as has been proven with drugs like methotrexate
- Acupuncture or Acupressure
What is alternative therapy?
Does it work?
Self help
- Acupressure at home.
Can you try it?
- Acupuncture is generally safe.
- Make sure only sterile disposable needles are used
- Safety in pregnancy and children under 10 years is unknown
- It does relieve pain associated with osteoarthritis, back conditions and fibromyalgia.
- It is not a cure and repeated sessions are required to keep the pain levels low
Ayurvedic Treatment
What is it?
Does it work?
However, in rheumatoid arthritis ayurvedic treatments failed to show significant benefits over placebo (Semin Arthritis Rheum. 2005 Apr;34(5):705-13).
Can you try it?
- Unlicensed ayurvedic doctors may not use pure forms of the medication and there is a risk of heavy metal contamination
- In very large doses ginger can irritate the stomach
- Do not use these medicines if you are on a blood thinning medication
- They can interact with traditional
- medicines
Self help
Turmeric
Initial results showed that a version of turmeric extract that was free of essential oils had a significant impact on arthritis and most closely matched the composition of commercially available supplements. This version was used in subsequent experiments and was shown to prevent acute and chronic arthritis, even when it was administered after arthritis had been induced. In addition, turmeric significantly inhibited joint destruction due to arthritis and inhibited NF-κB, a protein that controls the gene expression of substances that produce an inflammatory response. Turmeric also altered the expression of hundreds of genes involved in joint swelling and destruction and prevented an increase in osteoclasts (cells that break down bone) in joints.
Before turmeric supplements can be recommended for medicinal use, clinical trials are clearly needed to verify/determine whether treatment with adequate doses of well-characterized turmeric extracts can indeed prevent/suppress disease flares in RA patients, as well as to explore any potential benefits of turmeric dietary supplements in the prevention or treatment of more common forms of arthritis in the general population.
Can you try it?
Homeopathy
What is it?
Does it work?
Can I try it?
Do not stop prescribed medicine for arthritis while on homeopathy.
Naturopathic Medicine
What is it?
Does it work?
Can I try it?
Do not stop prescribed medicine for arthritis.
Herbs
A lack of standardization of herbal remedies also makes it challenging to understand what causes adverse interactions. Contamination, misidentification of an herbal plant, or an incorrectly substituted plant all raise issues of quality and can result potentially in an unwanted side effect. Of 400 users of complementary medicine surveyed, Abbot, White, and Ernst (1996) found 8% of those who tried herbal remedies had an adverse reaction.
Natural Therapies
Avocado/Soyabean
Boron
Bromelain
Glucosamine and Chondroitin
Do these supplements really works ?
If patients choose to take dietary supplements to control their symptoms, they should be advised to take Chondroitin sulfate with Glucosamine sulfate which may have an additive effect. Three months of treatment is a sufficient period for the evaluation of efficacy; if there is no clinically significant decrease in symptoms by this time, the supplements should be discontinued. Furthermore, there is no evidence that these agents prevent osteoarthritis in healthy persons or in persons with knee pain but normal radiographs. Also of note, these supplements will not cure arthritis — and that they are only a part of a multipronged treatment.
Some physicians advise patients to use it in three-month-on, two-month-off cycles. Some patients who use these supplements have been able to use [fewer] anti-inflammatory and pain medications. There are things that work for certain patients that don’t work for others.
Which Brand of supplement should I Use?
There are many different brands of Glucosamine and Chondroitin, which are usually sold together in one supplement. Unfortunately, at this time, there is no government monitoring to ensure the purity of these products.
In order to assure that you get a consistent dose of the supplements, stick with a reputable manufacturer; choose products sold by large and well-established companies. If you don’t recognize a brand name, ask about the company’s reputation, how long it has been in business and how long the store has stocked the brand. The dose is 1500 mg of glucosamine and 1200 mg of chondroitin daily.
Who should not take these Supplements?
People with diabetes should use caution when taking Glucosamine because of concern that it might raise blood sugar, an issue which is not confirmed yet.
The effects of these supplements on a growing child or developing baby are not yet known. For that reason, Glucosamine and Chondroitin are not recommended for children, women who are pregnant and women who could become pregnant.
What are the side effects of Glocosamine And Chondrotin?
- Nausea
- Diarrhea or constipation
- Heartburn
- Increased intestinal gas
It is important to check with your doctor before starting any new treatments. Your doctor can review the other medications you are taking and help you decide whether or not these supplements are right for you. Do not take more of the supplements than is recommended.
Ginger
Other Supplements
- DMSO. Once widely used to relieve joint and tissue inflammation, it fell out of favor when animal studies showed high doses damaged the lens of the eye. Don’t use it without consulting your doctor.
- Evening primrose oil. See GLA.
- Fish oil or omega oils. Studies show it relieves the pain of RA. The dose needed is 2000 mg daily
- Flaxseed. There are many good nutritional reasons to add it to your diet, but studies of its effect on arthritis have shown mixed results. Its anti-inflammatory properties work best if other vegetable-based oils are restricted.
- GLA. Gamma linolenic acid (GLA) is an omega-6 fatty acid the body uses to make anti-inflammatory agents, unlike other omega-6 fatty acids that actually increase inflammation. It’s found in evening primrose oil, black currant oil, and borage oil supplements. Several studies show it relieves the stiffness and pain of RA. In one study, some patients were able to quit taking NSAIDs.
- MSM. It’s widely touted for relief of pain and inflammation. Its safety and effectiveness have yet to be determined.
- SAM-e. Many European studies over the last 20 years show SAM-e is as effective as anti-inflammatory painkillers in treating OA but with fewer side effects. It works in conjunction with vitamin B-12, B-6, and folate. Claims that SAM-e repairs and rebuilds cartilage lack evidence, as studies have been done only in the lab and in animals.
- Shark cartilage. Ground-up cartilage from Pacific Ocean sharks is supposed to relieve the inflammation and pain of arthritis. Animal and lab studies are promising, but there are no human studies to support claims.
Stinging nettle. Taken orally or applied to the skin, stinging nettle is supposed to reduce the pain and inflammation of OA. Some studies show that patients can lower their dosages of NSAIDs by taking stinging nettle in extract form. Two small studies showed stinging nettle applied topically