A Guide to Integrative Medicine for RA

Five complementary therapies that can help reduce your rheumatoid arthritis symptoms and boost quality of life.

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Anyone with rheumatoid arthritis (RA) knows that pain meds and injections can be your best friends. But they can also cause side effects, such as an upset stomach, muscle weakness or swelling. That’s one reason doctors and researchers have been studying the ability of alternative therapies to ease RA symptoms when used in conjunction with traditional treatments.

“Complementary therapies are good for symptomatic relief, but they don’t play a role in treating the disease process,” explains Magdalena Cadet, MD, director of rheumatology at New York Hospital Queens in New York City. That means none of the measures below can or should replace the drugs prescribed by your rheumatologist—they’re meant as add-ons to make life a little easier and you a little happier. Hard evidence about some of these therapies is scarce, but consider talking with your rheumatologist about the following:

Physical activity
Dr. Cadet says she has patients who’ve benefited from increasing their activity, especially when supervised by a physical therapist. “They tend to have improved flexibility, less-tender joints and better range of motion.” In fact, one study of men with RA of the knee showed that both aerobic exercise and simple strengthening moves helped reduce pain.

Talk with your rheumatologist about the intensity and duration of exercise that’s right for you, but generally start with 30 minutes a day of low-impact exercise, such as walking or swimming. Next, try adding some strength-training moves. If traditional weight lifting hurts your joints, ask your rheumatologist for a referral to a physical therapist; most insurance policies cover at least a few sessions if your doctor deems them necessary.

A physical therapist can show you some isometric exercises, moves in which you tense your muscles without a lot of other movement, that you can do daily. Plus, a physical therapist can demonstrate proper form and make sure you do the same, preventing joint pain and injury.

Looks like acupuncture (a practice based in traditional Chinese medicine, in which tiny, painless needles are inserted into the skin to stimulate specific points on the body) really can reduce symptoms of chronic pain, according to a recent review of 29 studies, funded by the National Institutes of Health’s National Center for Complementary and Alternative Medicine. While none of these studies included RA specifically, the results were similar for several types of pain, including osteoarthritis, shoulder pain and even chronic headaches.

“Acupuncture is thought to help by releasing tight muscles, as well as stimulating the release of endorphins [the brain’s feel-good chemicals],” explains Dr. Cadet, noting that it’s also believed to alter the brain’s perception of pain. But acupuncture can make you vulnerable to infection, so Dr. Cadet advises discussing the option with your rheumatologist before giving it a try.Massage
Although specific studies on massage and RA are lacking, research on massage as a treatment for other types of arthritis is promising. One study in the Archives of Internal Medicine showed that osteoarthritis patients had less pain and stiffness and better range of motion after getting Swedish massage one or two times a week for eight weeks. What’s more, Dr. Cadet has seen it help her own patients. “Regular massage in a supporting role has helped promote more joint and muscle flexibility for them,” she says. Talk with your rheumatologist about what type of massage you might try, and how frequently you should get it done.

If you’re feeling anxious or blue, meditation can help soothe your spirits, according to a study of RA patients in the journal Arthritis Care & Research. After six months of mindfulness meditation, participants reported 35% less psychological distress than they had at the study’s onset, despite the fact that their actual disease symptoms hadn’t improved.

Mindfulness is the simplest kind of meditation—and you can try it right now. Turn your attention to the process of breathing for several minutes, consciously noticing as you inhale and exhale. When unrelated thoughts pop up (and they will!), acknowledge them and then return your focus to your breath. How’s that for mind over matter?

April 2013