Complementary Therapies for Arthritis

What Is Complementary Therapy?

Complementary therapy includes treatments and products that are not traditionally used in conventional medicine and treatments. They range from ancient systems of medicine, for example; Traditional Chinese Medicine (TCM) and Ayurveda, to treatments such as massage, chiropractic and osteopathy, herbal medicine and aromatherapy.

Complementary therapy emphasises ‚Äėwellness‚Äô that¬†comes from a balance between the body, the mind and¬†the environment. Complementary therapy practitioners¬†aim to restore this balance by treating each person as a¬†unique individual, often recommending lifestyle changes¬†and encouraging a person to take a more active approach¬†to their own health.

Today, the gap between conventional treatment and complementary therapy is blurring. Many complementary treatments are based on anatomy and physiology, while modern treatments utilise a more holistic approach and have adopted some therapies that originated in complementary therapy.

Should You Try Complementary Therapy?

Before starting any complementary treatment or product it is important to check what evidence is available to suggest that it may work for you. Several complementary treatments are beginning to be backed up by scientific evidence. However, for many others, it is still unclear whether they are truly effective, harmful or just a waste of time and money.

In some cases, the beneficial effects of complementary therapy may last for only a short time, often without a long term benefit. This may be due to the placebo effect when people feel better or show physiological signs of improvement because they believe a therapy is working.

More research is needed to analyse the long term results of complementary treatments.

As always, you should ask your GP about any complementary therapy you might be considering.

Complementary Therapies Video Playlist

What Complementary Therapies Can Be Used For Arthritis?

Evidence-Based Complementary Therapies For Arthritis:

Acupuncture

Western medical acupuncture is based upon one of the¬†most ancient systems ‚Äď Traditional Chinese Medicine¬†(TCM); it involves inserting fine needles into specific¬†points of the body realigning the flow of energy (chi).

It relieves pain by diverting or changing the way in which the messages from tissues to the brain are processed and also by stimulating the body’s own painkillers (the endorphins and encephalins).

Acupuncture is one of the most popular complementary medicine treatments; it is used for pain management in physiotherapy and is often combined with herbal treatments by practitioners of TCM.

There is clear scientific evidence that acupuncture can be beneficial if you have Osteoarthritis in your knees, Fibromyalgia or low back pain. However, this effect may not last for the long term and further acupuncture treatments may be required. Acupuncture is recommended for those who are not eligible for joint replacement operations or who cannot tolerate pain killers.

Acupuncture generally has a very good safety record. In less than 3% of people, it may cause dizziness after a session or cause bleeding and bruising.

Nutrition and dietary supplements

Maintaining a healthy body weight is an important factor in maintaining overall health and in managing arthritis. A diet low in saturated fats and high in omega-3 and fruit and vegetables is recommended. There is some evidence that vegetarian diets can be beneficial for people with inflammatory types of arthritis.

Herbal medicine

Herbal remedies have been used in many cultures since ancient times. Today about one-quarter of pharmaceutical preparations contain at least one active ingredient extracted from plant sources. Medical herbalists and naturopaths work with herbal remedies using the whole plant.

Generally speaking, herbal remedies are safe but can sometimes cause side effects. These can include stomach upsets, sleeplessness and pains in your muscles or joints. Some herbal remedies may also interact with your prescribed medication.

One of the most beneficial herbs for Osteoarthritis is Boswellia (from the frankincense tree). Some clinical trials with this herb have shown to reduce pain and stiffness, and improve physical function in people with Osteoarthritis.

Other herbs may be beneficial for arthritis, but the evidence is inconclusive. It is best to avoid self-prescribing and consult with a suitably qualified practitioner and check with your doctor before starting the treatment to avoid any side effects and herb-drug interactions.

Manual therapies

There is a wide variety of manual therapies including acupressure, chiropractic, massage and osteopathy. The latest research reviews demonstrate that some people with lower back pain can benefit from osteopathy, and massage therapy can be helpful for some people with Fibromyalgia.

Tai chi and Yoga

Tai chi combines deep breathing and relaxation with slow and gentle movements. Originally developed as a martial art in 13th-century China, tai chi is today practised around the world as a health-promoting exercise.

Some studies demonstrate that tai chi improved mood, quality of life, and overall physical function in people with Osteoarthritis and Fibromyalgia.

Yoga incorporates several elements of exercise and breathing that may be beneficial for arthritis and may help improve strength, flexibility and balance.

Research has indicated that long-term yoga participants have significantly gained bone density, which can be attributed to the effects of muscles working against gravity. Some studies have shown beneficial effects for people with Fibromyalgia.

Relaxation techniques

Relaxation techniques include muscle relaxation, refocusing, breathing control or visual imagery.

Relaxation techniques are an important part of yoga and tai chi. Progressive muscle relaxation is used to help with muscle tension and cope with pain, while there’s little evidence that it is effective in the treatment of Rheumatoid Arthritis and Osteoarthritis, there’s promising evidence to suggest that it may be useful for Fibromyalgia and low back pain.

Mindfulness meditation

Mindfulness meditation is becoming popular with mainstream health practitioners. It involves nonjudgmental attention to experiences in the present moment. This technique can be beneficial for people with Rheumatoid Arthritis.

Researchers have found that it helps to regulate emotions and improves people’s ability to cope with pain. They noted that those with a history of depression responded better than others to mindfulness meditation.

Promising but inconclusive evidence:

Herbal products that have some promising but inconclusive evidence for beneficial effects in Osteoarthritis include: Devil’s claw, ginger extract, pine bark extract and rosehip extract.

Borage seed oil and Evening Primrose oil show some beneficial effects in Rheumatoid Arthritis.

Green-lipped mussel extract is native to New Zealand. The evidence that this assists Osteoarthritis is mixed.

Balneotherapy (mineral baths) in some studies have shown to be beneficial for Rheumatoid Arthritis and Fibromyalgia.

Cherries may have benefits for some arthritis that is inflammatory such as Gout Arthritis and Rheumatoid Arthritis. It has been suggested that antioxidant compounds found in cherries may inhibit the enzymes that increase inflammation. There is some evidence that uric acid may be lowered further by eating cherries in addition to taking uric acid lowering medicine.

Supplements that can be beneficial if you have arthritis:
  • Avocado-soybean unsaponifiable (ASU) are shown to¬†help with pain and stiffness in Osteoarthritis, and¬†in some cases reduce the progression of Osteoarthritis.¬†ASU is used in the form of gel capsules containing¬†a natural vegetable extract made from avocado and¬†soybean oils.
  • Calcium and vitamin D. Long term use of corticosteroids in inflammatory arthritis can lead to weak bones and the bone disease osteoporosis. Calcium plays an important role in strengthening bones and preventing osteoporosis. Exercise and eating calcium-rich foods can help you to maintain bone health providing you are not deficient in vitamin D. There is some evidence that people who have Rheumatoid Arthritis have low levels of vitamin D. More research is needed to demonstrate whether vitamin D can play a role in treating Rheumatoid Arthritis. You can get vitamin D in a variety of ways: through your skin, from your diet, by prescription and from supplements. The best way for the majority of people is to restore vitamin D levels through daily outdoor activities. Seniors, people with dark skin and people with some conditions such as Crohn‚Äôs Disease may require vitamin D supplementation. Ask your doctor whether you need Calcium and vitamin D supplements.
  • Capsaicin is the main active component of chilli peppers. It is available in the form of gel, cream and plasters. It works by its ability to reduce substance P, one of the chemicals involved in pain. Capsaicin can be effective in reducing pain in Osteoarthritis.
  • Folic acid. Some drugs, such as methotrexate for inflammatory types of arthritis interfere with how the body uses folic acid. Taking folic acid can help to prevent side effects during methotrexate treatment. Ask your doctor or specialist how much folic acid you need to take.
  • Fish oil has proved to be beneficial for Rheumatoid Arthritis. Fish oil contains anti-inflammatory omega-3 fatty acids (EPA & DHA). Deepwater fish such as tuna, sardines, mackerel and salmon are the richest sources of omega-3, but many New Zealanders do not eat enough of these fatty fish. Supplemental fish oil has been shown to help reduce joint pain, swelling, stiffness and increase joint mobility. Quite large amounts of omega-3 are needed for the best effects, so a concentrated fish oil supplement providing about 3 g of omega-3 (EPA & DHA) daily is a good option. Discuss with your doctor how much fish oil you need to take, especially if you‚Äôre taking warfarin or aspirin as your blood-thinning control may be affected.
  • Glucosamine and Chondroitin are both natural components of cartilage. Glucosamine sulphate is a very popular supplement used for Osteoarthritis. Research results are inconclusive. You may want to try glucosamine sulphate with or without chondroitin for three to six months, and if your joint pain and stiffness are improved you can choose to continue these supplements. You shouldn‚Äôt take glucosamine sulphate if you‚Äôre allergic to shellfish. Check with your doctor before starting on glucosamine if you‚Äôre taking warfarin (your blood-thinning control may be affected) or if you have high levels of sugar in the blood due to diabetes.
  • SAMe (S-adenosylmethionine) is an active compound made from an amino acid methionine ‚Äď it can be beneficial for some people with Osteoarthritis improving function and reducing pain. SAMe can cause mild side effects including nausea, headaches and a dry mouth. Discuss with your doctor before taking this supplement if you have asthma or other chronic conditions.

Complementary Therapies and Arthritis Factsheet

(Downloadable PDF)

Complementary-therapies-nutrients

Little evidence:

Popular complementary treatments with very little evidence suggesting that these therapies might work in arthritis include aromatherapy, biofeedback, chiropractic, hypnosis, magnetic therapy and Qigong.

More research is needed to be able to assess the long-term benefits of these treatments for people with arthritis.

Copper bracelets are widely used by people with arthritis but there is no scientific evidence to prove their beneficial effects.

To find qualified, registered naturopaths in New Zealand, visit Naturopaths & Medical Herbalists of New Zealand

Safety Checklist Before Trying Complementary Therapies for Arthritis

If you decide to try a complementary medicine treatment, the following checklist will help ensure your treatment is reliable and safe:
  • Contact the professional association for your chosen¬†therapy and ask for a list of members in your area.
  • Be very cautious about any practitioner who advises¬†you to abandon your conventional medical treatment.
  • During the first visit ask your practitioner about their¬†training, experience and qualifications.
  • Ask your complementary therapist how this treatment¬†or product works and whether they are safe.
  • Ask how much the treatment will cost and how long¬†it will take.
  • Find out if they have indemnity insurance if something
    goes wrong.
  • Ask your complementary therapy practitioner about¬†any possible interactions of the product or therapy¬†with your current medical treatment.

Key Points About Complementary Therapy and Arthritis:

Take responsibility of your health by being an informed consumer. Find out and consider what scientific studies have been done on the safety and effectiveness of the complementary therapy that interests you.

Keep in mind that ‚Äúnatural‚ÄĚ does not¬†necessarily mean ‚Äúsafe‚ÄĚ, be aware that¬†some products may interact with medications¬†(prescription or over-the-counter dietary¬†supplements), and some may have side effects¬†on their own.

Always tell your doctor and your complementary medicine practitioner of all drugs, treatments and remedies you take.

! Never stop taking prescribed medication without talking to your GP or specialist !

What Is Complementary Therapy?

Complementary therapy includes treatments and products that are not traditionally used in conventional medicine and treatments. They range from ancient systems of medicine, for example; Traditional Chinese Medicine (TCM) and Ayurveda, to treatments such as massage, chiropractic and osteopathy, herbal medicine and aromatherapy.

Complementary therapy emphasises ‚Äėwellness‚Äô that¬†comes from a balance between the body, the mind and¬†the environment. Complementary therapy practitioners¬†aim to restore this balance by treating each person as a¬†unique individual, often recommending lifestyle changes¬†and encouraging a person to take a more active approach¬†to their own health.

Today, the gap between conventional treatment and complementary therapy is blurring. Many complementary treatments are based on anatomy and physiology, while modern treatments utilise a more holistic approach and have adopted some therapies that originated in complementary therapy.

Should You Try Complementary Therapy?

Before starting any complementary treatment or product it is important to check what evidence is available to suggest that it may work for you. Several complementary treatments are beginning to be backed up by scientific evidence. However, for many others, it is still unclear whether they are truly effective, harmful or just a waste of time and money.

In some cases, the beneficial effects of complementary therapy may last for only a short time, often without a long term benefit. This may be due to the placebo effect when people feel better or show physiological signs of improvement because they believe a therapy is working.

More research is needed to analyse the long term results of complementary treatments.

As always, you should ask your GP about any complementary therapy you might be considering.

What Complementary Therapies Can Be Used For Arthritis?

Evidence-Based Complementary Therapies For Arthritis:

Acupuncture

Western medical acupuncture is based upon one of the¬†most ancient systems ‚Äď Traditional Chinese Medicine¬†(TCM); it involves inserting fine needles into specific¬†points of the body realigning the flow of energy (chi).

It relieves pain by diverting or changing the way in which the messages from tissues to the brain are processed and also by stimulating the body’s own painkillers (the endorphins and encephalins).

Acupuncture is one of the most popular complementary medicine treatments; it is used for pain management in physiotherapy and is often combined with herbal treatments by practitioners of TCM.

There is clear scientific evidence that acupuncture can be beneficial if you have Osteoarthritis in your knees, Fibromyalgia or low back pain. However, this effect may not last for the long term and further acupuncture treatments may be required. Acupuncture is recommended for those who are not eligible for joint replacement operations or who cannot tolerate pain killers.

Acupuncture generally has a very good safety record. In less than 3% of people, it may cause dizziness after a session or cause bleeding and bruising.

Nutrition and dietary supplements

Maintaining a healthy body weight is an important factor in maintaining overall health and in managing arthritis. A diet low in saturated fats and high in omega-3 and fruit and vegetables is recommended. There is some evidence that vegetarian diets can be beneficial for people with inflammatory types of arthritis.

Herbal medicine

Herbal remedies have been used in many cultures since ancient times. Today about one-quarter of pharmaceutical preparations contain at least one active ingredient extracted from plant sources. Medical herbalists and naturopaths work with herbal remedies using the whole plant.

Generally speaking, herbal remedies are safe but can sometimes cause side effects. These can include stomach upsets, sleeplessness and pains in your muscles or joints. Some herbal remedies may also interact with your prescribed medication.

One of the most beneficial herbs for Osteoarthritis is Boswellia (from the frankincense tree). Some clinical trials with this herb have shown to reduce pain and stiffness, and improve physical function in people with Osteoarthritis.

Other herbs may be beneficial for arthritis, but the evidence is inconclusive. It is best to avoid self-prescribing and consult with a suitably qualified practitioner and check with your doctor before starting the treatment to avoid any side effects and herb-drug interactions.

Manual therapies

There is a wide variety of manual therapies including acupressure, chiropractic, massage and osteopathy. The latest research reviews demonstrate that some people with lower back pain can benefit from osteopathy, and massage therapy can be helpful for some people with Fibromyalgia.

Tai chi and Yoga

Tai chi combines deep breathing and relaxation with slow and gentle movements. Originally developed as a martial art in 13th-century China, tai chi is today practised around the world as a health-promoting exercise.

Some studies demonstrate that tai chi improved mood, quality of life, and overall physical function in people with Osteoarthritis and Fibromyalgia.

Yoga incorporates several elements of exercise and breathing that may be beneficial for arthritis and may help improve strength, flexibility and balance.

Research has indicated that long-term yoga participants have significantly gained bone density, which can be attributed to the effects of muscles working against gravity. Some studies have shown beneficial effects for people with Fibromyalgia.

Relaxation techniques

Relaxation techniques include muscle relaxation, refocusing, breathing control or visual imagery.

Relaxation techniques are an important part of yoga and tai chi. Progressive muscle relaxation is used to help with muscle tension and cope with pain, while there’s little evidence that it is effective in the treatment of Rheumatoid Arthritis and Osteoarthritis, there’s promising evidence to suggest that it may be useful for Fibromyalgia and low back pain.

Mindfulness meditation

Mindfulness meditation is becoming popular with mainstream health practitioners. It involves nonjudgmental attention to experiences in the present moment. This technique can be beneficial for people with Rheumatoid Arthritis.

Researchers have found that it helps to regulate emotions and improves people’s ability to cope with pain. They noted that those with a history of depression responded better than others to mindfulness meditation.

Promising but inconclusive evidence:

Herbal products that have some promising but inconclusive evidence for beneficial effects in Osteoarthritis include: Devil’s claw, ginger extract, pine bark extract and rosehip extract.

Borage seed oil and Evening Primrose oil show some beneficial effects in Rheumatoid Arthritis.

Green-lipped mussel extract is native to New Zealand. The evidence that this assists Osteoarthritis is mixed.

Balneotherapy (mineral baths) in some studies have shown to be beneficial for Rheumatoid Arthritis and Fibromyalgia.

Cherries may have benefits for some arthritis that is inflammatory such as Gout Arthritis and Rheumatoid Arthritis. It has been suggested that antioxidant compounds found in cherries may inhibit the enzymes that increase inflammation. There is some evidence that uric acid may be lowered further by eating cherries in addition to taking uric acid lowering medicine.

Supplements that can be beneficial if you have arthritis:
  • Avocado-soybean unsaponifiable (ASU) are shown to¬†help with pain and stiffness in Osteoarthritis, and¬†in some cases reduce the progression of Osteoarthritis.¬†ASU is used in the form of gel capsules containing¬†a natural vegetable extract made from avocado and¬†soybean oils.
  • Calcium and vitamin D. Long term use of corticosteroids in inflammatory arthritis can lead to weak bones and the bone disease osteoporosis. Calcium plays an important role in strengthening bones and preventing osteoporosis. Exercise and eating calcium-rich foods can help you to maintain bone health providing you are not deficient in vitamin D. There is some evidence that people who have Rheumatoid Arthritis have low levels of vitamin D. More research is needed to demonstrate whether vitamin D can play a role in treating Rheumatoid Arthritis. You can get vitamin D in a variety of ways: through your skin, from your diet, by prescription and from supplements. The best way for the majority of people is to restore vitamin D levels through daily outdoor activities. Seniors, people with dark skin and people with some conditions such as Crohn‚Äôs Disease may require vitamin D supplementation. Ask your doctor whether you need Calcium and vitamin D supplements.
  • Capsaicin is the main active component of chilli peppers. It is available in the form of gel, cream and plasters. It works by its ability to reduce substance P, one of the chemicals involved in pain. Capsaicin can be effective in reducing pain in Osteoarthritis.
  • Folic acid. Some drugs, such as methotrexate for inflammatory types of arthritis interfere with how the body uses folic acid. Taking folic acid can help to prevent side effects during methotrexate treatment. Ask your doctor or specialist how much folic acid you need to take.
  • Fish oil has proved to be beneficial for Rheumatoid Arthritis. Fish oil contains anti-inflammatory omega-3 fatty acids (EPA & DHA). Deepwater fish such as tuna, sardines, mackerel and salmon are the richest sources of omega-3, but many New Zealanders do not eat enough of these fatty fish. Supplemental fish oil has been shown to help reduce joint pain, swelling, stiffness and increase joint mobility. Quite large amounts of omega-3 are needed for the best effects, so a concentrated fish oil supplement providing about 3 g of omega-3 (EPA & DHA) daily is a good option. Discuss with your doctor how much fish oil you need to take, especially if you‚Äôre taking warfarin or aspirin as your blood-thinning control may be affected.
  • Glucosamine and Chondroitin are both natural components of cartilage. Glucosamine sulphate is a very popular supplement used for Osteoarthritis. Research results are inconclusive. You may want to try glucosamine sulphate with or without chondroitin for three to six months, and if your joint pain and stiffness are improved you can choose to continue these supplements. You shouldn‚Äôt take glucosamine sulphate if you‚Äôre allergic to shellfish. Check with your doctor before starting on glucosamine if you‚Äôre taking warfarin (your blood-thinning control may be affected) or if you have high levels of sugar in the blood due to diabetes.
  • SAMe (S-adenosylmethionine) is an active compound made from an amino acid methionine ‚Äď it can be beneficial for some people with Osteoarthritis improving function and reducing pain. SAMe can cause mild side effects including nausea, headaches and a dry mouth. Discuss with your doctor before taking this supplement if you have asthma or other chronic conditions.

Complementary Therapies and Arthritis Factsheet

(Downloadable PDF)

Complementary-therapies-nutrients

Little evidence:

Popular complementary treatments with very little evidence suggesting that these therapies might work in arthritis include aromatherapy, biofeedback, chiropractic, hypnosis, magnetic therapy and Qigong.

More research is needed to be able to assess the long-term benefits of these treatments for people with arthritis.

Copper bracelets are widely used by people with arthritis but there is no scientific evidence to prove their beneficial effects.

Safety Checklist Before Trying Complementary Therapies for Arthritis

If you decide to try a complementary medicine treatment, the following checklist will help ensure your treatment is reliable and safe:
  • Contact the professional association for your chosen¬†therapy and ask for a list of members in your area.
  • Be very cautious about any practitioner who advises¬†you to abandon your conventional medical treatment.
  • During the first visit ask your practitioner about their¬†training, experience and qualifications.
  • Ask your complementary therapist how this treatment¬†or product works and whether they are safe.
  • Ask how much the treatment will cost and how long¬†it will take.
  • Find out if they have indemnity insurance if something
    goes wrong.
  • Ask your complementary therapy practitioner about¬†any possible interactions of the product or therapy¬†with your current medical treatment.

Key Points About Complementary Therapy and Arthritis:

Take responsibility of your health by being an informed consumer. Find out and consider what scientific studies have been done on the safety and effectiveness of the complementary therapy that interests you.

Keep in mind that ‚Äúnatural‚ÄĚ does not¬†necessarily mean ‚Äúsafe‚ÄĚ, be aware that¬†some products may interact with medications¬†(prescription or over-the-counter dietary¬†supplements), and some may have side effects¬†on their own.

Always tell your doctor and your complementary medicine practitioner of all drugs, treatments and remedies you take.

! Never stop taking prescribed medication without talking to your GP or specialist !

Complementary Therapies Video Playlist:

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