Alternative Therapies for Rheumatic Diseases
Some alternative therapies or complementary treatments can help relieve the pain and stiffness of rheumatic diseases. Find out which ones can help improve flexibility or even stop disease progression.
By Eleanor Roberts, PhD
Medically Reviewed by Lindsey Marcellin, MD, MPH
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There's no denying that medication plays an important role in the treatment of rheumatic diseases like arthritis. But the use of complementary treatments — such as acupuncture, meditation, hot and cold therapies, and topical creams — can also provide temporary pain relief and improve mobility.
Remember that while these alternative treatments may be helpful, it's essential to consult with your rheumatologist before you decide to go the complementary or alternative route. Here's a rundown of what may help.
Topical creams:Counter-irritants, including menthol, camphor, and eucalyptus oil, actually work by irritating the nerve endings in the skin and distracting the brain. Methylsalicylate, which is related to aspirin, blocks chemicals that contribute to pain. Capsaicin, an ingredient found naturally in chile peppers, has been shown to relieve pain for many people.
The American College of Rheumatology’s guidelines for osteoarthritis say that topical analgesics such as methylsalicylate or capsaicin cream may be effective by themselves to relieve joint pain, or they can be added on to other treatments.
Transcutaneous electrical nerve stimulation (TENS) and neuromuscular electrical stimulation (NMES):While TENS devices block pain signals via small electrical pulses, NMES stimulates muscle tissue to strengthen it. Both may be effective for some, although effects are moderate, and some studies have shown little to no benefit.
Acupuncture:Thought to relieve muscle tightness, acupuncture has been shown to help pain and physical dysfunction in knee osteoarthritis. According to Andrew Wong, MD, chief of rheumatology and program director at UCLA Medical Center, “acupuncture and acupressure are effective for helping manage pain of osteoarthritis, but not for inflammatory arthritis like rheumatoid arthritis [except] as an adjunct.”
“Acupuncture is only just beginning to be looked at scientifically," says Calvin Brown, MD, professor of medicine in the division of rheumatology at Northwestern University in Chicago. "Some studies have shown that pretend [sham] acupuncture, where they stick needles in random places, seems to work, so it’s hard to distinguish whether it’s acupuncture or a placebo effect.”
Heat and cold therapies:Research has shown that heat and cold therapies can relieve rheumatoid arthritis pain, either on their own or combined with other treatments. So what's better, ice or heat? "The truth is we don’t know that one is better than the other," says Dr. Brown. "It’s oftentimes just a preference that simply provides a modest degree of comfort to a patient.” Here's the difference:
- Heat therapy increases blood flow, tolerance for pain, and flexibility. Examples are paraffin wax, microwaves, ultrasound, hydrotherapy, and moist heat.
- Cold therapy that numbs nerves may reduce inflammation and muscle spasms. Examples are cold packs, ice massage, soaking in cold water, cooling sprays, and ointments.
Relaxation therapy:Meditation, progressive tensing then relaxing of muscles, and breathing exercises can relax muscles and relieve pain. “Relaxation therapies are beneficial and it’s important to recognize that not only is treating the disease or condition important, but so is helping individuals to cope with this condition," Brown says. "We rarely cure them, so relaxation therapy can be a part of learning to cope.”
Chiropractic manipulation:Chiropractic treatment, especially when combined with heat, has been shown to reduce lower back pain for people with osteoarthritis. “I think that chiropractic care has a place in overall arthritis care and management, [especially treatments that] overlap with what physiotherapists do," says Dr. Wong.
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