Brunilda Nazario, MD
Alternative therapies for arthritis include everything from acupuncture, copper bracelets, and magnets to glucosamine and chondroitin supplements and yoga. But are any of these therapies really a match for your achy, creaky joints?
Many people with arthritis look to these alternative therapies to help relieve the pain, stiffness, stress, anxiety, and depression that accompany their disease. The Arthritis Foundation reports that two-thirds of people with arthritis have tried alternative therapies.
And some of these alternative treatments really work, say leading arthritis experts, and even have scientific evidence behind them (although most doctors admit that more research is needed). On the other hand, many more alternative treatments don't work or need more studies to support any anecdotal claims.
Here's what's known -- and not yet known -- about some of the more popular alternative arthritis remedies.
The mind-body practices of yoga and tai chi may help many people with arthritis.
Though there are few studies that look at the effects of yoga on arthritis per se, a study published in the British Journal of Rheumatology did find that people with rheumatoid arthritis (RA) who participated in a yoga program over a three-month period had greater grip strength than those who did not practice yoga.
Another study published in the Journal of Rheumatology reported that people who practiced yoga showed a significant improvement in pain, tenderness, and finger range of motion for osteoarthritis (OA) of the hands.
"Yoga and tai chi are exercises, and exercise is good," sums up David Pisetsky, MD, chief of rheumatology at Duke University Medical Center in Durham, N.C. "They can help improve muscle strength and balance."
Exercise also helps people with arthritis maintain a healthy weight, which can aid in alleviating some of the symptoms of the disease. Excess weight can make achy joints feel that much worse. Swimming, walking, and other low-impact exercises can also help with pain relief and weight loss.
A recent study by the National Center for Complementary and Alternative Medicine estimated that 3.1 million adults in the U.S. are treated with acupuncture each year. And a lot of these individuals likely got needled to treat their arthritis. Acupuncture involves using thin needles to stimulate specific points on the body in hopes of removing blockages to channels of energy known as meridians, allowing energy to flow properly through the body.
A number of studies have looked at acupuncture in the two most common types of arthritis --OA and RA. The most recent review article involved 3,498 people with OA in 16 trials and found that acupuncture was superior to sham acupuncture for short-term improvements in pain and function, but that the benefits were pretty small.
"There is currently insufficient research to determine which arthritis patients benefit most from acupuncture," says review author Eric Manheimer, MS, a research associate at the Center for Integrative Medicine at the University of Maryland School of Medicine in Baltimore. "Future research may be important to try to identify the optimal candidate for acupuncture on the basis of individual beliefs, expectations, and psychological profile."
Pisetsky's verdict: Give acupuncture a shot. "It may provide some temporary pain relief but does not change the course of the illness," Pisetsky says. "If you think it is beneficial, try it."
Glucosamine and chondroitin are popular nutritional supplements that have been widely studied for their effectiveness in treating arthritis. While many people with arthritis and doctors stand by the supplements, the studies have not been all that kind. The latest research -- an analysis of 10 studies -- showed that glucosamine and chondroitin don't do much to relieve the pain associated with hip or knee OA, or modify the disease process once it has started.
This is not the first study to cast doubt on the effectiveness of these two supplements. The Glucosamine/Chondroitin Arthritis Intervention Trial (GAIT) also showed that these supplements did not improve knee OA pain. A follow-up arm showed that they did not do any better than placebo in slowing loss of cartilage that occurs in knee OA. That said, a smaller subset of 354 GAIT participants with moderate-to-severe OA pain did get some relief with the combined supplements. (These findings need to be confirmed in larger studies.)
Pisetsky says that it is OK to give these supplements a try.
"If you want to take them and perceive a benefit, that's fine, but tell your doctor," he says. All herbs and supplements may have unknown and potentially dangerous interactions with medication. If you're taking medication, it's best to check with your doctor before trying any supplements.
Many alternative remedies -- such as copper bracelets or magnets -- may not have much, if any, scientific evidence to back them up or disprove them. Indeed, Kerry Ludlam, a spokeswoman for the Arthritis Foundation, reports that there is a lack of research both for and against the usefulness of alternative therapies.
"There's a void of information," she says. Since many of the alternative therapies cited for the relief of arthritis are considered harmless (other than perhaps to your pocketbook), many doctors say that if you want to try them, go ahead.
Pisetsky agrees."There is no clear evidence that copper bracelets work, so at best they are unproven remedies, but they are not that expensive and so they can be tried," Pisetsky says.
The real issue is if you turn to unproven alternative remedies for your arthritis in place conventional therapies with proven track records, Pisetsky says.
Before reaching for supplements or putting on a copper bracelet, find out what is causing your joint pain, he says. "Try conventional therapies first, but at the end of the day, if you decide to give an alternative remedy a try, do it intelligently,” he says.
"We don't want to have people go out and miss useful therapy because they think these alternatives don't have side effects."
SOURCES:University of Maryland Medical Center web site: "Osteoarthritis Sufferers Seek Complementary Care."Arthritis Foundation: "Guide to Alternative Therapies."Vignon, E. Arthritis & Rheumatism, September 2003; vol 48: p S77.Reginster, J. Lancet, January 2001; vol 357: pp 251-256.WebMD Health News: "Modest Arthritis Benefit Seen from MSM."Pavelka, J. Osteoarthritis and Cartilage, October 2004; vol 12: p S74. Clegg, D. New England Journal of Medicine, Feb. 23, 2006; vol 354: pp 795-808.Scharf, H.P. Annals of Internal Medicine, July 4, 2006; vol 145: pp12-20.Wandel, S. BMJ, 2010; vol 341.David Pisetsky, MD, chief of rheumatology, Duke University Medical Center, Durham, N.C.Manheimer, E. The Cochrane Library. 2010; Issue 1.
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