Rheumatoid Arthritis Health Article

Alternative treatment

A variety of alternative therapies has been recommended for patients with RA. Meditation, hypnosis, guided imagery, and relaxation techniques have been used effectively to control pain. Acupressure and acupuncture have also been used for pain. Bodywork can be soothing, decreasing stress and tension, and is thought to improve/restore chemical balance within the body.

A multitude of nutritional supplements can be useful for RA. Fish oils, the enzymes bromelain and pancreatin, and the antioxidants (vitamins A, C, and E, selenium, and zinc) are the primary supplements to consider.

Many herbs also are useful in the treatment of RA. Anti-inflammatory herbs may be very helpful, including tumeric (Curcuma longa), ginger (Zingiber officinale), feverfew (Chrysanthemum parthenium), devil's claw (Harpagophytum procumbens), Chinese thoroughwax (Bupleuri falcatum), and licorice (Glycyrrhiza glabra). Lobelia (Lobelia inflata) and cramp bark (Vibernum opulus) can be applied topically to the affected joints.

Homeopathic practitioners recommended Rhus toxicondendron and Bryonia (Bryonia alba) for acute prescriptions, but constitutional treatment, generally used for chronic problems like RA, is more often recommended. Yoga has been used for RA patients to promote relaxation, relieve stress, and improve flexibility. Nutritionists suggest that a vegetarian diet low in animal products and sugar may help to decrease both inflammation and pain from RA. Beneficial foods for patients with RA include cold water fish (mackerel, herring, salmon, and sardines) and flavonoid-rich berries (cherries, blueberries, hawthorn berries, blackberries, etc.).

RA, considered an autoimmune disorder, is often connected with food allergies/intolerances. An elimination/challenge diet can help to decrease symptoms of RA as well as identify the foods that should be eliminated to prevent flare-ups and recurrences. Hydrotherapy can help to greatly reduce pain and inflammation. Moist heat is more effective than dry heat, and cold packs are useful during acute flare-ups.

Prognosis

About 15% of all RA patients will have symptoms for a short period of time and will ultimately get better, leaving them with no long-term problems. A number of factors are considered to suggest the likelihood of a worse prognosis. These include:

• race and gender (female and Caucasian).
• more than 20 joints involved.
• extremely high erythrocyte sedimentation rate.
• extremely high levels of rheumatoid factor.
• consistent, lasting inflammation.
• evidence of erosion of bone, joint, or cartilage on x rays.
• poverty.
• older age at diagnosis.
• rheumatoid nodules.
• other coexisting diseases.
• certain genetic characteristics, diagnosable through testing.

Patients with RA have a shorter life span, averaging a decrease of three to seven years of life. Patients sometimes die when very severe disease, infection, and gastrointestinal bleeding occur. Complications due to the side effects of some of the more potent drugs used to treat RA are also factors in these deaths.

Prevention

There is no known way to prevent the development of RA. The most that can be hoped for is to prevent or slow its progress.

BOOKS

Arthritis Foundation. The Good Living with Rheumatoid Arthritis. New York: Longstreet Press Inc., 2000.

Lipsky, Peter E. "Rheumatoid Arthritis." In Harrison's Principles of Internal Medicine. 14th ed. Ed. by Anthony S. Fauci, et al. New York: McGraw-Hill, 1998.

PERIODICALS

Case, J. P. "Old and New Drugs Used in Rheumatoid Arthritis: A Historical Perspective. Part 2: The Newer Drugs and Drug Strategies." American Journal of Therapeutics (May–June 2001): 163-79.

Goekoop, Y. P, et al. "Combination Therapy in Rheumatoid Arthritis." Current Opinions in Rheumatology (May 2001): 177-83.

Koivuniemi, R. and M. Leirisalo-Repo. "Juvenile Chronic Arthritis in Adult Life: A Study of Long-term Outcome in Patients with Juvenile Chronic Arthritis or Adult Rhuematoid Arthritis." Clinical Rheumatology (1999): 220-6.

ORGANIZATION

American College of Rheumatology. 60 Executive Park South, Suite 150, Atlanta, GA 30329. (404) 633-1870. <http://www.rheumatology.org>.

Arthritis Foundation. 1330 West Peachtree St., Atlanta, GA 30309. (404) 872-7100. <http://www.arthritis.org>.

Liz Meszaros

KEY TERMS

Articular bones—Two or more bones connected to each other via a joint.

Joint—Structures holding two or more bones together.

Pauciarticular juvenile RA—Rheumatoid arthritis found in children that affects less than four joints.

Polyarticular juvenile RA—Rheumatoid arthritis found in children that affects more than four joints.

Synovial joint—A type of joint that allows articular bones to move.

Synovial membrane—The membrane that lines the inside of the articular capsule of a joint and produces a lubricating fluid called synovial fluid.