Kate Mitchell was 10 when she started having ankle pain. It wasn’t until she was 19 that she was diagnosed with rheumatoid arthritis (RA). And by the time she found medication that worked for her, she was 21.
In the meantime, she turned to remedies ranging from ice cream to acupuncture to feel better.
“I’ve tried many, many things over the years,” says Mitchell, of Boston, now 32.
People with rheumatoid arthritis often experiment with different treatments before finding the best way to manage their symptoms. Sometimes they seek solutions before they’ve been diagnosed with RA, or because the RA medications they’ve been prescribed aren’t working well.
Alternative treatments can complement RA care, says Nilanjana Bose, MD, rheumatologist at Lonestar Rheumatology in Houston.
“I like to have an open mind when it comes to treatment options,” she says. “I realize that there is no one-size-fits-all solution.”
People with joint pain often head to physical therapy or the gym to seek relief. Casey Howell, 36, started physical therapy when she had joint pain after having her first baby. She thought her pain was caused by the weight she had gained during her pregnancy. But even as she lost weight, she had frequent bouts of flu-like symptoms. She now realizes it was rheumatoid arthritis flare-ups.
“The PT helped a little,” says Howell, of Orlando, FL. “But what I’ve found is that if you train you have to be careful because you can train too much.”
physical therapy may help RA patients, but it’s not a primary treatment option, Bose says.
“Work with a good therapist who knows a bit about rheumatoid arthritis and knows how to protect those joints,” she says. “We don’t want a therapist who will drag the patient through intense, very active exercises that could end up damaging tender or inflamed joints.”
For Howell, joining a fitness coaching program designed for people with RA was a game-changer. Her trainer gave her a stretching and exercise routine, advice on water intake and healthy eating, and connecting with other members of the program’s online group.
“At that time, I literally had to move in bed,” Howell explains. “As the program continued, I found myself able to go from being in bed to being able to lift 3 pounds. Finding her was like a saving grace. It was a big turnaround for me: just having a trainer there to help me with a routine and keep me motivated and not fall into that dark place.
Choose low impact aerobic exercise, like riding a stationary bike, swimming and walking, says Bose. Strength training is okay, as long as it’s not too high impact.
Mitchell tried to find relief by cutting foods from her diet after being diagnosed with RA. Although eliminating hydrogenated oils didn’t make a difference in her symptoms, stopping gluten and dairy did.
“I don’t eat gluten, dairy, corn, soy and eggs; all trigger my rheumatoid arthritis pain to varying degrees,” she says.
It’s fine to try elimination diets and stick with them if they work for you, says Bose. There’s no “PR diet” proven to work for everyone. But generally, following an anti-inflammatory diet is a good idea.
“I keep it very simple,” she says. For example, she recommends avoiding sugar and red meat and eating more fruits, vegetables and nuts.
When Howell’s early rheumatoid arthritis medications weren’t helping her symptoms, she was started on an intravenous drip
amounts of B vitamins, calcium and magnesium. They made him feel better, at least in the short term, she says.
vitamins are fine for people with rheumatoid arthritis, as long as they don’t overdo it. says Bose. “Even too many good things can be bad,” she says. “These vitamins are helpful, they might give them a boost and just help them be more productive and more compliant [with their treatment plan].”
If you are considering taking supplements, consult your doctor first to they can make sure that what you’re taking won’t interact with your medications. You may also want to talk to your doctor or dietitian about any dietary adjustments to maximize the nutrients you get from food.
Acupuncture can help control rheumatoid arthritis pain, says Bose.
She recommends going to a licensed practitioner. Acupressure and deep tissue massage may also have benefits. “It helps stimulate deep tissue points, like pressure points, and it can help regulate some of the perceptions of pain,” she says.
As for visits to chiropractors, Bose notes some special concerns for people with RA.
“We don’t recommend chiropractic care as much,” she says. “It’s fine to do it once in a while, but the problem with chiropractic care is that you have to be careful with the manipulation of the spine and not have problems with it.”
After trying a series of remedies but still couldn’t care for her children and maintain her daily life, Howell saw a healer for spiritual energy cleansing, using crystals and essential oils.
“At this point I was desperate, I would try anything,” Howell says. “She was cleaning and she noticed that I was stressed and overwhelmed. It also helped to some extent, but I was still in the same position.
Alternative therapies like this shouldn’t necessarily be dismissed, as long as they’re not harmful and the patient feels a benefit, Bose says.
“I think a lot of it also comes down to the faith of the person, the trust they have in the healer,” she says. “A lot of things can get better when you just have the confidence, whether it’s the doctor or the healer.”
Bose recommends being open with your doctor about any additional remedies you try. And remember that your RA medications are the most important.
“I want to promote a safe space where [patients] can talk to me freely,” she says. “There is a role for many of these alternative treatment options. But I stress to them that it won’t treat your rheumatoid arthritis, so if you’re using it in exclusion of your medications, it’s not the right approach.
Mitchell agrees. She now manages her RA with multiple medications, as well as dietary and chiropractic visits.
“While there are non-drug tools that work for me to some extent, nothing has ever made such a big difference as medication,” she says.
For Howell, it’s the combination of new RA medications, daily exercise on his trainer’s schedule, massage, occasional IV drips and regular mental health therapy that is helping him manage his symptoms.
“I found that I had to do all these things,” she says. “It’s a lot of investment, but at least I can say that I’m able to take care of my children and can start living my life again.”