A major focus of Complementary and Alternative Medicine (CAM) is alternative systems of medicine from non-Western traditions and cultures, including acupuncture, Traditional Chinese Medicine (TCM), Ayurveda, traditional healing practices, naturopathy, as well as alternative Western systems such as homeopathy.1
Acupuncture and traditional Chinese medicine
Acupuncture is one part of the larger system of Traditional Chinese Medicine (TCM) that combines a variety of nutritional, herbal, and mind-body approaches. Acupuncture is an ancient treatment developed in China 5,000 years ago based on the theory that the body contains a network of energy (chi is the term for this energy) pathways (or meridians) and that specific points along the meridians function as gateways that allow the energy to flow through the body. Acupuncture involves the placement of needles at combinations of acupuncture points, as well as the use of heat from burning herbs, to facilitate the flow of energy.2
Acupuncture has been studied extensively as a treatment for osteoarthritis. Positive results from studies have shown that acupuncture is effective in relieving symptoms of osteoarthritis of the knee.1
Currently, there is only preliminary and inconsistent evidence of the effectiveness of acupuncture in RA. Results from several trials suggest that acupuncture is effective in relieving pain associated with RA. However, contradictory results from more recent and well-designed studies have failed to show any benefit in terms of relief of pain, inflammation, or reductions in inflammatory markers in RA.2
A safety concern associated with acupuncture may be hygiene. However, acupuncturists pre-clean the areas of the skin in which needles will be injected. Acupuncture needles are single-use sterile medical devices which are packaged individually and discarded after use. Acupuncture should be avoided in patients with heart disease affecting the valves of the heart, bleeding disorders, infections, and during pregnancy. It should also be avoided in patients being treated with anticoagulants. It should be used cautiously in elderly patients or patients who have significant health problems, patients with diabetes, and patients with a seizure disorder.1
Homeopathy, a system of medicine based on the “law of similars”, was developed in the early 19th century by a German doctor (Samuel Hahnemann) who believed that substances that caused certain symptoms (such as nausea and vomiting), when given in extremely diluted solutions, would also cure those symptoms by provoking a defense response in the body. Homeopathic treatments are derived from a wide variety of sources, including plants, minerals, venoms, and even pharmaceuticals. There is a limited body of evidence showing that homeopathy may be effective in relieving symptoms related to RA, such as joint pain. However, a recent review of existing evidence raised doubts as to whether homeopathy is any more effective than placebo in providing symptomatic relief in RA.3
Ayurveda (this word from Sanskrit translates as “science of life” or “life-knowledge”) is a system of medicine that originated in India over 5,000 years ago, making it possibly the world’s most ancient system of natural medicine. Ayurvedic medicine is comprised of integrated practices including diet, herbal remedies, exercise, meditation, yoga, massage, and bodywork, that have the goal of health on physical, psychological, and spiritual levels. There is some evidence that certain herbal remedies that are part of Ayurvedic medicine may be effective in providing symptom relief in RA. The herbal formula known as RA-1, which contains ashwagandha (Withania somnifera), boswellia or gugula (Boswellia serrate), and ginger (Zingiberis officinale), may have benefits for patients with RA. Anti-inflammatory effects have also been attributed to a resin extract of boswellia that is used as incense. Some evidence exists that the herb guggul (Commiphora mukul) which is available in capsule form may provide pain relief and improve functioning in osteoarthritis.4
Use of herbal supplements or remedies is common in Ayurvedic practice. Consult with your doctor before you start taking an herbal supplement. There may be health risks associated with use of any supplement, including interactions with medications that you are taking and negative effects associated with existing health conditions you may have. Your doctor is in the best position to determine the safe use of any supplement.
Naturopathy involves the practice of using natural substances to restore and maintain a balance of internal body chemistry. It uses a natural and holistic approach to health, involving nutrition, herbal remedies, body manipulation, exercise, reduction of stress, and acupuncture, among other techniques. This medical approach is practiced by a naturopath and naturopathic physicians have the highest level of training in this system of medicine. While there is no evidence that naturopathy itself may be useful in RA, individual interventions commonly used in naturopathic medicine, including herbal remedies, mind-body techniques, and body manipulation, may be useful in relief of symptoms including pain and improvement of functioning.5
Use of herbal supplements or remedies is common in naturopathic practice. Consult with your doctor before you start taking an herbal supplement. There may be health risks associated with use of any supplement, including interactions with medications that you are taking and negative effects associated with existing health conditions you may have. Your doctor is in the best position to determine the safe use of any supplement.