Lesson 8 of 8: Complementary and Alternative Therapies

[MUSIC PLAYING] Medicines, especially DMARDs, are the cornerstone of treatment for rheumatoid arthritis. But there are a number of complementary and alternative therapies that have been shown to have a positive impact on those of us who suffer from RA. Taking control of the disease, mentally and physically, is a big part of living successfully with this disease. Let's start with strategies that engage the mind and body. Yoga has been in existence as a way to boost physical and mental health for about 5,000 years. The practice of yoga involves moving into a series of poses, often using breathing and relaxation techniques. Many styles of yoga, including Iyengar yoga, are safe for most people with RA. At the other end of the spectrum are forms that involve quickly moving from pose to pose that would count as light cardiovascular exercise. Yoga can provide those suffering from RA with a much needed option for gentle exercise. Yoga reduces tension and improves joint flexibility, muscle strength, and balance. Studies have shown that yoga may improve RA symptoms, including the measures of disease activity and function. It's smart to work, at first, with a yoga instructor, who can help tailor your exercises to suit your abilities. And also, confirm with your doctor that yoga is correct for you. Tai chi has been used for centuries to help improve balance of the mind and body. Like yoga, Tai chi combines deep breathing with a gentle flowing movement and meditation. In China, it has been used to treat arthritis. But what is its impact on a condition like RA? Tai chi, originally a traditional Chinese martial art, combines slow and gentle movements with mental focus. There are various styles of Tai chi, a number of which are suitable for people with RA. These styles involve breathing and relaxation exercises, along with some basic postures that flow smoothly from one to the other through graceful movements. Intensity in Tai chi is low and gives a moderate increase in heart rate. In patients who have RA, Tai chi was found to improve mobility in the lower body joints, the hips, the knees, and the ankles. Smaller studies have also shown that Tai chi reduced fatigue and disability and improved physical function and pain. Patients with RA find Tai chi quite enjoyable as an activity, one that they're not inclined to give up. This is quite important, because RA patients can benefit a great deal from sustainable exercise. Many people are helped by touch therapies, which can range from hands-on treatments, such as acupuncture or spinal manipulation to massage. A growing number of studies find touch therapies to be effective, and massage therapy especially has grown more popular in the United States in recent years. What's behind it? We often think of massages as a luxury. But for people who suffer from RA or other musculoskeletal pain, the right type of massage isn't just a way of pampering yourself. It can help manage your condition. There are all kinds of massage techniques, ranging from gentle to intense. But most aim to relieve stress and sore muscles. Studies show that moderate pressure massage can lead to reduced pain and stiffness and an increase in range of motion, hand grip strength, and overall function in people with RA and related conditions. Evidence suggests that massage works by increasing blood flow and bringing more nutrients to tissues. It may also reduce levels of the stress hormone cortisol and decrease heart rate and blood pressure, thus lowering anxiety. Many people are confused by the term occupational therapy, I know I was. What exactly is OT, as it's called? And how can it benefit those who suffer from RA? ALLAN GIBOFSKY: Occupational therapy is not about getting a job, as it might sound. Rather, it's about looking at the world through the lens of occupations, anything that occupies your time, and whatever you might need to stay as independent as possible. Wherever RA creates a struggle with everyday tasks, from gripping a toothbrush, to getting in and out of the car, to getting dressed, or cooking a dinner, occupational therapy can offer solutions. Occupational therapy is regarded as one of the cornerstones in management of RA and can take a variety of approaches. One is educating patients. For example, teaching you how to reduce joint strain through proper ergonomic and joint protection techniques, or rethinking how everyday tasks can be done in a way that reduces fatigue. Similar to physical therapy, occupational therapy may suggest exercises designed to increase range of motion, flexibility, and strength that might help in performing a particular task like combing your hair or turning a doorknob. Finally, an occupational therapist can assist with making and fitting orthotic devices that are designed to help correct the musculoskeletal alignment of a joint. This can be anything from a shoe insert or a wrist splint to an assistive device that helps you sleep at night. Often, people tend to think of occupational therapy as rehabilitative or after something else has happened. But actually, occupational therapy can play an important role in preventing the need for surgery or an increase in medication. There is no miracle diet for RA. However, there are many foods that can help you fight inflammation and improve joint pain and other symptoms. Let's have a look. Although there is no magic one size fits all menu, there has been a great deal of focus on the so-called Mediterranean diet, because of its anti-inflammatory and cardio-protective effects, especially for patients with RA. This diet would include a diet rich in whole foods, fruits, vegetables, fish, especially those containing omega-3 fatty acids, nuts, beans, and olive oil, but low in processed foods including sugary soft drinks and saturated fat. Studies confirm the overall health benefits of a Mediterranean diet, from reductions in blood pressure and cholesterol levels, to a lower risk of death from heart disease and other potentially fatal chronic illnesses. In RA, a Mediterranean diet specifically reduced pain and increased physical functioning in some patients. Recently, a supercharged version of the Mediterranean diet has been proposed, known as the ITIS diet. This tweaked Mediterranean diet is loaded with anti-inflammatory foods and herbs, specifically formulated to improve gut health and improve RA symptoms. Preliminary results show the significant improvement in pain scores and disease activity after two weeks. This is an early finding from a small study but certainly offers very exciting prospects for the potential role of diet as a complement to regular medical care. We've come a long way in this RA series and still have much further to go. I hope you've discovered things that help in your journey. Thanks for watching. [MUSIC PLAYING]