Compared with conventional treatments for arthritis, you are likely to have much less guidance when it comes to deciding on whether to use complementary therapies, and which ones. Although hundreds of such therapies exist, only a few have actually proved to be effective when evaluated in rigorous studies.
To become a wise consumer of complementary therapies, become a skeptical one. Don't buy into any treatment that promises a cure. And be sure to ask questions about complementary therapies: Do the claims rely only on testimonials from people who have tried the treatment, rather than on scientific studies? Are the promises extravagant? Do proponents advise not telling your doctor about the treatment? Do they suggest stopping medical treatment? Are the ingredients unidentified or "secret"? Is the source of your information selling the treatment? If your answer to any of these questions is "yes," your best response to trying a therapy may be "no."
Finally, if you are contemplating any physical or complementary treatment, discuss it with your doctor to make sure it will support, rather than hinder, your arthritis management plan.
Many Americans undergo acupuncture treatments to help relieve pain, including the pain of arthritis. Acupuncture, which involves the application of tiny, sterile needles to the skin, has been a staple of Chinese medicine for 2,000 years. Acupuncture may work by releasing endorphins, a natural morphine-like chemical in the nervous system. A 2010 article in Cochrane Database Systems Reviews looked at 16 studies involving nearly 3,500 people with osteoarthritis of the knee, hip, or hand. The studies compared acupuncture with either sham acupuncture (in which needles were either inserted at incorrect points or didn't penetrate the skin), another treatment such as medication, or a waiting list control group. Compared with fake acupuncture or the control group, real acupuncture offered small improvements in pain and function, the authors concluded. But they suggested that much of the benefit resulted from the placebo effect (that is, the participants expected the acupuncture to make them better).
For rheumatoid arthritis, findings were mixed. A 2008 review in Arthritis and Rheumatism evaluated eight studies that included a total of 536 patients; four studies compared acupuncture with sham acupuncture and four with other treatments, such as medications. In some studies, acupuncture appeared to ease tender joints and morning stiffness, but the improvements weren't that much better than seen in the controls. Some of the studies also showed reductions in inflammatory markers (ESR and CRP) among those receiving acupuncture, suggesting that the technique may lessen inflammation. If you do choose to try acupuncture, talk with your doctor first, and find a licensed acupuncturist.
Many people with pain in their muscles and joints turn to massage therapy (also called muscular therapy) for relief. They just might be on the right track, according to a 2006 study involving 68 white women with knee osteoarthritis, published in Archives of Internal Medicine. The study participants who received Swedish massage had significant improvements in pain and function, compared with people who did not receive massage. However, the study only used one form of massage therapy (and there are many) so further research is needed to determine whether other forms work as well.
Chiropractors use spinal adjustments and other joint and soft-tissue manipulations to prevent and treat a variety of disorders of the muscles, bones, and nervous system. This therapy is often used for back pain. In 2006, researchers randomly assigned 250 people with disease of the vertebral joints, intervertebral disks, or both to receive either moist heat and chiropractic treatment or only moist heat. The people who got both therapies had less pain and a greater range of motion than those who did not receive the chiropractic treatment. But more research is needed to confirm the effectiveness of this approach.