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Complementary and Alternative Medicine - Cam

Search Health Information    Rheumatoid Arthritis (Holistic)

Rheumatoid Arthritis (Holistic)

About This Condition

Is there relief for rheumatoid arthritis? RA is a chronic inflammatory disease in which the immune system attacks the joints and other body parts. According to research or other evidence, the following self-care steps may be helpful.
  • Choose good oils

    Animal fats may contribute to inflammation, but olive oil may make you feel better

  • Try fish oil

    3,000 mg of omega-3 fatty acids a day helps many people reduce pain

  • Check for food allergies or sensitivities

    Your doctor can help you figure out if certain foods are making your arthritis worse

About

About This Condition

Rheumatoid arthritis (RA) is a chronic inflammatory disease in which the immune system attacks the joints and sometimes other parts of the body. The cause of RA remains unknown.

Symptoms

The most common symptom of RA is joint pain and morning joint stiffness. Several joints on both sides of the body are usually affected, especially those of the hands, wrists, knees, and feet. Affected joints may feel warm or appear swollen. People with RA may have other symptoms, including weakness, fatigue, weight loss, and, occasionally, fever.

Healthy Lifestyle Tips

Although exercise may initially increase pain , gentle exercises help people with RA.1 , 2 Women with RA taking low-dose steroid therapy can safely participate in a weight-bearing exercise program with many positive effects on physical function, activity and fitness levels, and bone mineral density, and with no aggravation of disease activity.3 Many doctors recommend swimming, stretching, or walking to people with RA.

Holistic Options

The role of manipulation in managing RA has received little study. In one small controlled trial,4 patients with RA were found to have more tenderness at certain body locations compared to healthy people. Six minutes of gentle spinal manipulation decreased this tenderness temporarily in the spinal areas but not in areas around the knees or ankles. The effect of manipulation on the symptoms or progression of RA has not been investigated.

Eating Right

The right diet is the key to managing many diseases and to improving general quality of life. For this condition, scientific research has found benefit in the following healthy eating tips.

Recommendation Why
Eat healthy fats
A low-fat diet that avoids animal fat in meat and dairy may help decrease the severity of rheumatoid arthritis.

Feeding a high-fat diet to animals who are susceptible to autoimmune disease has increased the severity of RA.5 People with RA have been reported to eat more fat, particularly animal fat, than those without RA.6 In short-term studies, diets completely free of fat have helped people with RA.7 Since at least some dietary fat is essential for humans, though, the significance of this finding is not clear.

Pour on the olive oil
Olive oil appears to reduce the symptoms of rheumatoid arthritis.

Preliminary evidence suggests that consumption of olive oil, rich in oleic acid, may decrease the risk of developing RA.8 One trial in which people with RA received either fish oil or olive oil, found that olive oil capsules providing 6.8 grams of oleic acid per day for 24 weeks produced modest clinical improvement and beneficial changes in immune function . However, as there was no placebo group in that trial, the possibility of a placebo effect cannot be ruled out.9

Limit animal fats
People with RA who eat less arachidonic acid (an omega-6 fatty acid found in animal fats), by avoiding meat, egg yolks, and whole-milk products may experience a reduction in tender and swollen joints.

Arachidonic acid is an omega-6 fatty acid found in animal fats that the body uses to make inflammatory substances. In a controlled study,10 people with rheumatoid arthritis were instructed to reduce their arachidonic acid intake to less than 90 mg per day by eating minimal amounts of meat, no egg yolks, and only low-fat milk products. Compared with a group following a typical Western diet, the low arachidonic acid diet led to a 14% reduction in the number of tender and swollen joints. A second part of this study also found that the anti-inflammatory benefits of fish oil were significantly better when combined with the low arachidonic acid diet.

Try fasting, followed by a vegetarian diet
In one study, fasting followed by a 12-month vegetarian diet improved rheumatoid arthritis symptoms.

Fasting has been shown to improve both signs and symptoms of RA, but most people have relapsed after the returning to a standard diet.11 , 12 When fasting was followed by a 12-month vegetarian diet, however, the benefits of fasting appeared to persist.13 , 14 It is not known why the combination of these dietary programs (i.e., fasting followed by a vegetarian diet) might be helpful, and the clinical trial that investigated this combination15 has been criticized both for its design and interpretation.16 , 17 , 18

Try the Warmbrand diet
A diet free of meat, poultry, dairy, chemicals, sugar, eggs, and processed foods has helped people with rheumatoid arthritis in anecdotal reports.

Strictly vegetarian diets that are also very low in fat have been reported to reduce RA symptoms.19 , 20 In the 1950s through the 1970s, Max Warmbrand, a naturopathic doctor, used a very low-fat diet to treat people with RA. He recommended a diet free of meat, dairy, chemicals, sugar, eggs, and processed foods.21 A short-term (ten weeks) study employing a similar approach failed to produce beneficial effects.22 Long before publication of that negative report, however, Dr. Warmbrand had claimed that his diet took at least six months to achieve noticeable results. In one trial lasting 14 weeks—still significantly less than six months—a pure vegetarian, gluten-free (no wheat, rye, or barley) diet was gradually changed to permit dairy, leading to improvement in both symptoms and objective laboratory measures of disease.23 The extent to which a low-fat vegetarian diet (or one low in animal fat) would help people with RA remains unclear.

Check for food allergies or sensitivities
Your healthcare provider can help you determine if certain foods are making your arthritis worse.

Food sensitivities develop when pieces of intact protein in food are able to cross through the intestinal barrier. Many patients with RA have been noted to have increased intestinal permeability, especially when experiencing symptoms,24 and RA has been linked to allergies and food sensitivities .25 In many people, RA worsens when they eat foods to which they are allergic or sensitive and improves by avoiding these foods.26 , 27 , 28 , 29 In one study, the vast majority of RA patients had elevated levels of antibodies to milk, wheat, or both, suggesting a high incidence of allergy to these substances.30 English researchers have reported that one-third of people with RA may be able to control their disease completely through allergy elimination.31 Identification and elimination of symptom-triggering foods should be done with the help of a physician.

Cut back on coffee
Drinking four or more cups of coffee per day was associated with an increased risk of developing rheumatoid arthritis in preliminary research.

Drinking four or more cups of coffee per day has been associated with an increased risk of developing rheumatoid arthritis in preliminary research.32

Supplements

What Are Star Ratings?

Our proprietary “Star-Rating” system was developed to help you easily understand the amount of scientific support behind each supplement in relation to a specific health condition. While there is no way to predict whether a vitamin, mineral, or herb will successfully treat or prevent associated health conditions, our unique ratings tell you how well these supplements are understood by some in the medical community, and whether studies have found them to be effective for other people.

For over a decade, our team has combed through thousands of research articles published in reputable journals. To help you make educated decisions, and to better understand controversial or confusing supplements, our medical experts have digested the science into these three easy-to-follow ratings. We hope this provides you with a helpful resource to make informed decisions towards your health and well-being.

3 Stars Reliable and relatively consistent scientific data showing a substantial health benefit.

2 Stars Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit.

1 Star For an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support.

Supplement Why
3 Stars
Borage Oil
1.1 to 2.8 grams of GLA daily
Learn More

Oils containing the omega-6 fatty acid gamma linolenic acid (GLA)— borage oil,33 , 34 , 35 black currant seed oil,36 and evening primrose oil (EPO)37 , 38—have been reported to be effective in the treatment for people with RA. Although the best effects have been reported with use of borage oil, that may be because more GLA was used in borage oil trials (1.1–2.8 grams per day) compared with trials using black currant seed oil or EPO. The results with EPO have been mixed and confusing, possibly because the placebo used in those trials (olive oil) may have anti-inflammatory activity. In a double-blind trial, positive results were seen when EPO was used in combination with fish oil.39 GLA appears to be effective because it is converted in part to prostaglandin E1, a hormone-like substance known to have anti-inflammatory activity.

3 Stars
Fish Oil
3 grams daily of EPA plus DHA
Learn More

Many double-blind trials have proven that omega-3 fatty acids in fish oil , called EPA and DHA , partially relieve symptoms of RA.40 , 41 , 42 , 43 , 44 , 45 , 46 The effect results from the anti-inflammatory activity of fish oil.47 Many doctors recommend 3 grams per day of EPA and DHA, an amount commonly found in 10 grams of fish oil. Positive results can take three months to become evident. In contrast, a double-blind trial found flaxseed oil (source of another form of omega-3 fatty acid) not to be effective for RA patients.48

3 Stars
Tripterygium wilfordii
360 to 570 mg daily
Learn More

In a preliminary trial, an extract of the Chinese herbal remedy Tripterygium wilfordii Hook F, in the amount of 360 to 570 mg per day for 16 weeks, produced improvement in symptoms and laboratory tests in eight of nine patients with rheumatoid arthritis. However, one patient developed high blood pressure during the trial.50 In a double-blind trial, an extract of this herb, given in the amount of 360 mg per day for 20 weeks was significantly more effective than a placebo at reducing disease activity.51 A lower amount (160 mg/day) was also more effective than the placebo, but the difference was not statistically significant. No serious side effects were reported.

3 Stars
Vitamin E
1,200 to 1,800 IU daily
Learn More

People with RA have been reported to have an impaired antioxidant system, making them more susceptible to free radical damage.52 Vitamin E is an important antioxidant, protecting many tissues, including joints, against oxidative damage. Low vitamin E levels in the joint fluid of people with RA have been reported.53 In a double-blind trial, approximately 1,800 IU per day of vitamin E was found to reduce pain from RA.54 Two other double-blind trials (using similar high levels of vitamin E) reported that vitamin E had approximately the same effectiveness in reducing symptoms of RA as anti-inflammatory drugs.55 , 56 In other double-blind trials, 600 IU of vitamin E taken twice daily was significantly more effective than placebo in reducing RA, although laboratory measures of inflammation remained unchanged.57 , 58

2 Stars
Boswellia
400 to 800 mg of gum resin extract three times daily
Learn More

Boswellia is an herb used in Ayurvedic medicine (the traditional medicine of India) to treat arthritis. Boswellia has reduced symptoms of RA in most reports.59 While some double-blind trials60 using boswellia have produced positive results, some equivocal results61 and negative findings have also been reported.62 In some trials where boswellia has appeared ineffective, though, patients have been allowed to continue use of nonsteroidal anti-inflammatory drugs (NSAIDs). Such use of NSAIDs can confound experimental results, because boswellia and NSAIDs work in a similar fashion to reduce inflammation. Some doctors suggest using 400–800 mg of gum resin extract in capsules or tablets three times per day.

Ginger is another Ayurvedic herb used to treat people with arthritis. A small number of case studies suggest that taking 6–50 grams of fresh or powdered ginger per day may reduce the symptoms of RA.63 A combination formula containing ginger, turmeric, boswellia, and ashwagandha has been shown in a double-blind trial to be slightly more effective than placebo for RA;64 the amounts of herbs used in this trial are not provided by the investigators.

2 Stars
Cat’s Claw
Refer to label instructions
Learn More

In a double-blind trial, supplementation with an extract from cat's claw (Uncaria tomentosa) for 24 weeks was significantly more effective than a placebo in reducing the number of painful joints in patients with rheumatoid arthritis. The amount used was 20 mg of extract three times per day. The extract was obtained from a specific strain of cat's claw that contains pentacyclic oxindole alkaloids, compounds that appear to influence the activity of the immune system. The extract was purified to be free of tetracyclic oxindole alkaloids, which may inhibit the beneficial effects of the other alkaloids.65

2 Stars
Cayenne
Apply 0.025 to 0.075% capsaicin ointment four times per day over painful areas
Learn More

A cream containing small amounts of capsaicin, a substance found in cayenne pepper, can help relieve pain when rubbed onto arthritic joints, according to the results of a double-blind trial.66 Capsaicin achieves this effect by depleting nerves of a pain-mediating neurotransmitter called substance P. Although application of capsaicin cream initially causes a burning feeling, the burning lessens with each application and disappears for most people in a few days. Creams containing 0.025–0.075% of capsaicin are available and may be applied to the affected joints three to five times a day. A doctor should supervise this treatment.

2 Stars
Cetyl Myristoleate
540 mg daily for 30 days
Learn More

Cetyl myristoleate (CMO) has been proposed to act as a joint “lubricant” and anti-inflammatory agent. In a double-blind trial, people with various types of arthritis that had failed to respond to nonsteroidal anti-inflammatory drugs received either CMO (540 mg per day orally for 30 days) or a placebo.67 These people also applied CMO or placebo topically, according to their perceived need. Sixty-four percent of those receiving CMO improved, compared with 14% of those receiving placebo. More research is needed to determine whether CMO has a legitimate place in the treatment options offered RA patients.

2 Stars
Devil’s Claw
4.5 to 10 grams daily of powdered herb or 800 mg of a standardized extract three times daily
Learn More

Devil’s claw has anti-inflammatory and analgesic actions. Several open and double-blind trials have been conducted on the anti-arthritic effects of devil’s claw.68 The results of these trials have been mixed, so it is unclear whether devil’s claw lives up to its reputation in traditional herbal medicine as a remedy for people with RA. A typical amount used is 800 mg of encapsulated extracts three times per day or powder in the amount of 4.5–10 grams per day.

2 Stars
DMSO
Consult a qualified healthcare practitioner
Learn More

The use of dimethyl sulfoxide ( DMSO ) for therapeutic applications is controversial in part because some claims made by advocates appear to extend beyond current scientific evidence, and in part because topical use greatly increases the absorption of any substance that happens to be on the skin, including molecules that are toxic to the body. Nonetheless, there is some preliminary evidence that when applied to the skin, it has anti-inflammatory properties and alleviates pain, such as that associated with RA.69 , 70 DMSO appears to reduce pain by inhibiting the transmission of pain messages by nerves.71 It comes in different strengths and degrees of purity, and certain precautions must be taken when applying DMSO. For these reasons, DMSO should be used only under the supervision of a doctor.

2 Stars
Evening Primrose Oil
540 to 1,100 mg daily of GLA
Learn More

Oils containing the omega-6 fatty acid gamma linolenic acid (GLA)— borage oil,72 , 73 , 74 black currant seed oil,75 and evening primrose oil (EPO)76 , 77—have been reported to be effective in the treatment for people with RA. Although the best effects have been reported with use of borage oil, that may be because more GLA was used in borage oil trials (1.1–2.8 grams per day) compared with trials using black currant seed oil or EPO. The results with EPO have been mixed and confusing, possibly because the placebo used in those trials (olive oil) may have anti-inflammatory activity. In a double-blind trial, positive results were seen when EPO was used in combination with fish oil.78 GLA appears to be effective because it is converted in part to prostaglandin E1, a hormone-like substance known to have anti-inflammatory activity.

2 Stars
Green-Lipped Mussel
1,050 to 2,100 mg daily of freeze-dried powder or 210 mg daily of lipid extract
Learn More

Supplementation with New Zealand green-lipped mussel  (Perna canaliculus) significantly improved RA symptoms in 68% of participants in a double-blind trial.79 Other studies have been carried out, some of which have confirmed these findings, while others have not.80 , 81 , 82 , 83 , 84 In a recent double-blind trial, use of green-lipped mussel as a lipid extract (210 mg per day) or a freeze-dried powder (1,150 mg per day) for three months led to a decrease in joint tenderness and morning stiffness, and to better overall function.85 However, members of the Australian Rheumatism Association have reported side effects, such as stomach upset , gout , and skin rashes, occurring in people taking certain New Zealand green-lipped mussel extracts. One case of hepatitis has been reported in association with the use of a New Zealand green-lipped mussel extract.86

2 Stars
Pantothenic Acid
2,000 mg daily
Learn More

Research suggests that people with RA may be partially deficient in pantothenic acid (vitamin B5).87 In one placebo-controlled trial, those with RA had less morning stiffness, disability, and pain when they took 2,000 mg of pantothenic acid per day for two months.88

2 Stars
Selenium
200 mcg daily
Learn More

People with RA have been found to have lower selenium levels than healthy people.89 , 90 One91 of two double-blind trials using at least 200 mcg of selenium per day for three to six months found that selenium supplementation led to a significant reduction in pain and joint inflammation in RA patients, but the other reported no beneficial effect.92 More controlled trials are needed to determine whether selenium reduces symptoms in people with RA.

2 Stars
Turmeric
400 mg of curcumin three times daily
Learn More

Turmeric is a yellow spice often used to make curry dishes. The active constituent, curcumin, is a potent anti-inflammatory compound that protects the body against free radical damage.93 A double-blind trial found curcumin to be an effective anti-inflammatory agent in RA patients.94 The amount of curcumin usually used is 400 mg three times per day.

Ginger is another Ayurvedic herb used to treat people with arthritis. A small number of case studies suggest that taking 6–50 grams of fresh or powdered ginger per day may reduce the symptoms of RA.95 A combination formula containing ginger, turmeric, boswellia, and ashwagandha has been shown in a double-blind trial to be slightly more effective than placebo for RA;96 the amounts of herbs used in this trial are not provided by the investigators.

2 Stars
Zinc
Consult a qualified healthcare practitioner
Learn More

Deficient zinc levels have been reported in people with RA.97 Some trials have found that zinc reduced RA symptoms,98 but others have not.99 , 100 Some suggest that zinc might only help those who are zinc-deficient,101 and, although there is no universally accepted test for zinc deficiency, some doctors check white-blood-cell zinc levels.

1 Star
Betaine Hydrochloride
Refer to label instructions
Learn More

Many years ago, two researchers reported that some individuals with RA had inadequate stomach acid .102 Hydrochloric acid, called HCl by chemists, is known to help break down protein in the stomach before the protein can be absorbed in the intestines. Allergies generally occur when inadequately broken down protein is absorbed from the intestines. Therefore, some doctors believe that when stomach acid is low, supplementing with betaine HCl can reduce food-allergy reactions by helping to break down protein before it is absorbed. In theory such supplementation might help some people with RA, but no research has investigated whether betaine HCl actually reduces symptoms of RA.

Supplementation with betaine HCl should be limited to people who have a proven deficit in stomach acid production. Of doctors who prescribe betaine HCl, the amount used varies with the size of the meal and with the amount of protein ingested. Although typical amounts recommended by doctors range from 600 to 2,400 mg of betaine HCl per meal, use of betaine HCl needs to be monitored by a healthcare practitioner and tailored to the needs of the individual.

1 Star
Boron
Refer to label instructions
Learn More

Boron supplementation at 3–9 mg per day may be beneficial, particularly in treating people with juvenile RA, according to very preliminary research.103 The benefit of using boron to treat people with RA remains unproven.

1 Star
Bromelain
Refer to label instructions
Learn More

Bromelain has significant anti-inflammatory activity. Many years ago in a preliminary trial, people with RA who were given bromelain supplements experienced a decrease in joint swelling and improvement in joint mobility.104 The amount of bromelain used in that trial was 20–40 mg, three or four times per day, in the form of enteric-coated tablets. The authors provided no information about the strength of activity in the bromelain supplements that were used. (Today, better quality bromelain supplements are listed in gelatin-dissolving units [GDU] or in milk-clotting units [MCU].) Enteric-coating protects bromelain from exposure to stomach acid. Most commercially available bromelain products today are not enteric-coated.

1 Star
Burdock
Refer to label instructions
Learn More

Burdock root has been used historically both internally and externally to treat painful joints. Its use in the treatment of people with RA remains unproven.

1 Star
Cajeput Oil
Refer to label instructions
Learn More

Topical applications of several botanical oils are approved by the German government for relieving symptoms of RA.105 These include primarily cajeput (Melaleuca leucodendra) oil, camphor oil, eucalyptus oil, fir (Abies alba and Picea abies) needle oil, pine (Pinus spp.) needle oil, and rosemary oil. A few drops of oil or more can be applied to painful joints several times a day as needed. Most of these topical applications are based on historical use and are lacking modern clinical trials to support their effectiveness in treating RA.

1 Star
Camphor Oil
Refer to label instructions
Learn More

Topical applications of several botanical oils are approved by the German government for relieving symptoms of RA.106 These include primarily cajeput (Melaleuca leucodendra) oil, camphor oil, eucalyptus oil, fir (Abies alba and Picea abies) needle oil, pine (Pinus spp.) needle oil, and rosemary oil. A few drops of oil or more can be applied to painful joints several times a day as needed. Most of these topical applications are based on historical use and are lacking modern clinical trials to support their effectiveness in treating RA.

1 Star
Chaparral
Refer to label instructions
Learn More

Southwestern Native American and Hispanic herbalists have long recommended topical use of chaparral on joints affected by RA. The anti-inflammatory effects of chaparral found in test tube research suggests this practice might have value, though clinical trials have not yet investigated chaparral’s usefulness in people with RA. Chaparral should not be used internally for this purpose.

1 Star
Copper
Refer to label instructions
Learn More

Copper acts as an anti-inflammatory agent needed to activate superoxide dismutase (SOD), an enzyme that protects joints from inflammation. People with RA tend toward copper deficiency107 and copper supplementation has been shown to increase SOD levels in humans.108 The Journal of the American Medical Association quoted one researcher as saying that while “Regular aspirin had 6% the anti-inflammatory activity of [cortisone] . . . copper [when added to aspirin] had 130% the activity [of cortisone].”109

Several copper compounds have been used successfully in treating people with RA,110 and a controlled trial using copper bracelets reported surprisingly effective results compared with the effect of placebo bracelets.111 Under certain circumstances, however, copper can increase inflammation in rheumatoid joints.112 Moreover, the form of copper most consistently reported to be effective, copper aspirinate (a combination of copper and aspirin ), is not readily available. Nonetheless, some doctors suggest a trial of 1–3 mg of copper per day for at least several months.

1 Star
Eucalyptus Oil
Refer to label instructions
Learn More

Topical applications of several botanical oils are approved by the German government for relieving symptoms of RA.113 These include primarily cajeput (Melaleuca leucodendra) oil, camphor oil, eucalyptus oil, fir (Abies alba and Picea abies) needle oil, pine (Pinus spp.) needle oil, and rosemary oil. A few drops of oil or more can be applied to painful joints several times a day as needed. Most of these topical applications are based on historical use and are lacking modern clinical trials to support their effectiveness in treating RA.

1 Star
Fir Needle Oil
Refer to label instructions
Learn More

Topical applications of several botanical oils are approved by the German government for relieving symptoms of RA.114 These include primarily cajeput (Melaleuca leucodendra) oil, camphor oil, eucalyptus oil, fir (Abies alba and Picea abies) needle oil, pine (Pinus spp.) needle oil, and rosemary oil. A few drops of oil or more can be applied to painful joints several times a day as needed. Most of these topical applications are based on historical use and are lacking modern clinical trials to support their effectiveness in treating RA.

1 Star
Ginger
Refer to label instructions
Learn More

Ginger is another Ayurvedic herb used to treat people with arthritis. A small number of case studies suggest that taking 6–50 grams of fresh or powdered ginger per day may reduce the symptoms of RA.115 A combination formula containing ginger, turmeric, boswellia, and ashwagandha has been shown in a double-blind trial to be slightly more effective than placebo for RA;116 the amounts of herbs used in this trial are not provided by the investigators.

1 Star
Glucosamine
Refer to label instructions
Learn More
In a preliminary trial, supplementation with glucosamine hydrochloride (1,500 mg per day) for 12 weeks produced a small but statistically significant improvement of pain in people with rheumatoid arthritis. However, other measures of disease activity, such as the number of swollen and painful joints did not improve.117
1 Star
Meadowsweet
Refer to label instructions
Learn More

Meadowsweet was used historically for a wide variety of conditions, including treating rheumatic complaints of the joints and muscles.118

1 Star
Nettle
Refer to label instructions
Learn More

The historic practice of applying nettle topically (with the intent of causing stings to relieve arthritis) has been assessed by a questionnaire study.119 The nettle stings were reported to be safe except for causing a sometimes painful, sometimes numbing rash lasting 6 to 24 hours. Further studies are required to determine whether this practice is therapeutically effective.

1 Star
Phenylalanine
Refer to label instructions
Learn More

D-phenylalanine has been used with mixed results to treat chronic pain , including pain caused by RA.120 No research has evaluated the effectiveness of DL-phenylalanine, a related supplement, in treating people with RA. The effect of either form of phenylalanine in the treatment of people with RA remains unproven.

1 Star
Picrorhiza
Refer to label instructions
Learn More

Preliminary studies conducted in India with the herb picrorhiza show a benefit for people with RA.121 Currently, this therapeutic effect remains weakly supported and therefore unproven.

1 Star
Pine Needle Oil
Refer to label instructions
Learn More

Topical applications of several botanical oils are approved by the German government for relieving symptoms of RA.122 These include primarily cajeput (Melaleuca leucodendra) oil, camphor oil, eucalyptus oil, fir (Abies alba and Picea abies) needle oil, pine (Pinus spp.) needle oil, and rosemary oil. A few drops of oil or more can be applied to painful joints several times a day as needed. Most of these topical applications are based on historical use and are lacking modern clinical trials to support their effectiveness in treating RA.

1 Star
Rosemary Oil
Refer to label instructions
Learn More

Topical applications of several botanical oils are approved by the German government for relieving symptoms of RA.123 These include primarily cajeput (Melaleuca leucodendra) oil, camphor oil, eucalyptus oil, fir (Abies alba and Picea abies) needle oil, pine (Pinus spp.) needle oil, and rosemary oil. A few drops of oil or more can be applied to painful joints several times a day as needed. Most of these topical applications are based on historical use and are lacking modern clinical trials to support their effectiveness in treating RA.

1 Star
White Willow
Refer to label instructions
Learn More

Although willow is slow acting as a pain reliever, the effect is thought to last longer than the effect of willow’s synthetic cousin, aspirin . One double-blind trial found that willow bark combined with guaiac, sarsaparilla , black cohosh , and poplar (each tablet contained 100 mg of willow bark, 40 mg of guaiac, 35 mg of black cohosh, 25 mg of sarsaparilla, and 17 mg of poplar) relieved pain due to RA better than placebo over a two-month period.124 The exact amount of the herbal combination used in the trial is not given, however, and patients were allowed to continue their other pain medications. Clinical trials on willow alone for RA are lacking. Some experts suggest that willow may be taken one to four weeks before results are noted.125

1 Star
Yucca
Refer to label instructions
Learn More

Yucca , a traditional remedy, is a desert plant that contains soap-like components known as saponins. Yucca tea (7 or 8 grams of the root simmered in a pint of water for 15 minutes) is often drunk for symptom relief three to five times per day. The effects of yucca in the treatment of people with RA has not been studied.

References

1. Kay DR, Webel RB, Drisinger TE, et al. Aerobic exercise improves performance in arthritis patients. Clin Res 1985;33:919A [abstract].

2. Harkcom TM, Lampman RM, Banwell BF, Castor CW. Therapeutic value of graded aerobic exercise training in rheumatoid arthritis. Arthrit Rheum 1985;28:32–8.

3. Westby MD, Wade JP, Rangno KK, Berkowitz J. A randomized controlled trial to evaluate the effectiveness of an exercise program in women with rheumatoid arthritis taking low dose prednisone. J Rheumatol 2000;27:1674–80.

4. Dhondt W, Willaeys T, Verbruggen LA, et al. Pain threshold in patients with rheumatoid arthritis and effect on manual oscillations. Scand J Rheumatol 1999;28:88–93.

5. Levy JA, Ibrahim AB, Shirai T, et al. Dietary fat affects immune response, production of antiviral factors, and immune complex disease in NZP/NZW mice. Proc Natl Acad Sci 1982;79:1974–8.

6. Jacobsson I, Lindgarde F, Manthorpe R, et al. Correlation of fatty acid composition of adipose tissue lipids and serum phosphatidylcholine and serum concentrations of micronutrients with disease duration in rheumatoid arthritis. Ann Rheum Dis 1990;49:901–5.

7. Lucas CP, Power L. Dietary fat aggravates active rheumatoid arthritis. Clin Res 1981;29:754A [abstract].

8. Linos A, Kaklamani VG, Koukmantaki Y, et al. Dietary factors in relation to rheumatoid arthritis: a role for olive oil and cooked vegetables. Am J Clin Nutr 1999;70:1077–82.

9. Kremer JM, Lawrence DA, Jubiz W, et al. Dietary fish oil and olive oil supplementation in patients with rheumatoid arthritis. Clinical and immunologic effects. Arthritis Rheum 1990;33:810–20.

10. Adam O, Beringer C, Kless T, et al. Anti-inflammatory effects of a low arachidonic acid diet and fish oil in patients with rheumatoid arthritis. Rheumatol Int 2003;23:27-36.

11. Hafström I, Ringertz B, Gyllenhammar H, et al. Effects of fasting on disease activity, neutrophil function, fatty acid composition, and leukotriene biosynthesis in patients with rheumatoid arthritis. Arthritis Rheum 1988;31:585–92.

12. Skoldstam L, Magnusson KE. Fasting, intestinal permeability, and rheumatoid arthritis. Rheum Dis Clin North Am 1991;17:363–71 [review].

13. Kjeldsen­Kragh J, Haugen M, Borchgrevink CF, et al. Controlled trial of fasting and one­year vegetarian diet in rheumatoid arthritis. Lancet 1991;338:899–902.

14. Kjeldsen-Kragh J, Haugen M, Borchgrevink CF, Forre O. Vegetarian diet for patients with rheumatoid arthritis-status: two years after introduction of the diet. Clin Rheumatol 1994;13:475–82.

15. Kjeldsen­Kragh J, Haugen M, Borchgrevink CF, et al. Controlled trial of fasting and one­year vegetarian diet in rheumatoid arthritis. Lancet 1991;338:899–902.

16. Seignalet J. Diet, fasting, and rheumatoid arthritis. Lancet 1992;339:68–9 [letter].

17. Abuzakouk M, O’Farrelly C. Diet, fasting, and rheumatoid arthritis. Lancet 1992;339:68 [letter].

18. Panayi GS. Diet, fasting, and rheumatoid arthritis. Lancet 1992;339:69 [letter].

19. Skoldstam L. Fasting and vegan diet in rheumatoid arthritis. Scand J Rheumatol 1987;15:219–21.

20. Nenonen M, Helve T, Hanninen O. Effects of uncooked vegan food—“living food”—on rheumatoid arthritis, a three month controlled and randomised study. Am J Clin Nutr 1992;56:762 [abstract #48].

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