Rheumatoid arthritis (RA) is what is called an autoimmune disease. In this type of disease, a person's immune system (the system in the body responsible for fighting disease) mistakenly attacks the person's own body. In RA, the parts attacked are the linings of the joints (places in the body where two bones connect). The reasons that this happens are complex and not fully understood. RA causes pain, swelling, and stiffness in a person's joints and problems with functioning. However, RA affects different people in different ways, in terms of the symptoms they have, how serious the symptoms are, and how long the symptoms last. RA is different from other types of arthritis (such as osteoarthritis). For example: * RA usually occurs in a symmetrical pattern; for example, if one hand is affected, usually the other will be, too. * RA often affects the wrists and fingers, though it can affect other parts of the body. * RA is an autoimmune disease affecting the entire body. A person with RA may feel tired and weak, have fevers at times, lose appetite, lose weight, and generally not feel well. To find out more about RA, contact the National Institute of Arthritis and Musculoskeletal and Skin Diseases (see "For More Information"). There are many proven treatments in conventional medicine for RA. They are used to relieve pain, reduce swelling, slow down or stop the damage to joints, help the person function better, and improve the person's sense of well-being. Medications include nonsteroidal anti-inflammatory drugs (NSAIDs), disease-modifying antirheumatic drugs (DMARDs), biological response modifiers, and corticosteroids. Non-drug treatments include physical therapy; modified exercise programs; devices such as canes, special shoes, and splints (rigid supports that keep a part of the body from moving while it heals); and lifestyle changes--such as balancing activity with rest, eating a healthy diet, and reducing stress. Scientific research is advancing in understanding the many complexities of RA and in uncovering new and promising treatments. It is important for people with RA to have their condition followed by a rheumatologist (a physician who specializes in diseases of the bones, muscles, and joints). This helps prevent or minimize damage to the joints and disability, which can occur if RA is left untreated over time. Why do some people with rheumatoid arthritis use CAM, and what do they use? Among the many reasons that some people use CAM for RA are: * Because conventional treatment is not working as well as they would like * A wish for greater relief of symptoms and/or disability * Issues with side effects of drug treatment * A desire to reduce some of the stress that comes from living with a chronic illness and to cope better * A belief that CAM therapies are safer and more "natural" * Widespread advertising and attractive claims for many CAM products * Preparations made from botanicals (plants and their products, including herbs) * Vitamins and minerals in unconventional amounts * Other products taken by mouth, such as fish oil * Dietary approaches * Preparations applied to the skin, such as balms and liniments * Hydrotherapy * Items that are worn (for example, magnetic clothing or copper bracelets) * Mind-body therapies such as relaxation techniques, meditationA conscious mental process using certain techniques -- such as focusing attention or maintaining a specific posture -- to suspend the stream of thoughts and relax the body and mind., prayer for health purposes, and tai chi * Whole medical systems, such as AyurvedaA whole medical system that originated in India. It aims to integrate the body, mind, and spirit to prevent and treat disease. Therapies used include herbs, massage, and yoga. (a traditional medicine of India), traditional Chinese medicineA whole medical system that originated in China. It is based on the concept that disease results from disruption in the flow of qi and imbalance in the forces of yin and yang. Practices such as herbs, meditation, massage, and acupuncture seek to aid healing by restoring the yin-yang balance and the flow of qi., homeopathyA whole medical system that originated in Europe. Homeopathy seeks to stimulate the body's ability to heal itself by giving very small doses of highly diluted substances that in larger doses would produce illness or symptoms (an approach called "like cures like")., and chiropractic * Other therapies delivered by CAM practitioners--for example, acupunctureA family of procedures that originated in traditional Chinese medicine. Acupuncture is the stimulation of specific points on the body by a variety of techniques, including the insertion of thin metal needles though the skin. It is intended to remove blockages in the flow of qi and restore and maintain health. or massage It is beyond the scope of this report to discuss the scientific evidence about all CAM therapies used for RA. The therapies listed below were selected because they are among those most frequently discussed in the scientific literature and inquired about at the NCCAM Clearinghouse.c In reading about them, you will also see some general points to consider about similar therapies (for example, other botanicals). You can seek science-based information on any CAM therapy that interests you through some of the resources listed in "For More Information."
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