Complementary remedies for rheumatoid arthritis

Rheumatoid arthritis (RA) is an inflammatory disease in which the synovial membranes lining some joints become thickened, inflamed and produce excess synovial fluid leading to redness, stiffness, swelling and pain. Inflammation gradually spreads to involve the underlying bone, which becomes worn and distorted. Usually, RA affects the smaller joints in your hands and feet but can also occur in the neck, wrists, knees and ankles.

People suffering from RA often feel unwell and may notice weight loss, fever and inflammation in other parts of their body such as the eyes. RA affects around one per cent of the population, with three times as many women affected as men. A quarter of patients develop symptoms before the age of 30, but most new cases occur in the 40-50 age group.

RA was thought to be linked with an overactive immune system attacking the joint linings following a viral infection. New research suggests that RA may be the opposite - the result of an underactive immune system the leads to a build-up of a type of immune cell (T-lymphocyte) that attacks the joints leading to inflammation and damage. Another theory is that RA is triggered by a previous infection - 80 per cent of RA patients have antibodies to the Epstein-Barr virus, which causes glandular fever.

Avoid cold draughts and keep as warm as possible in winter. People with RA should exercise their hands in hot, soapy water first thing in the morning and throughout the day. Frequent hot baths/showers are also soothing. Some people find hot or cold compresses helpful.

Several trials show that fish oil supplements helped to relieve joint tenderness and fatigue in patients with rheumatoid arthritis. One study found that after 14 weeks of taking fish oil supplements, patients with rheumatoid arthritis had reduced neutrophil leukotriene B4 production (a marker for inflammation). Most double-blind trials report a decrease in morning stiffness, swelling, the number of painful joints, and overall pain. As a result, many people are able to reduce the dose of painkillers needed.

Extracts of New Zealand green-lipped mussel (Perna canaliculus) help to reduce inflammation in joints and can reduce the pain and swelling of osteoarthritis. They contain substances known as glycoproteins, which are thought to work by preventing white blood cells from moving into the joints, where they would have released powerful chemicals making pain and swelling worse. Some evidence suggests extracts may help to reduce the pain and swelling of osteoarthritis by 35 to 45 per cent and can outperform non-steroidal anti-inflammatory drugs such as ibuprofen and indomethacin.

Other supplements that may be helpful include bromelain and Devil's claw.