Understanding the Role and Uses of Alternative Therapies for the Management
of Rheumatoid Arthritis

Archana       Tripathy; Nitish       Swain; Bhawna       Gupta
doi:10.2174/1573397117666211116102454
Abstract

With the growing popularity of complementary and alternative medicine (CAM) among individuals with chronic pain and muscular problems, a number of patients with rheumatoid arthritis (RA) show their interest in CAM interventions for disease improvement. Various reports published on CAM are based on an animal model of RA; however, there is often a lack of high-quality clinical investigations for explaining the success stories of CAM therapies in patients with RA. CAMs having the potential to be used for therapy in patients with RA have been identified, however lack of awareness and skepticism of their efficacy has made the patients reluctant to choose these drug-less therapies. In this review, we have summarized the existing evidence which suggests promising efficacy of different alternative therapies in managing RA and providing both physical and mental well-being to RA patients.
Keywords: Complementary and alternative medicine, rheumatoid arthritis, educational interventions, naturopathy, yoga, touch therapy.
« Previous Next »
Graphical Abstract

[1] 
Silman AJ, Pearson JE. Epidemiology and genetics of rheumatoid arthritis. Arthritis Res  2002; 4(Suppl. 3): S265-72.
[http://dx.doi.org/10.1186/ar578] [PMID: 12110146] 
[2] 
Entezami P, Fox DA, Clapham PJ, Chung KC. Historical perspective on the etiology of rheumatoid arthritis. Hand Clin  2011; 27(1): 1-10.
[http://dx.doi.org/10.1016/j.hcl.2010.09.006] [PMID: 21176794] 
[3] 
Janeway CA, Capra JD, Travers P, Walport M. Immunobiology: The immune system in health and disease.  4th Ed.. Edinburgh: Churchill Livingstone 1999.
[4] 
Janeway CA Jr, Travers P, Walport M, Shlomchik MJ. Principles of innate and adaptive immunity. Immunobiology: the immune system in health and disease.New York: Garland Science 2001.
[5] 
Cruse JMLR, Wang H. Antigen presentation. Immunology guidebook.  Amsterdam: Elsevier 2004; pp. 267-76.
[6] 
Cooper GS, Bynum ML, Somers EC. Recent insights in the epidemiology of autoimmune diseases: Improved prevalence estimates and understanding of clustering of diseases. J Autoimmun  2009; 33(3-4): 197-207.
[http://dx.doi.org/10.1016/j.jaut.2009.09.008] [PMID: 19819109] 
[7] 
Smolen JS, Aletaha D, Barton A, et al. Rheumatoid arthritis. Nat Rev Dis Primers  2018; 4: 18001.
[http://dx.doi.org/10.1038/nrdp.2018.1] [PMID: 29417936] 
[8] 
Sanmartí R, García-Rodríguez S, Álvaro-Gracia JM, et al. 2014 update of the Consensus Statement of the Spanish Society of Rheumatology on the use of biological therapies in rheumatoid arthritis. Reumatol Clin  2015; 11(5): 279-94.
[http://dx.doi.org/10.1016/j.reumae.2015.05.002] [PMID: 26051464] 
[9] 
Guo Q, Wang Y, Xu D, Nossent J, Pavlos NJ, Xu J. Rheumatoid arthritis: Pathological mechanisms and modern pharmacologic therapies. Bone Res  2018; 6: 15.
[http://dx.doi.org/10.1038/s41413-018-0016-9] [PMID: 29736302] 
[10] 
Rezaei H, Saevarsdottir S, Geborek P, Petersson IF, van Vollenhoven RF, Forslind K. Evaluation of hand bone loss by digital X-ray radiogrammetry as a complement to clinical and radiographic assessment in early rheumatoid arthritis: results from the SWEFOT trial. BMC Musculoskelet Disord  2013; 14: 79.
[http://dx.doi.org/10.1186/1471-2474-14-79] [PMID: 23497111] 
[11] 
Kasarełło K, Cudnoch-Jędrzejewska A, Członkowski A, Mirowska-Guzel D. Mechanism of action of three newly registered drugs for multiple sclerosis treatment. Pharmacol Rep  2017; 69(4): 702-8.
[http://dx.doi.org/10.1016/j.pharep.2017.02.017] [PMID: 28550802] 
[12] 
Rainsford KD, Parke AL, Clifford-Rashotte M, Kean WF. Therapy and pharmacological properties of hydroxychloroquine and chloroquine in treatment of systemic lupus erythematosus, rheumatoid arthritis and related diseases. Inflammopharmacology  2015; 23(5): 231-69.
[http://dx.doi.org/10.1007/s10787-015-0239-y] [PMID: 26246395] 
[13] 
Chikanza IC, Jawed S, Naughton D, Blake DR. Why do we need new treatments for rheumatoid arthritis? J Pharm Pharmacol  1998; 50(4): 357-69.
[http://dx.doi.org/10.1111/j.2042-7158.1998.tb06874.x] [PMID: 9625479] 
[14] 
Xing Y-Y, Wang J-Y, Wang K, et al. Inhibition of rheumatoid arthritis using bark, leaf, and male flower extracts of Eucommia ulmoides. Evid Based Complement Alternat Med  2020; 2020: 3260278.
[http://dx.doi.org/10.1155/2020/3260278] [PMID: 32855647] 
[15] 
Kongkwamcharoen C, Itharat A, Pipatrattanaseree W, Ooraikul B. Effects of various preextraction treatments of Crinum asiaticum leaf on its anti-inflammatory activity and chemical properties. Evid Based Complement Alternat Med  2021; 2021: 8850744.
[http://dx.doi.org/10.1155/2021/8850744] [PMID: 33574885] 
[16] 
Efthimiou P, Kukar M. Complementary and alternative medicine use in rheumatoid arthritis: Proposed mechanism of action and efficacy of commonly used modalities. Rheumatol Int  2010; 30(5): 571-86.
[http://dx.doi.org/10.1007/s00296-009-1206-y] [PMID: 19876631] 
[17] 
Castro-Sánchez AM, Matarán-Peñarrocha GA, Lara-Palomo I, Saavedra-Hernández M, Arroyo-Morales M, Moreno-Lorenzo C. Hydrotherapy for the treatment of pain in people with multiple sclerosis: A randomized controlled trial. Evid Based Complement Alternat Med  2012; 2012: 473963.
[http://dx.doi.org/10.1155/2012/473963] 
[18] 
Khanna S, Jaiswal KS, Gupta B. Disease-modifying antirheumatic diets: The new treatment modalities for rheumatoid arthritis. EMJ Rheumatol  2018; 5(1): 93-9.
[19] 
Khanna S, Jaiswal KS, Gupta B. Managing rheumatoid arthritis with dietary interventions. Front Nutr  2017; 4: 52.
[http://dx.doi.org/10.3389/fnut.2017.00052] [PMID: 29167795] 
[20] 
da Mota LMH, Cruz BA, Brenol CV, et al. 2012 Brazilian Society of Rheumatology Consensus for the treatment of rheumatoid arthritis. Rev Bras Reumatol  2012; 52(2): 152-74.
[PMID: 22460407] 
[21] 
Schrieber L, Colley M. Patient education. Best Pract Res Clin Rheumatol  2004; 18(4): 465-76.
[http://dx.doi.org/10.1016/j.berh.2004.03.008] [PMID: 15301981] 
[22] 
Taal E, Rasker JJ, Wiegman O. Group education for rheumatoid arthritis patients. In: Seminars in arthritis and rheumatism.  Amsterdam: Elsevier 1997; pp. 805-16.
[23] 
Jiang X, Sandberg ME, Saevarsdottir S, Klareskog L, Alfredsson L, Bengtsson C. Higher education is associated with a better rheumatoid arthritis outcome concerning for pain and function but not disease activity: Results from the EIRA cohort and Swedish rheumatology register. Arthritis Res Ther  2015; 17: 317.
[http://dx.doi.org/10.1186/s13075-015-0836-6] [PMID: 26546562] 
[24] 
Lorig KR, Holman H. Self-management education: History, definition, outcomes, and mechanisms. Ann Behav Med  2003; 26(1): 1-7.
[http://dx.doi.org/10.1207/S15324796ABM2601_01] [PMID: 12867348] 
[25] 
Lorig KR, Ritter PL, González VM. Hispanic chronic disease self-management: A randomized community-based outcome trial. Nurs Res  2003; 52(6): 361-9.
[http://dx.doi.org/10.1097/00006199-200311000-00003] [PMID: 14639082] 
[26] 
Cooper H, Booth K, Fear S, Gill G. Chronic disease patient education: Lessons from meta-analyses. Patient Educ Couns  2001; 44(2): 107-17.
[http://dx.doi.org/10.1016/S0738-3991(00)00182-8] [PMID: 11479051] 
[27] 
Marianne Belleza RN. Rheumatoid Arthritis.   Available from: https://nurseslabs.com/2017
[28] 
Hill J. Rheumatology nurse specialists-do we need them? Rheumatology  2007; 46(3): 379-81.
[http://dx.doi.org/10.1093/rheumatology/kel431] 
[29] 
Paice E, Dacre J. Higher specialist training in rheumatology. Rheumatology  2002; 41(12): 1424-7.
[http://dx.doi.org/10.1093/rheumatology/41.12.1424] [PMID: 12468824] 
[30] 
Das P, Moorthy A, Dharmanand B. Rheumatology training in India compared to the United Kingdom. Indian J Rheumatol  2018; 13: 113.
[http://dx.doi.org/10.4103/injr.injr_78_17] 
[31] 
Helewa A, Goldsmith CH, Lee P, et al. Effects of occupational therapy home service on patients with rheumatoid arthritis. Lancet  1991; 337(8755): 1453-6.
[http://dx.doi.org/10.1016/0140-6736(91)93138-Y] [PMID: 1675329] 
[32] 
Jennifer F. RA Facts: What are the latest statistics on rheumatoid arthritis?  Available from: https://www.rheumatoidarthritis.org/ra/facts-and-statistics/
[33] 
Kidd BL, Langford RM, Wodehouse T. Arthritis and pain. Current approaches in the treatment of arthritic pain. Arthritis Res Ther  2007; 9(3): 214.
[http://dx.doi.org/10.1186/ar2147] [PMID: 17572915] 
[34] 
Aletaha D, Smolen JS. Diagnosis and management of rheumatoid arthritis: A review. JAMA  2018; 320(13): 1360-72.
[http://dx.doi.org/10.1001/jama.2018.13103] [PMID: 30285183] 
[35] 
Hammond A. What is the role of the occupational therapist? Best Pract Res Clin Rheumatol  2004; 18(4): 491-505.
[http://dx.doi.org/10.1016/j.berh.2004.04.001] [PMID: 15301983] 
[36] 
Steultjens EM, Dekker J, Bouter LM, van Schaardenburg D, van Kuyk MA, van den Ende CH. Occupational therapy for rheumatoid arthritis. Cochrane Database Syst Rev  2004; (1): CD003114.
[PMID: 14974005] 
[37] 
Miller WR.  Enhancing motivation for change in substance abuse treatment. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 1999. Report No.: (SMA) 99-3354.
[38] 
Scott DL, Steer S. The course of established rheumatoid arthritis. Best Pract Res Clin Rheumatol  2007; 21(5): 943-67.
[http://dx.doi.org/10.1016/j.berh.2007.05.006] [PMID: 17870037] 
[39] 
Korte KJ, Schmidt NB. Motivational enhancement therapy reduces anxiety sensitivity. Cognit Ther Res  2013; 37: 1140-50.
[http://dx.doi.org/10.1007/s10608-013-9550-3] 
[40] 
Georgopoulou S, Prothero L, Lempp H, Galloway J, Sturt J. Motivational interviewing: Relevance in the treatment of rheumatoid arthritis? Rheumatology (Oxford)  2016; 55(8): 1348-56.
[http://dx.doi.org/10.1093/rheumatology/kev379] [PMID: 26515960] 
[41] 
Elkin I, Shea MT, Watkins JT, et al. National Institute of Mental Health treatment of depression collaborative research program: General effectiveness of treatments. Arch Gen Psychiatry  1989; 46(11): 971-82.
[http://dx.doi.org/10.1001/archpsyc.1989.01810110013002] [PMID: 2684085] 
[42] 
Turk DC, Meichenbaum D, Wall P, Melzack R. A cognitive-behavioral approach to pain management. 1994.
[http://dx.doi.org/10.4324197813/15748931] 
[43] 
Weisenberg M. Cognitive aspects of pain and pain control. Int J Clin Exp Hypn  1998; 46(1): 44-61.
[http://dx.doi.org/10.1080/00207149808409989] [PMID: 9439102] 
[44] 
  Available from: http://ayush.gov.in/about-the-systems/naturo- pathy
[45] 
Mooventhan A, Shetty GB. Effect of integrative naturopathy and yoga in a patient with rheumatoid arthritis associated with type 2 diabetes and hypertension. Anc Sci Life  2017; 36(3): 163-6.
[http://dx.doi.org/10.4103/asl.ASL_80_16] [PMID: 28867861] 
[46] 
Chou P-C, Chu H-Y. Clinical efficacy of acupuncture on rheumatoid arthritis and associated mechanisms: A systemic review. Evid Based Complement Alternat Med  2018; 2018: 8596918.
[http://dx.doi.org/10.1155/2018/8596918] 
[47] 
Mooventhan A, Nivethitha L. Scientific evidence-based effects of hydrotherapy on various systems of the body. N Am J Med Sci  2014; 6(5): 199-209.
[http://dx.doi.org/10.4103/1947-2714.132935] [PMID: 24926444] 
[48] 
Codish S, Abu-Shakra M, Flusser D, Friger M, Sukenik S. Mud compress therapy for the hands of patients with rheumatoid arthritis. Rheumatol Int  2005; 25(1): 49-54.
[http://dx.doi.org/10.1007/s00296-003-0402-4] [PMID: 14618372] 
[49] 
Singh GB, Atal CK. Pharmacology of an extract of salai guggal ex-Boswellia serrata, a new non-steroidal anti-inflammatory agent. Agents Actions  1986; 18(3-4): 407-12.
[http://dx.doi.org/10.1007/BF01965005] [PMID: 3751752] 
[50] 
Siddiqui MZ. Boswellia serrata, a potential antiinflammatory agent: An overview. Indian J Pharm Sci  2011; 73(3): 255-61.
[PMID: 22457547] 
[51] 
Henderson CJ, Panush RS. Diets, dietary supplements, and nutritional therapies in rheumatic diseases. Rheum Dis Clin North Am  1999; 25(4): 937-968, ix.
[http://dx.doi.org/10.1016/S0889-857X(05)70112-5] [PMID: 10573768] 
[52] 
Kumar R, Singh S, Saksena AK, Pal R, Jaiswal R, Kumar R. Effect of Boswellia serrata extract on acute inflammatory parameters and tumor necrosis factor-α in complete Freund’s adjuvant-induced animal model of rheumatoid arthritis. Int J Appl Basic Med Res  2019; 9(2): 100-6.
[http://dx.doi.org/10.4103/ijabmr.IJABMR_248_18] [PMID: 31041173] 
[53] 
Majeed M, Majeed S, Narayanan NK, Nagabhushanam K. A pilot, randomized, double-blind, placebo-controlled trial to assess the safety and efficacy of a novel Boswellia serrata extract in the management of osteoarthritis of the knee. Phytother Res  2019; 33(5): 1457-68.
[http://dx.doi.org/10.1002/ptr.6338] [PMID: 30838706] 
[54] 
Haroyan A, Mukuchyan V, Mkrtchyan N, et al. Efficacy and safety of curcumin and its combination with boswellic acid in osteoarthritis: A comparative, randomized, double-blind, placebo-controlled study. BMC Complement Altern Med  2018; 18(1): 7.
[http://dx.doi.org/10.1186/s12906-017-2062-z] [PMID: 29316908] 
[55] 
  Available from: https://nccih.nih.gov/health/tgvine
[56] 
Canter PH, Lee HS, Ernst E. A systematic review of randomised clinical trials of Tripterygium wilfordii for rheumatoid arthritis. Phytomedicine  2006; 13(5): 371-7.
[http://dx.doi.org/10.1016/j.phymed.2006.01.010] [PMID: 16487688] 
[57] 
Lv QW, Zhang W, Shi Q, et al. Comparison of Tripterygium wilfordii Hook F with methotrexate in the treatment of active rheumatoid arthritis (TRIFRA): A randomised, controlled clinical trial. Ann Rheum Dis  2015; 74(6): 1078-86.
[http://dx.doi.org/10.1136/annrheumdis-2013-204807] [PMID: 24733191] 
[58] 
Siddiqui IA, Afaq F, Adhami VM, Ahmad N, Mukhtar H. Antioxidants of the beverage tea in promotion of human health. Antioxid Redox Signal  2004; 6(3): 571-82.
[http://dx.doi.org/10.1089/152308604773934323] [PMID: 15130283] 
[59] 
Curtis CL, Harwood JL, Dent CM, Caterson B. Biological basis for the benefit of nutraceutical supplementation in arthritis. Drug Discov Today  2004; 9(4): 165-72.
[http://dx.doi.org/10.1016/S1359-6446(03)02980-5] [PMID: 14960396] 
[60] 
Singh R, Ahmed S, Malemud CJ, Goldberg VM, Haqqi TM. Epigallocatechin-3-gallate selectively inhibits interleukin-1β-induced activation of mitogen activated protein kinase subgroup c-Jun N-terminal kinase in human osteoarthritis chondrocytes. J Orthop Res  2003; 21(1): 102-9.
[http://dx.doi.org/10.1016/S0736-0266(02)00089-X] [PMID: 12507586] 
[61] 
Miller TE, Dodd J, Ormrod DJ, Geddes R. Anti-inflammatory activity of glycogen extracted from Perna canaliculus (NZ green-lipped mussel). Agents Actions  1993; 38(Spec No): C139-42.
[http://dx.doi.org/10.1007/BF01991164] [PMID: 8317309] 
[62] 
Wakimoto T, Kondo H, Nii H, et al. Furan fatty acid as an anti-inflammatory component from the green-lipped mussel Perna canaliculus. Proc Natl Acad Sci USA  2011; 108(42): 17533-7.
[http://dx.doi.org/10.1073/pnas.1110577108] [PMID: 21972415] 
[63] 
Halpern GM. Anti-inflammatory effects of a stabilized lipid extract of Perna canaliculus (Lyprinol). Allerg Immunol (Paris)  2000; 32(7): 272-8.
[PMID: 11094640] 
[64] 
Lawson BR, Belkowski SM, Whitesides JF, Davis P, Lawson JW. Immunomodulation of murine collagen-induced arthritis by N, N-dimethylglycine and a preparation of Perna canaliculus. BMC Complement Altern Med  2007; 7: 20.
[http://dx.doi.org/10.1186/1472-6882-7-20] [PMID: 17562016] 
[65] 
Williams JE. Review of antiviral and immunomodulating properties of plants of the Peruvian rainforest with a particular emphasis on Una de Gato and Sangre de Grado. Altern Med Rev  2001; 6(6): 567-79.
[PMID: 11804547] 
[66] 
Mur E, Hartig F, Eibl G, Schirmer M. Randomized double blind trial of an extract from the pentacyclic alkaloid-chemotype of uncaria tomentosa for the treatment of rheumatoid arthritis. J Rheumatol  2002; 29(4): 678-81.
[PMID: 11950006] 
[67] 
Sandoval M, Okuhama NN, Zhang X-J, et al. Anti-inflammatory and antioxidant activities of cat’s claw (Uncaria tomentosa and Uncaria guianensis) are independent of their alkaloid content. Phytomedicine  2002; 9(4): 325-37.
[http://dx.doi.org/10.1078/0944-7113-00117] [PMID: 12120814] 
[68] 
Sandoval M, Charbonnet RM, Okuhama NN, et al. Cat’s claw inhibits TNFalpha production and scavenges free radicals: Role in cytoprotection. Free Radic Biol Med  2000; 29(1): 71-8.
[http://dx.doi.org/10.1016/S0891-5849(00)00327-0] [PMID: 10962207] 
[69] 
  Available from: https://www.ayurveda.com/resource/general-information. 
[70] 
Balkrishna A, Sakat SS, Joshi K, et al. Anti-inflammatory and anti-arthritic efficacies of an indian traditional herbo-mineral medicine “Divya Amvatari Ras” in Collagen Antibody-Induced Arthritis (CAIA) mouse model through modulation of IL-6/IL-1β/TNF-α/NFκB signaling. Front Pharmacol  2019; 10: 659.
[http://dx.doi.org/10.3389/fphar.2019.00659] [PMID: 31333447] 
[71] 
Bag A, Kumar Bhattacharyya S, Kumar Pal N, Ranjan Chattopadhyay R. Anti-inflammatory, anti-lipid peroxidative, antioxidant and membrane stabilizing activities of hydroalcoholic extract of Terminalia chebula fruits. Pharm Biol  2013; 51(12): 1515-20.
[http://dx.doi.org/10.3109/13880209.2013.799709] [PMID: 24004166] 
[72] 
Kumar G, Srivastava A, Sharma SK, Rao TD, Gupta YK. Efficacy & safety evaluation of Ayurvedic treatment (Ashwagandha powder & Sidh Makardhwaj) in rheumatoid arthritis patients: A pilot prospective study. Indian J Med Res  2015; 141(1): 100-6.
[http://dx.doi.org/10.4103/0971-5916.154510] [PMID: 25857501] 
[73] 
Basnyat S, Kolasinski SL. Ayurvedic medicine for rheumatoid arthritis. Curr Rheumatol Rep  2014; 16(8): 435.
[http://dx.doi.org/10.1007/s11926-014-0435-6] [PMID: 24938440] 
[74] 
Venkatesha SH, Berman BM, Moudgil KD. Herbal medicinal products target defined biochemical and molecular mediators of inflammatory autoimmune arthritis. Bioorg Med Chem  2011; 19(1): 21-9.
[http://dx.doi.org/10.1016/j.bmc.2010.10.053] [PMID: 21115252] 
[75] 
Patel SS, Shah PV. Evaluation of anti-inflammatory potential of the multidrug herbomineral formulation in male Wistar rats against rheumatoid arthritis. J Ayurveda Integr Med  2013; 4(2): 86-93.
[http://dx.doi.org/10.4103/0975-9476.113869] [PMID: 23930040] 
[76] 
Lubberts E, van den Berg WB. Cytokines in the pathogenesis of rheumatoid arthritis and collagen-induced arthritis Madame Curie Bioscience Database. Landes Bioscience 2000-2013. Available from: www.ncbi.nlm.nih.gov/books/NBK6288.
[77] 
Burrage PS, Mix KS, Brinckerhoff CE. Matrix metalloproteinases: Role in arthritis. Front Biosci  2006; 11: 529-43.
[http://dx.doi.org/10.2741/1817] [PMID: 16146751] 
[78] 
Nagy G, Koncz A, Telarico T, et al. Central role of nitric oxide in the pathogenesis of rheumatoid arthritis and systemic lupus erythematosus. Arthritis Res Ther  2010; 12(3): 210.
[http://dx.doi.org/10.1186/ar3045] [PMID: 20609263] 
[79] 
Alwarith J, Kahleova H, Rembert E, et al. Nutrition interventions in rheumatoid Arthritis: The potential use of plant-based diets. A review. Front Nutr  2019; 6: 141.
[http://dx.doi.org/10.3389/fnut.2019.00141] [PMID: 31552259] 
[80] 
Iliades C. How to eat right when you have lupus.  Available from: https://www.everydayhealth.com/lupus/eating-right-with-lupus.aspx
[81] 
Murray MT, Pizzorno JE. Encyclopedia of Natural Medicine.  2nd Ed.. New York: Three Rivers Press 1998.
[82] 
Procaccini C, Carbone F, Galgani M, et al. Obesity and susceptibility to autoimmune diseases. Expert Rev Clin Immunol  2011; 7(3): 287-94.
[http://dx.doi.org/10.1586/eci.11.18] [PMID: 21595595] 
[83] 
Benito-Garcia E, Feskanich D, Hu FB, Mandl LA, Karlson EW. Protein, iron, and meat consumption and risk for rheumatoid arthritis: A prospective cohort study. Arthritis Res Ther  2007; 9(1): R16.
[http://dx.doi.org/10.1186/ar2123] [PMID: 17288585] 
[84] 
Kjeldsen-Kragh J, Haugen M, Borchgrevink CF, et al. Controlled trial of fasting and one-year vegetarian diet in rheumatoid arthritis. Lancet  1991; 338(8772): 899-902.
[http://dx.doi.org/10.1016/0140-6736(91)91770-U] [PMID: 1681264] 
[85] 
Boeing H, Bechthold A, Bub A, et al. Critical review: Vegetables and fruit in the prevention of chronic diseases. Eur J Nutr  2012; 51(6): 637-63.
[http://dx.doi.org/10.1007/s00394-012-0380-y] [PMID: 22684631] 
[86] 
Pattison DJ, Symmons DP, Lunt M, et al. Dietary β-cryptoxanthin and inflammatory polyarthritis: Results from a population-based prospective study. Am J Clin Nutr  2005; 82(2): 451-5.
[http://dx.doi.org/10.1093/ajcn/82.2.451] [PMID: 16087992] 
[87] 
Miggiano GA, Gagliardi L. Diet, nutrition and rheumatoid arthritis. Clin Ter  2005; 156(3): 115-23.
[PMID: 16048032] 
[88] 
Singh J, Saag K, Bridges S Jr, Akl E, Bannuru R, Sullivan M. American College of Rheumatology guideline for the treatment of rheumatoid arthritis. Arthritis Rheumatol  2016; 68(1): 1-26.
[89] 
UmaMaheswari T, Hemalatha T, Sankaranarayanan P, Puvanakrishnan R. Enzyme therapy: Current perspectives. Indian J Exp Biol  2016; 54(1): 7-16.
[90] 
Pavan R, Jain S, Kumar A. Properties and therapeutic application of bromelain: A review. Biotechnol Res Int  2012; 2012: 976203.
[http://dx.doi.org/10.1155/2012/976203] 
[91] 
Akhtar NM, Naseer R, Farooqi AZ, Aziz W, Nazir M. Oral enzyme combination versus diclofenac in the treatment of osteoarthritis of the knee-a double-blind prospective randomized study. Clin Rheumatol  2004; 23(5): 410-5.
[http://dx.doi.org/10.1007/s10067-004-0902-y] [PMID: 15278753] 
[92] 
Klein G, Kullich W. Short-term treatment of painful osteoarthritis of the knee with oral enzymes. Clin Drug Investig  2000; 19: 15-23.
[http://dx.doi.org/10.2165/00044011-200019010-00003] 
[93] 
Mazourov V, Lila A, Klimko N, Raimuev K, Makulova T. The efficacy of systemic enzyme therapy in the treatment of rheumatoid arthritis. Int J Immunother  1997; 13: 85-91.
[94] 
Cronkleton E. Debra Rose Wilson P, MSN, RN, IBCLC, AHN-BC, CHT editor. What is aromatherapy?   Available from: https://www.healthline.com/2018
[95] 
Gok Metin Z, Ozdemir L. The effects of aromatherapy massage and reflexology on pain and fatigue in patients with rheumatoid arthritis: A randomized controlled trial. Pain Manag Nurs  2016; 17(2): 140-9.
[http://dx.doi.org/10.1016/j.pmn.2016.01.004] [PMID: 27091583] 
[96] 
Ali B, Al-Wabel NA, Shams S, Ahamad A, Khan SA, Anwar F. Essential oils used in aromatherapy: A systemic review. Asian Pac J Trop Biomed  2015; 5: 601-11.
[http://dx.doi.org/10.1016/j.apjtb.2015.05.007] 
[97] 
Lin T-C, Wang S-H, Huang C-C, Lai Y-C, Song T-Y, Tsai M-S. Anti-fatigue, antioxidation, and anti-inflammatory effects of eucalyptus oil aromatherapy in swimming-exercised rats. Chin J Physiol  2018; 61(5): 257-65.
[http://dx.doi.org/10.4077/CJP.2018.BAG572] [PMID: 30384399] 
[98] 
Adorjan B, Buchbauer G. Biological properties of essential oils: An updated review. Flavour Fragrance J  2010; 25: 407-26.
[http://dx.doi.org/10.1002/ffj.2024] 
[99] 
Hwang J-H, Lee S-O, Kim Y-K. Effects of thermotherapy combined with aromatherapy on pain, flexibility, sleep, and depression in elderly women with osteoarthritis. J Muscle Joint Health  2011; 18: 192-202.
[http://dx.doi.org/10.5953/JMJH.2011.18.2.192] 
[100] 
McCall T. An Introduction to Yoga Therapy. Yoga Journal 2017.  Available from: https://www.yogajournal.com/teach/an-introduction-to-yoga-therapy/
[101] 
History of Yoga Therapy.   Available from: https://yogauonline.com/
[102] 
Clark L, Edwards S, Thwala J, Louw P. The influence of yoga therapy on anxiety. Inkanyiso. J Humanit Soc Sci  2011; 3: 24-31.
[103] 
Wolever RQ, Bobinet KJ, McCabe K, et al. Effective and viable mind-body stress reduction in the workplace: A randomized controlled trial. J Occup Health Psychol  2012; 17(2): 246-58.
[http://dx.doi.org/10.1037/a0027278] [PMID: 22352291] 
[104] 
Haslock I, Monro R, Nagarathana R, Nagendra H, Raguram N. Measuring the effects of yoga in rheumatoid arthritis. Rheumatology  1994; 33: 787.
[http://dx.doi.org/10.1093/rheumatology/33.8.787-a] 
[105] 
Badsha H, Chhabra V, Leibman C, Mofti A, Kong KO. The benefits of yoga for rheumatoid arthritis: Results of a preliminary, structured 8-week program. Rheumatol Int  2009; 29(12): 1417-21.
[http://dx.doi.org/10.1007/s00296-009-0871-1] [PMID: 19184028] 
[106] 
Ross A, Thomas S. The health benefits of yoga and exercise: A review of comparison studies. J Altern Complement Med  2010; 16(1): 3-12.
[http://dx.doi.org/10.1089/acm.2009.0044] [PMID: 20105062] 
[107] 
Aranya H. Swami Yoga Philosophy of Patanjali. Calcutta: Calcutta University Press 1981.
[108] 
Samanta S, Maiti S, Mondal A, Nilkamal M. An Intensive Research Study on Rheumatoid Arthritis through Yoga Shakti. J Women’s Health Care  2015; 4: 2167.
[109] 
Carmody J, Baer RA. Relationships between mindfulness practice and levels of mindfulness, medical and psychological symptoms and well-being in a mindfulness-based stress reduction program. J Behav Med  2008; 31(1): 23-33.
[http://dx.doi.org/10.1007/s10865-007-9130-7] [PMID: 17899351] 
[110] 
Rosenkranz MA, Davidson RJ, Maccoon DG, Sheridan JF, Kalin NH, Lutz A. A comparison of mindfulness-based stress reduction and an active control in modulation of neurogenic inflammation. Brain Behav Immun  2013; 27(1): 174-84.
[http://dx.doi.org/10.1016/j.bbi.2012.10.013] [PMID: 23092711] 
[111] 
Zeidan F, Martucci KT, Kraft RA, Gordon NS, McHaffie JG, Coghill RC. Brain mechanisms supporting the modulation of pain by mindfulness meditation. J Neurosci  2011; 31(14): 5540-8.
[http://dx.doi.org/10.1523/JNEUROSCI.5791-10.2011] [PMID: 21471390] 
[112] 
Santos-Longhurst A. Everything You Need to Know about Sensory Deprivation Tank Therapy. In: Timothy J. Legg P, PsyD, editor.   Available from: https://www.healthline.com/2014
[113] 
Feinstein JS, Khalsa SS, Yeh HW, et al. Examining the short-term anxiolytic and antidepressant effect of Floatation-REST. PLoS One  2018; 13(2): e0190292.
[http://dx.doi.org/10.1371/journal.pone.0190292] [PMID: 29394251] 
[114] 
Chiropractic adjustments.   Available from: https://www.mayoclinic.org/
[115] 
Health. NCfCaI. Chiropractic In depth National Center for Complementary and Integrative Health  2018. www.nccbih.nih.gov/ health/chiropractic-in-depth.
[116] 
Casey DM. Rheumatoid Arthritis and Chiropractic: Making the Best of It. 2019. Available from: https://www.thejoint.com/2017/07/06/rheumatoid-arthritis-and-chiropractic-making-the-best-of-it. 
[117] 
The health benefits of tai chi. 2019. Available from: https://www.health.harvard.edu/staying-healthy/the-health-benefits-of-tai-chi. 
[118] 
Annis B. The Healing Power of Touch. 2018.  Available from: https://www.curetoday.com
[119] 
Gangloff JM. The Science & Controversy Behind Touch Therapies. 2005.  Available from: https://www.curetoday.com
[120] 
Fazzino DL, Griffin MTQ, McNulty RS, Fitzpatrick JJ. Energy healing and pain: A review of the literature. Holist Nurs Pract  2010; 24(2): 79-88.
[http://dx.doi.org/10.1097/HNP.0b013e3181d39718] [PMID: 20186018] 
[121] 
Stein D. Essential Reiki: A complete guide to an ancient healing art: Celestial arts. 1995, Celestial Arts. ISBN: 0895947366. 1995.
[122] 
Park J, McCaffrey R, Dunn D, Goodman R. Managing osteoarthritis: Comparisons of chair yoga, Reiki, and education (pilot study). Holist Nurs Pract  2011; 25(6): 316-26.
[http://dx.doi.org/10.1097/HNP.0b013e318232c5f9] [PMID: 22015342] 
[123] 
Gale GD, Rothbart PJ, Li Y. Infrared therapy for chronic low back pain: A randomized, controlled trial. Pain Res Manag  2006; 11(3): 193-6.
[http://dx.doi.org/10.1155/2006/876920] [PMID: 16960636] 
[124] 
Richardson C, Maciver K, Wright M, Wiles J. Patient reports of the effects and side-effects of TENS for chronic non-malignant pain following a four week trial. Pain Clin  2001; 13: 265-76.
[http://dx.doi.org/10.1163/156856901753702447] 
[125] 
Bio Energy Healing. 2019.  Available from: https://www.the-cma.org
[126] 
Rock B. What is Bio Energy Therapy and how does it benefit you? 2018.  Available from: https://anandacentre.com
[127] 
Yasmeen A, Sofi G, Khan K. Aamar-e-Advia (shelf-lives) of drugs in Unani system of medicine: A conceptual review. J Integr Med  2020; 18(2): 114-24.
[http://dx.doi.org/10.1016/j.joim.2020.01.003] [PMID: 31983657] 
[128] 
Mohd M, Sofi G, Jahan N, Baig Z. Unani approaches to the method of formulating a Murakkab (compound drug formulation). J Ayurveda Integr Med  2018; 10(4): 302-7.
[129] 
Singh S, Nair V, Gupta YK. Antiarthritic activity of majoon suranjan (a polyherbal Unani formulation) in rat. Indian J Med Res  2011; 134: 384-8.
[PMID: 21985823] 
[130] 
Brune K. Safety of anti-inflammatory treatment--new ways of thinking. Rheumatology (Oxford)  2004; 43(Suppl. 1): i16-20.
[http://dx.doi.org/10.1093/rheumatology/keh104] [PMID: 14752171] 
[131] 
Gordon A, Merenstein JH, D’Amico F, Hudgens D. The effects of therapeutic touch on patients with osteoarthritis of the knee. J Fam Pract  1998; 47(4): 271-7.
[PMID: 9789512] 
[132] 
Tao X, Lipsky PE. The Chinese anti-inflammatory and immunosuppressive herbal remedy Tripterygium wilfordii Hook F. Rheum Dis Clin North Am  2000; 26(1): 29-50, viii.
[http://dx.doi.org/10.1016/S0889-857X(05)70118-6] [PMID: 10680192] 
[133] 
Afzal M, Al-Hadidi D, Menon M, Pesek J, Dhami MS. Ginger: An ethnomedical, chemical and pharmacological review. Drug Metabol Drug Interact  2001; 18(3-4): 159-90.
[http://dx.doi.org/10.1515/DMDI.2001.18.3-4.159] [PMID: 11791883] 
[134] 
Chainani-Wu N. Safety and anti-inflammatory activity of curcumin: A component of tumeric (Curcuma longa). J Altern Complement Med  2003; 9(1): 161-8.
[http://dx.doi.org/10.1089/107555303321223035] [PMID: 12676044] 
[135] 
Driessen M-J, Dekker J, Lankhorst G, van der Zee J. Occupational therapy for patients with chronic diseases: CVA, rheumatoid arthritis and progressive diseases of the central nervous system. Disabil Rehabil  1997; 19(5): 198-204.
[http://dx.doi.org/10.3109/09638289709166527] [PMID: 9184785] 
[136] 
Hurkmans E. SP0106 Motivational interviewing and self-regulation to increase physical activity in patients with rheumatoid arthritis. Ann Rheum Dis  2013; 71: 27.
[http://dx.doi.org/10.1136/annrheumdis-2012-eular.1581] 
[137] 
Zwikker HE, van den Ende CH, van Lankveld WG, et al. Effectiveness of a group-based intervention to change medication beliefs and improve medication adherence in patients with rheumatoid arthritis: A randomized controlled trial. Patient Educ Couns  2014; 94(3): 356-61.
[http://dx.doi.org/10.1016/j.pec.2013.12.002] [PMID: 24388126] 
[138] 
Srivastava KC, Mustafa T. Ginger (Zingiber officinale) in rheumatism and musculoskeletal disorders. Med Hypotheses  1992; 39(4): 342-8.
[http://dx.doi.org/10.1016/0306-9877(92)90059-L] [PMID: 1494322] 
[139] 
Dcodhar S, Sethi R, Srimal R. Preliminary study on antirheumatic activity of curcumin (diferuloyl methane). Indian J Med Res  2013; 138.
[140] 
van Vugt RM, Rijken PJ, Rietveld AG, van Vugt AC, Dijkmans BA. Antioxidant intervention in rheumatoid arthritis: Results of an open pilot study. Clin Rheumatol  2008; 27(6): 771-5.
[http://dx.doi.org/10.1007/s10067-008-0848-6] [PMID: 18274814] 
[141] 
Meena N, Singh Chawla SP, Garg R, Batta A, Kaur S. Assessment of vitamin D in rheumatoid arthritis and its correlation with disease activity. J Nat Sci Biol Med  2018; 9(1): 54-8.
[http://dx.doi.org/10.4103/jnsbm.JNSBM_128_17] [PMID: 29456394] 
[142] 
Berbert AA, Kondo CRM, Almendra CL, Matsuo T, Dichi I. Supplementation of fish oil and olive oil in patients with rheumatoid arthritis. Nutrition  2005; 21(2): 131-6.
[http://dx.doi.org/10.1016/j.nut.2004.03.023] [PMID: 15723739] 
[143] 
Kovalenko V, Shuba N, Golovatskiy I, Bortkevich O, Yasinskaya V. Estimation of efficacy of basic therapy of rheumatoid arthritis on the basis of systemic enzyme therapy: Results of five-year monitoring. Int J Immunother  2001; 17: 129-33.
[144] 
Telles S, Naveen KV, Gaur V, Balkrishna A. Effect of one week of yoga on function and severity in rheumatoid arthritis. BMC Res Notes  2011; 4: 118.
[http://dx.doi.org/10.1186/1756-0500-4-118] [PMID: 21481278] 
[145] 
Zautra AJ, Davis MC, Reich JW, et al. Comparison of cognitive behavioral and mindfulness meditation interventions on adaptation to rheumatoid arthritis for patients with and without history of recurrent depression. J Consult Clin Psychol  2008; 76(3): 408-21.
[http://dx.doi.org/10.1037/0022-006X.76.3.408] [PMID: 18540734] 
[146] 
Brosseau LU, Pelland LU, Casimiro LY, Robinson VI, Tugwell PE, Wells GE. Electrical stimulation for the treatment of rheumatoid arthritis. Cochrane Database Syst Rev  2002; (2): CD003687.
[PMID: 12076504] 
[147] 
Oosterveld FG, Rasker JJ, Floors M, et al. Infrared sauna in patients with rheumatoid arthritis and ankylosing spondylitis. A pilot study showing good tolerance, short-term improvement of pain and stiffness, and a trend towards long-term beneficial effects. Clin Rheumatol  2009; 28(1): 29-34.
[http://dx.doi.org/10.1007/s10067-008-0977-y] [PMID: 18685882] 
Rights & Permissions Print Cite
Article Metrics
24
1
Journal Information
For Authors
For Editors
For Reviewers
Explore Articles
Open Access
Open Access Articles
For Visitors
DOI https://dx.doi.org/10.2174/1573397117666211116102454	Print ISSN 1573-3971
Publisher Name Bentham Science Publisher	Online ISSN 1875-6360
Current Rheumatology Reviews

Understanding the Role and Uses of Alternative Therapies for the Management of Rheumatoid Arthritis

Abstract Play Pause

Graphical Abstract

Related Books

Abstract
