Rheumatoid Arthritis (cont.)
William C. Shiel Jr., MD, FACP, FACR
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Melissa Conrad Stöppler, MD
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Catherine Burt Driver, MD
Catherine Burt Driver, MD, is board certified in internal medicine and rheumatology by the American Board of Internal Medicine. Dr. Driver is a member of the American College of Rheumatology. She currently is in active practice in the field of rheumatology in Mission Viejo, Calif., where she is a partner in Mission Internal Medical Group.
In this Article
- Rheumatoid arthritis (RA) facts
- What is rheumatoid arthritis (RA)?
- Rheumatoid arthritis vs. osteoarthritis
- What are rheumatoid arthritis causes and risk factors?
- What are complications of rheumatoid arthritis?
- What are rheumatoid arthritis symptoms and signs?
- What tests do physicians use to diagnose rheumatoid arthritis?
- What are the stages of rheumatoid arthritis?
- What is the treatment for rheumatoid arthritis? What are types of rheumatoid arthritis medications?
- "First-line" rheumatoid arthritis medications
- "Second-line" or "slow-acting" rheumatoid arthritis drugs (disease-modifying anti-rheumatic drugs or DMARDs)
- What are newer rheumatoid arthritis medical treatments?
- Rheumatoid arthritis diet, exercise, therapy, home remedies, and alternative medicine
- What about rheumatoid arthritis and pregnancy?
- What is the prognosis for patients with rheumatoid arthritis?
- Is there a cure for RA?
- What are tips for living with rheumatoid arthritis?
- Is it possible to prevent rheumatoid arthritis?
- What specialists treat rheumatoid arthritis (RA)?
- What new information about RA has come from the 2015 national meeting of the American College of Rheumatology?
- What research is being done on rheumatoid arthritis?
- Are there support groups for people with rheumatoid arthritis?
- Where can people get additional information on rheumatoid arthritis?
- Get a Grip on Rheumatoid Arthritis
- Take the RA Quiz
- Joint Friendly Exercises for RA
- Newly Diagnosed Rheumatoid Arthritis Treatment
- Rheumatoid Arthritis FAQs
- Find a local Rheumatologist in your town
Rheumatoid arthritis diet, exercise, therapy, home remedies, and alternative medicine
Foods to avoid with RA
There is no special RA diet or diet "cure" for rheumatoid arthritis. One hundred years ago, it was touted that "night-shade" foods, such as tomatoes, would aggravate rheumatoid arthritis. This is no longer accepted as true. There are no specific foods or food groups that should be universally avoided by individuals with rheumatoid arthritis.
There is no evidence that gluten bothers rheumatoid arthritis. Nevertheless, for those who are definitely sensitive to gluten (wheat, barley, and rye), the gluten-free diet can prevent poor intestinal absorption of important nutrients because the small intestines can become inflamed in these individuals. Bowel inflammation can be detrimental for those also affected by rheumatoid arthritis if they become deficient in nutrients, such as vitamin D and folate.
Foods that fight RA inflammation
Nevertheless, there are some home remedies that may be helpful, although these are not considered as potent or effective as disease-modifying drugs. Fish oils, such as in salmon, and omega-3 fatty acids supplements have been shown to be beneficial in some short-term studies in rheumatoid arthritis. This suggests that there may be benefits by adding more fish to the diet, such as in the popular Mediterranean diet. The anti-inflammatory effects of curcumin in dietary turmeric, an ingredient in curry, may be beneficial in reducing symptoms of rheumatoid arthritis.
Supplements for RA
Supplements such as calcium and vitamin D are used to prevent osteoporosis in patients with rheumatoid arthritis. Folic acid is used as a supplement to prevent side effects of methotrexate treatment of rheumatoid arthritis. Alcohol is minimized or avoided in rheumatoid arthritis patients taking methotrexate.
The benefits of cartilage preparations such as glucosamine and chondroitin for rheumatoid arthritis remain unproven. Symptomatic pain relief can often be achieved with oral acetaminophen (Tylenol) or over-the-counter topical preparations, which are rubbed into the skin. Antibiotics, in particular the tetracycline drug minocycline (Minocin), have been tried for rheumatoid arthritis recently in clinical trials. Early results have demonstrated mild to moderate improvement in the symptoms of arthritis. Minocycline has been shown to impede important mediator enzymes of tissue destruction, called metalloproteinases, in the laboratory as well as in humans.
Exercises and home remedies for RA
Because impact loading the joints can aggravate inflamed, active rheumatoid arthritis and also be difficult when joints have been injured in the past by the disease, it is important to customize activities and exercise programs according to each individual's capacity. Physical therapy can be helpful. Movement exercises that are less traumatic for the joints, including yoga and tai chi, can be beneficial in maintaining flexibility and strength as well as lead to an improved general sense of well-being.
Proper regular exercise is important in maintaining joint mobility and in strengthening the muscles around the joints. Swimming is particularly helpful because it allows exercise with minimal stress on the joints. Physical and occupational therapists are trained to provide specific exercise instructions and can offer splinting supports. For example, wrist and finger splints can be helpful in reducing inflammation and maintaining joint alignment. Devices such as canes, toilet seat raisers, and jar grippers can assist in the activities of daily living. Heat and cold applications are modalities that can ease symptoms before and after exercise.
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