Alternative Therapy for Rheumatoid Arthritis - Research Paper Example

 Alternative Therapy for Rheumatoid Arthritis ABSTRACT Rheumatoid arthritis is often treated with anti-inflammatory medications and prescribed pharmaceuticals. Many patients are using alternative therapies to control their symptoms and disease of rheumatoid arthritis instead of using pharmaceuticals. Definition Rheumatoid arthritis is a chronic and progressive autoimmune disorder. It is distinguishable from other types of arthritis because of its symmetrical pattern. This means that it affect joints on both sides of the body. RA may also have a systemic effect on the body, effecting vital organs such as the skin, eyes, lungs, heart, blood, nerves, and kidneys. The classic symptoms of RA are swelling, stiffness and pain in the joints. [1] Characteristics RA is characterized by inflammation of the synovium, progressive bone erosion, joint malignant, and destruction of surrounding tissues and muscles. Quality of life Some factors that effect the RA patient’s quality of life are endemic to the disease. This helps to rule out the possibility of other disease. Patients rarely have RA as their only medical problem. It is estimated that seventy percent of the RA patients who are on DMARDS (disease-modifying ant rheumatic drugs) have at least one other disease. The combination of the RA and another co-existing disease ultimately leads to a higher rate of mortality as compared to healthy people. In other words, RA patients age faster than healthy people. This may or may not be the result of the initial onset of RA or whether the premature aging precedes the onset of RA. Statistics 2.1 million Americans (0.5% - 1.0%) are affected by rheumatoid arthritis. Women are twice as likely to have the disease as men. The onset of RA occurs between thirty to fifty-five years of age with a median age of fifty-five years. Forty-nine billion dollars is spent annually for direct medical and lost wages and productivity. This amounts to $8500 per RA patient per year as the average cost of pharmaceutical therapy for rheumatoid arthritis which amount to 9 million physicians’ visits and 250,000 hospitalizations per year. [2] Alternative Therapies Yoga Yoga is an alternative therapy that has its roots in ancient India. It was used by the Indian culture as a sort of psycho-spiritual treatment for various diseases. Yoga is considered to have a positive effect on mental and spiritual health. The National Health Interview Survey of 2002 on Yoga use in the United States discovered certain traits endemic to people who where regular practitioners. It found that yoga users were primarily Caucasian (85%) and female (76%) with a mean age of 39.5 years. [3] In this study, it was found that the practice of yoga has a “modulating effect on physiological and neurophysiologic symptoms.” [4] Some of the documented effects of yoga practice found in this study were; decrease in resting heart rate, increase in baro- reflex sensitivity in healthy elderly patients in addition to significant blunting of heart rate and blood pressure. Other benefits included decreased symptoms of stress, enhanced quality of life, and normalization of mean daily cortical levels in patients with prostate and breast cancer. Yoga is used to treat depression, improve muscle strength, increase endurance, improvement of balance and flexibility. It has also been shown to reduce pain associated with osteoarthritis of the hand, osteoarthritis of the knee, carp tunnel syndrome and localized lower back discomfort. RA patients reporting depression and anxiety disorders saw significant improvement in their mental health. By decreasing disease activity, the RA patient has a decreased perception of pain. It was concluded that a yoga program may slow the progression of the disease, enhance physical function, and decrease the risk of falls. Exercise Exercise can be defined as a planned regime of physical activity with the aim of having the outcome of a positive health benefit. [5] Regular exercise is crucial in the battle against RA. The majorities of the studies used to determine the effectiveness of exercise in RA patients has taken place in controlled environments. However, some has been done in the home with minimal clinical supervision. The drawback of an unsupervised exercise program is that there is a great temptation for the RA patient to follow his/her exercise regime. This is particularly true for those who have fibromyalgia, fibromyalgia, and rheumatoid arthritis. However, even healthy women admit that it is hard to stick to an exercise regime. Some of the reasons that they cite for this phenomena are stress, pain, disability, lack of social support, self-efficacy, and lack of time. [6] The main benefits of implementing an exercise regime into the lives of rheumatoid arthritis patients are; relief of disease symptoms, preservation of function, and maintenance of independence. Additionally, RA patients can benefit from exercise without aggravating joint symptoms. Other benefits of exercise for RA patients are; improvement of strength, increased mobility, decreased pain and fatigue, reversal of the effects of inflammatory disease, increased aerobic capacity, and increased muscle strength. Fish oils Fish oils have been demonstrated to have beneficial anti-inflammatory characteristics in randomized, double-blind, placebo-controlled trials on patients with rheumatoid arthritis and occlusive cardiovascular disease. Occlusive cardiovascular disease is prevalent among RA sufferers. The following benefits were associated with fish oil use among RA patients; improved gastro-intestinal function, improved cardiovascular function, relief of joint stiffness, minimalizes swollen and tender joints, and reduces fatigue associated with RA. As of this date, there have been 13 trials of fish oil in RA patients. The trials involved RA patients in the late stage of the disease with a duration of approximately ten years. RA patients in these studies were given fish oil in place of their prescribed NSAIDS (non steroidal anti-inflammatory drugs.) The results of these findings were; reduced morning stiffness, and decreased tend joint count. The doses of fish oil that produced anti-inflammatory results were between 2.6-7.1 g per day. Higher doses were favorable to “loading” (administering a large does initially to boost the effects on the body) and lower doses were found to basically maintain the anti-inflammatory effect. Additionally, fish oils have had positive clinical benefits for patients suffering from systemic lupus, and osteoarthritis as they provide colloidal, anti-inflammatory, and inhibitory effects on patients with RA too. In conclusion, there is a high level of evidence for benefits of fish oil in inflammatory diseases. However, there are barriers to the suggested use due to the lack of patentability and marketability to the general public. [7] Nutritional therapy Nutritional therapy is general viewed with skepticism by the mainstream medical community. One of the reasons for this is the fear that patients will neglect conventional forms of treatment. Relapses are also common in people with RA making the assessment of diet and nutrition difficult to measure. [8] The main reason for this is due to the fluctuation of the relapse pattern of the disease. Nutritional therapy may repress the mechanisms of the inflammatory process. Common types of nutritional therapy are the use of fish oil and the elimination diet (a fasting or vegetarian regime.) The benefits of a fasting and elimination diet are; decreased number of swollen and tender joints, decreased morning stiffness, and increased grip strength. However, not all RA patients have shown clinical improvement by fasting or implementing a fasting and elimination diet. In fact, there were no significant clinical differences to those RA patients who were not following a fasting or elimination diet. Results of the study on fasting and elimination diets suggested that the practice could cause rheumatoid cachexia and cause more harm than good. This was due to the lack of nutritional value inherent in the diet. In conclusion, nutrition and diet for RA patients used with other combination therapies may be useful but do not take the place of conventional medical treatment for rheumatoid arthritis. Therapeutic effects of foods What follows below is a discussion on the therapeutic effects of certain foods in the treatment of rheumatoid arthritis. [9] Avocado There are certain foods that have shown to help with the inflammation and other presenting symptoms of rheumatoid arthritis. The following is a discussion of these foods and the relief that they provide for RA patients. Avocado is reported to reduce inflammation, slow the breakdown of cartilage, and to stunt the body’s ability to produce inflammatory enzymes. There are no indicated side-effects associated with avocado consumption. Pineapple Pineapple is known to breakdown protein enzymes that exacerbate RA symptoms including inflammation and pain. The reduction of inflammation is the most prevalent therapeutical effect. However, practitioners need to take into account the fact that when taken with a blood thinner, side-effects could include stomach upset or diarrhea. Cherry Extract (Sour cherry) Cherry extract has been shown in clinical trials to reduce inflammation and pain in RA patients. It also contains the antioxidant, anthocyanin which is essential for overall vitality and good health Ginger The implementation of ginger into the diet of a patient with rheumatoid arthritis has shown to help reduce joint pain and inflammation. Ginger also works as an anti-inflammatory. Inflammation is causes the tissues around the effected joint to become inflamed and thus results in pain. Ginger is believed to relieve nausea and headaches. Precaution should be made as ginger can produce the side-effects of gas, bloating, heartburn, and bleeding if taken at a high dosage. Mediterranean Diet The first clinical study on the benefits of a Mediterranean diet was conducted by a man named Skoldstam. The study was conducted over twenty years ago with the purpose to “test the effect of fasting and lacto vegetarian diet in patients.” [10] The results are indication below. The characteristics of a Mediterranean diet include consuming food from plants, limiting meat intake, consuming moderate amounts of fish, moderate intake of wine, and replacing fatty products with extra-virgin olive oil. The main benefit associated with the implementation of this diet is decreased inflammation. Additionally, this diet may play a role in the prevention of rheumatoid arthritis. Conclusion In conclusion rheumatoid arthritis is an autoimmune disease that can eventually disable a person in their lifetime. Many patients will receive life time therapy in the form of medications, infusions or alternative medicine. As this disease continues to affect the population, researchers are continuously finding ways to treat stop the damage, treat symptoms and provide relief through alternative medicine rather than pharmaceuticals. BIBLIOGRAPHY 1. Allison, R. (2009). Therapy Class Review: Rheumatoid Arthritis. Pharmacy Times, 75(9), 24. Retrieved from http://www.web.ebscohost.yosemite.wbu.edu 2. Symmons, Deborah P. (2010). Rheumatoid arthritis: assessing disease activity and outcome. Clinical Medicine, 10 (3), 248-251. http://www.web.ebscohost.yosemite.wbu.edu 3. Birdee, G. S., Legedza, S., Saper, R. B., Bertisch, S.M., Eisenberg, D. M., Phillips, R.S. (2008). Characteristic of yoga users: results of a national survey. Journal of General Internal Medicine, 23, 1653-1658. doi: 10.1007/s11606-008-0735-5 4. Bosch, P. R., Traustadottir T., Howard, P., Matt, K. S. (July/August 2009). Functional and Physiological effects of yoga in women with rheumatoid arthritis: a pilot study. Alternative Therapies, 15(4), 24-31. Retrieved from http://www.web.ebscohost.yosemite.wbu.edu 5. Crowley, L. (2009). The effectiveness of home exercise programmes for patients with rheumatoid arthritis: a review of the literature. Physical Therapy Reviews, 14(3), 149-159. doi: 10.1179/174328809X435277. 6. Swardh, E, Biguet, G. Opava, C. H. (2008). Views on Exercise Maintenance: variations among patients with rheumatoid arthritis. Physical Therapy, 88(9), 1049-1060. doi:10.2522/ptj.20070178 7. Cleland, L. G., James, M. J., Proudman, S. M. (2003). The role of fish oils in the treatment of rheumatoid arthritis. Drugs 2003, 63, 845-853. doi: 0012/03/0009-0845 8. Rall, L. C., & Roubenoff, R. (July/August 2000). Nutrition and connective tissue health. Nutrition Today. 35(4), 142-50. 9. Pagan, C. N. (September/October 2009). Nourished by nature. Arthritis Today, 23(5) 70 – 84. Retrieved from http://www.web.ebscohost.yosemite.wbu.edu 10. Oliveriero, Francesa. (2009). Mediterranean Food Pattern in Rheumatoid Arthritis. Current Rheumatology Reviews, 2009, (5), 1573—3971. Read More