Robert Shmerling, MD, corresponding member of the faculty at Harvard Medical School in Boston and senior faculty editor at Harvard Health Publishing, says that people with RA are increasingly turning to therapies such as massage and acupuncture to help alleviate pain. Though these treatments have not been proven to help reduce the inflammation that causes RA symptoms, they can help improve feelings of well-being, which in turn can impact your RA, Dr. Shmerling says. “During most of these therapies, you’re potentially relaxed and less stressed,” Shmerling says. “You’re focused on healing and putting your mind at rest, so the treatments can have positive effects.” Most medical professionals refer to these treatments as “complementary therapies,” meaning they shouldn’t replace traditional treatment for RA but might add to the overall effects of conventional therapies.
Which Complementary Therapies Should You Try?
If you’re ready to add new approaches to your RA treatment regimen, consider these options.
1. Massage
Shmerling says studies on massage for RA are scant, but new guidelines from the ACR regarding integrative approaches for RA note that massage may be helpful. In fact, some research has found that massage might reduce pain and improve function in people with osteoarthritis or RA, though the researchers noted that additional studies are needed. In general, massage is safe for people with RA, Shmerling says, but be sure to review your current condition with your massage therapist before every session. “Each time, there should be a discussion of where the issues are and parts of the body that might be tender,” he says. “Massage tends to focus on muscles, while RA affects the joints. There’s usually a way to avoid having a massage that is too aggressive and ends up causing more trouble.”
2. Cognitive Behavioral Therapy (CBT)
CBT is a type of talk therapy that helps you work through your problems. The goal of CBT is to help you recognize and identify negative or problematic thoughts and behaviors and find ways to approach them in more effective ways. This is done with the help of a trained therapist over a set amount of time, usually anywhere between 5 to 20 weeks. The new ACR guidelines note that CBT and other mind-body approaches may be effective tools to include in your overall integrative RA treatment approach. Results from a review published in 2020 found that CBT may help in multiple ways: by alleviating RA-related fatigue and reducing feelings of anxiety and depression that often go hand-in-hand with managing a chronic condition like RA. There haven’t been many studies to measure the effects of biofeedback, though an analysis published in the journal Georgian Medical News found that, when used in combination with other therapies, it may help people with RA improve functional capabilities. If you’re interested in trying biofeedback or other mind-body techniques, such as hypnosis, guided imagery, or meditation, seek an experienced practitioner. Your rheumatologist may be able to provide a recommendation.
4. Acupuncture
This is done by inserting very small needles into the skin to stimulate specific areas of the body. According to the NCCIH, acupuncture is often used to alleviate joint pain. The ACR recommends trying acupuncture as a part of your overall RA management approach. When used alone or in combination with other therapies, acupuncture can help people with RA improve function and quality of life, according to a review published in the journal Evidence-Based Complementary and Alternative Medicine. But Shmerling says the pain relief may be the placebo effect, a phenomenon in which you receive inactive treatment but feel better because you believe it will work. “The needles are so thin that the patients can’t really tell if they’re being inserted,” Shmerling says. In many studies, the improvement was similar in people treated with actual acupuncture and the control group — those who only believed the treatment they received was acupuncture. Regardless, if you’re interested in trying acupuncture for RA, be sure to find a trained acupuncturist who uses sterile needles, Shmerling says. Improper technique can cause skin infections and other injuries, according to the NCCIH. Additional reporting by Madeline Vann, MPH and Kerry Weiss.
