Understanding Rheumatoid Arthritis

Stiff joints can be disconcerting, but if they ease when you move, you could easily overlook this sign that the inflammatory fire of rheumatoid arthritis has ignited. To prevent a bonfire of joint pain and swelling, you need to take the right action, quickly.

Your bones are connected at the ends by a capsule of connective tissue that contains a nourishing and lubricating fluid. Within the capsule itself, cartilage lines the end of each bone. This structure provides cushioning and protection for your bone ends as you move and keeps them aligned.

The inflammatory spark ignites here. In rheumatoid arthritis, immune cells mistakenly believe that the cartilage is the enemy, so they release enzymes that literally dissolve those cells. This creates irritation, swelling, and pain.

Where there’s smoke ...

In its early stages, the symptoms of rheumatoid arthritis are easy to dismiss as movement eases them. Because your circulation slows as you lay still overnight, the waste products of inflammation can’t be removed effectively, so affected joints can feel stiff when you wake. Once you get moving, circulation sweeps the inflammatory byproducts away.

You might dismiss it all as old age, particularly as rheumatoid arthritis especially targets females in late middle age. But if this disorder runs in your family, you really need to pay attention, because an immune fire can flare up at any time.

When that happens, the morning stiffness can become an ache. It may seem as though you’re coming down with something. But it’s not a virus; your dysfunctional immune system is the cause.

Without treatment, you can expect your pain to increase. If the inflammation isn’t brought under control, the cartilage on the ends of your bones can be completely destroyed, which could mean more pain, and swelling so intense that the joint dislocates. That’s why early action is so important.

If you’ve been diagnosed with rheumatoid arthritis, the aim of treatment is to push the autoimmunity into remission. But the danger of a flare-up persists. You need to develop lifelong vigilance and quickly identify any early symptoms that the disease has reignited.

The tools for hosing down that inflammatory fire come from both orthodox and natural treatments. The two fields are beginning to merge, with scientists validating the benefits of natural remedies in rigorous peer-reviewed studies.

Tools for fighting the fire

Fish oil

New research to help arrest rheumatoid arthritis has been published recently in a randomized, double-blind controlled trial that examined the effect of adding fish oil to standard medication regimens.

The study concluded that a high dose of fish oil fatty acids (5,500 mg of EPA and DHA), when administered to people newly diagnosed with rheumatoid arthritis, resulted in increased effectiveness of the first line drug therapy.

This research follows a range of studies that have been targeting the inflammatory modulating effects of fish oils specifically for the treatment of rheumatoid arthritis, and further studies are likely.

Herbs

Herbs can help ease rheumatoid arthritis too (see sidebar on page 42), although you should seek professional advice, as some herbs clash with prescription medications. Research on boswellia, turmeric, and ginger has been favourable.

Diet

Eating well helps: the immune battle is using a lot of energy, so you need more calories and protein than most people. But at the same time, food could be unappealing. When this happens, create a complete meal in a smoothie using pea protein powder, some fruit, water, and a handful of baby spinach leaves.

Also, following an anti-inflammatory diet can help. Some foods actively deter the inflammation process, and some foods inflame it. Modern processed foods and those high in saturated fats are generally pro-inflammatory, and fresh, unprocessed foods, especially seafood, are generally anti-inflammatory.

Stress

Stress management is another important aspect of treatment. That’s because as soon as you give your parasympathetic nervous system a chance to create calm, your immune system automatically calms down too. Meditation is an effective stress buster, and if you find your pain is relieved by movement, a moving meditation such as tai chi or yoga could be the stress reliever you need.

Exercise

There are targeted exercise regimens to help manage rheumatoid arthritis; ask your exercise physiologist. Keeping your joints mobile stimulates the production of more nourishing and lubricating synovial joint fluid, as well as boosting circulation that will help clear away inflammation.

Douse that fire when it’s tiny

The key tip to remember is the importance of taking action early, seeking professional advice as soon as you notice joint stiffness starting, particularly if rheumatoid arthritis runs in your family. The earlier you can douse that inflammatory fire, the less likely it will be able to flare up and do serious damage.

Natural supplements for rheumatoid arthritis

Many natural supplements have been studied for their effectiveness in treating arthritis symptoms. Some of these studies involve patients with osteoarthritis whose symptoms and response to treatment are similar to what would be seen for those with rheumatoid arthritis.

Omega-3 fatty acids found in fish oils are being studied for their anti-inflammatory properties and are showing benefits, including decreased pain and morning joint stiffness resulting in reduced use of nonsteroidal anti-inflammatory drugs.

Borage seed oil, which produces GLA (gamma-linolenic acid), has been shown in studies of patients with rheumatoid arthritis to reduce joint tenderness, swelling, and pain.

Avocado soybean unsaponifiables (ASU), a natural vegetable extract from avocado oil and soybean oil, has been studied in relation to osteoarthritis, showing significant reductions in its progression compared with a placebo.

SAM-e has also been extensively studied for its anti-inflammatory and analgesic properties in treating osteoarthritis symptoms, and evidence has shown that it is effective in reducing pain in this population.

Herbs may also play a large role in helping to treat the effects of rheumatoid arthritis. As always, it is important to check with your health care practitioner before taking any supplements to ensure they are right for you.

• Boswellia (Boswellia serrata), a traditional Ayurvedic treatment for inflammatory conditions, is being studied for its effectiveness in treating rheumatoid arthritis.
• Curcumin, a chemical in turmeric (Curcuma longa), was used to treat rheumatoid arthritis symptoms and disease activity with “significant” success in a 2012 study of 45 patients.
• Ginger (Zingiber officinale) has a long history of traditional use for its ability to reduce joint inflammation and pain. It’s thought that ginger’s ability to block COX-2, a chemical in the body that causes pain, may be at the root of ginger’s effectiveness.
• Green tea (Camellia sinensis), specifically the polyphenolic compounds from green tea, has shown effectiveness in animal studies for suppressing inflammatory chemicals involved in rheumatoid arthritis.