Natural Ways to Manage Rheumatoid Arthritis: A Comprehensive Guide

Natural Ways to Manage Rheumatoid Arthritis: A Comprehensive Guide
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Updated on December 11, 2024
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Rheumatoid arthritis (RA), a chronic autoimmune disease, causes inflammation, pain and swelling in the joints, but it can also affect other parts of the body. While there’s no cure, it’s possible to achieve remission, and the right treatment can prevent joint damage and more severe symptoms.

Medication, physical therapy, and, if necessary, surgery — are proven effective treatments for rheumatoid arthritis. But in addition to conventional Western medicine as prescribed by your doctor, some lifestyle changes and complementary practices may help you control your RA symptoms.

Think of natural approaches as a complement to, not a substitute for, medical treatment prescribed by your doctor. Medical treatment can prevent or delay joint damage, while these therapies are more likely to help with symptom relief.

 The practices below are generally considered safe for people with RA, but you should always check with your rheumatologist before trying any new supplements or complementary and integrative therapies.

Herbs and Supplements

Numerous dietary supplements have been proposed to help people with RA. Check with your doctor before starting them, because herbal supplements are not tested by the U.S. Food and Drug Adminstration (FDA) and may potentially interfere with prescription medications. That said, here are some of the most common ones used for RA.

Turmeric and Curcumin

Research has shown that curcumin — a major active component of turmeric — has anti-inflammatory properties that may make it helpful for RA and numerous other conditions. A meta-analysis of research found that the antioxidant activity and anti-inflammatory effects of curcumin are beneficial for RA treatment and that inflammation levels and clinical symptoms in patients with RA can be improved by curcumin supplementation.

 Researchers note that large randomized controlled trials on the effects of curcumin on patients with RA are still needed, though.

Because curcumin is rapidly removed from the body, several formulations exist on the market to increase its bioavailability — how much of the substance circulates in the body.

The Arthritis Foundation suggests looking for brands that use black pepper (piperine), phospholipids (Meriva, BCM-95), antioxidants (CurcuWIN), or nanoparticles (Theracurmin) for better bioavailability. Experts recommend 500 milligrams (mg) of curcumin twice a day for RA and to increase absorption even more, take the supplement with a meal containing some fat. Be sure that any curcumin supplement you take has been third-party, independently tested for authenticity and toxic metals. (Some turmeric supplements have been recalled in the past for lead contamination.)

Curcumin is generally safe, but as always, talk to your doctor before taking it.

Ginger

Ginger has been found to suppress inflammation and may play a protective role in gut health.

 While there hasn’t been all that much research on ginger for RA specifically, a couple of studies suggest that ginger may benefit RA through improvement in immune system function and decreasing inflammation.

Ginger capsules are the most potent formulation, notes the Arthritis Foundation. For RA, experts recommend about 250 mg of ginger three or four times a day, and no more than four grams (g) (4,000 mg) a day.

Omega-3 Supplements

Omega-3 fatty acids are essential nutrients, found in plant oils and fish, that have an anti-inflammatory effect. Studies have suggested that omega-3 fatty acids may help relieve tender joints and morning stiffness.

 And people with RA who took fish oil supplements — a common source of omega-3 supplementation — along with a disease modifying anti-rheumatic drug (DMARD) had a better response to their medication and achieved remission sooner.

Fish oil should be used with caution in people who take a blood thinner or aspirin — check with your doctor for optimal dosage.

 Look for a brand that has been tested for contaminants such as mercury and PCBs (man-made chemicals that have been found in fish).

Mind-Body Approaches

Maintaining a healthy emotional state is vital when you have RA. People with RA are more likely to experience mental health disorders, like depression and anxiety. Mind-body therapies such as mindfulness meditation, psychotherapy, yoga, and tai chi address the connections between your mental and physical health.

Mindfulness Meditation

Research shows that stress may play a role in the inflammatory process that causes RA pain. Inflammation in RA is partly caused by molecules called cytokines. Stress, among other things, produces cytokines. Mindfulness meditation, the practice of focusing on and paying attention to the present moment, can decrease stress and change the way you think about and experience your symptoms. Studies suggest it can reduce pain, stiffness, and tenderness, and improve well-being in people with RA, as well as help with RA-related symptoms like insomnia, depression, and fatigue.

Tai Chi and Qigong

Qigong and tai chi are ancient Chinese practices combining meditation, controlled breathing, and movement. There are subtle differences between the two, but when performed to promote health, tai chi is considered a form of qigong. It’s sometimes referred to as a “moving meditation” and involves a series of gentle, repeated movements.

Tai chi has a number of benefits for people with arthritis, notes the Arthritis Foundation: greater range of motion, improved muscle strength, flexibility, balance, cardiovascular fitness, and quality of life as well as reductions in pain, stress, inflammatory markers and disease activity.

Yoga

A review of research notes that while studies have produced conflicting results, yoga does seem to improve disease activity scores, morning stiffness, affected joints, and inflammation in people with RA. Studies have also shown that symptoms of depression in RA patients significantly decreased after yoga interventions. While some research found that yoga reduces RA pain, other studies have found no change.

If you do decide to try yoga for RA, and your doctor gives you the go-ahead, consider gentle forms of yoga like hatha and restorative practices and avoid higher intensity forms.

Complementary Therapies

When combined with a conventional treatment regimen, some complementary or integrative therapies may help ease the symptoms of RA.

Acupuncture

Acupuncture has long been used to treat pain. This traditional Chinese medicine (TCM) practice uses tiny, stainless steel needles to penetrate the skin along strategic points (acupoints) throughout the body. When an acupoint is stimulated, it sends a signal to the rest of the body, eliciting a response. A meta-analysis of research notes that evidence suggests it’s beneficial for pain relief and improved quality of life in people with RA. Acupuncture, researchers note, might also help reduce inflammatory markers in patients with RA.

Acupuncture is generally safe when performed by a qualified practitioner. The NCCAOM and the American Academy of Medical Acupuncture both offer directories of practitioners who have undergone the necessary training to perform acupuncture safely.

Massage Therapy

Massage can help people with RA manage pain. While there’s not a lot of research into how massage can benefit RA specifically, in one study of people with RA, researchers found that a group who received eight weeks of regular (two or three times a week) 30-minute massages reported significantly less pain and took less pain medication than a group who didn’t get massaged.

The following types of massage may be especially helpful for people with RA:

  • Myofascial release involves longer pressure on select areas of the body to break up tight connective tissue.
  • Swedish massage uses long strokes of varying pressure (often combined with lotions or oils) to work out knots in muscles.
  • Hot stone massage combines hands-on therapy with the application of hot stones that can relax muscles and ease pain. Heat can aggravate inflamed joints, however, so be cautious if you’re experiencing a flare.
  • Deep-tissue massage applies intense pressure and manipulates tissue to address stiffness and soreness. (If the pressure is uncomfortable, don’t continue with this style of massage.)

Topical Treatments

When applied directly to the skin, several therapies can help temporarily ease RA joint pain.

Pain-Relieving Creams and Gels

Creams or patches containing capsaicin, the active ingredient in chili peppers, may relieve minor RA pain, notes the Hospital for Special Surgery. It’s available in strengths ranging from 0.025 percent creams to prescription-strength patches with 8 percent capsaicin used to treat more severe forms of pain. The Hospital for Special Surgery suggests you might want to start with a cream containing 0.075 percent capsaicin.

Over-the-counter topical ointments, such as Voltaren gel (which is a nonsteroidal anti-inflammatory drug) can also provide some immediate pain relief when applied to joints and muscles.

Essential Oils

When applied topically or used with a diffuser, essential oils made from plant extracts may reduce muscle pain and improve sleep, which can be disrupted when you have RA. Lavender, ginger, and rosemary oils may be especially beneficial.

You can add essential oils to a bath or dilute the oil with a carrier oil and massage the solution into your joints. You can also add a few drops of essential oil to hot water and inhale the steam, or use a diffuser.

Hot and Cold Therapy for RA

Referred to as thermotherapy, hot and cold therapy can temporarily ease RA symptoms. Heat treatments, such as packs or warm baths, relax stiff joints, improving mobility. Cold treatments can alleviate acute pain you might experience during a flare.

Lifestyle Management

RA involves more than your joints — it’s a systemic condition that can affect your whole body. Which is why it’s necessary to take a holistic approach to managing the condition. Certain lifestyle changes and therapies practiced at home may help ameliorate RA symptoms and improve functioning.

Eat a Healthy Diet

A diet that’s anti-inflammatory, like the Mediterranean diet — which focuses on whole grains, fruits, vegetables, healthy fats such as olive oil, nuts, legumes, and fish — is recommended for RA.

There’s also evidence that bacteria in your intestines (gut) plays a role in the development and progression of RA.

 The fiber found in plant-based foods can improve gut health and may reduce inflammation and joint pain.

Exercise for RA

Exercise is considered an important aspect of RA treatment, and typically consists of stretching, range-of-motion exercises, modified strength training, and aquatic and aerobic exercise.

 If you don’t remain active, you may experience increased joint instability or contractures as your muscles around your joints become weak and your tendons and other soft tissues become inflamed.

A physical therapist can design an exercise program for you to maintain at home, with exercises that will help keep your joints as flexible as possible, and also keep your muscles strong — further relieving pressure on your joints.

Physical activity should be balanced with rest, which can help reduce joint inflammation and the associated symptoms of pain, stiffness, and swelling.

People with RA should review any new exercise plans with their physical therapist and healthcare providers to prevent injury.

Get Quality Sleep

The pain of RA can make it hard to sleep well, but good sleep is necessary for your overall health and it’s especially important when it comes to RA pain and inflammation. Exercise, meditation, improving your sleep hygiene (no screens or snacking before bed), and creating a calming sleep environment can help you sleep better.

Quit Smoking

Smoking cigarettes causes whole-body inflammation, notes the Arthritis Foundation. Smoking triggers immune system overactivity and the autoimmune response that leads to RA. Smoking is also a leading cause of gum disease, which is associated with arthritis. And smoking can also make certain RA medications, like methotrexate, rituximab, and anti-TNF biologics, less effective.

Manage Your Weight

About two-thirds of people with RA are overweight or obese, according to the Arthritis Foundation.

 In addition to the general health risks of obesity, carrying extra weight when you have RA puts additional stress on joints and increases your risk of heart disease. While it’s challenging, if you lose extra weight through exercise and diet and then maintain a healthy weight, it will make a big difference in your condition.

Moderate Your Alcohol Intake

There’s consensus that heavy drinking is never a good idea, and some experts question whether any level of alcohol consumption is healthy for anyone. But the picture becomes a bit more complicated when it concerns drinking in moderation for people with RA (moderation, per the Dietary Guidelines for Americans is no more than two drinks a day for men or one daily drink for women).

 The evidence on whether moderate drinking worsens RA is mixed, but too much alcohol can damage the liver, decrease bone density, and interfere with the effectiveness of certain RA medications.

Work With Your Healthcare Professional

While many natural therapies and lifestyle modifications are considered safe, it’s important to seek professional guidance when integrating these approaches into your RA treatment plan. Talk with your rheumatologist to see which therapies are right for you.

And remember, natural therapies can help ease symptoms of rheumatoid arthritis, but they don’t slow disease progression the way that current RA medications do. Consider them a complement to, not a substitute for, medical treatment.

Common Questions & Answers

Can rheumatoid arthritis be treated naturally?
There’s no cure for RA, but medical treatments prescribed by a rheumatologist can improve the course of the disease, prevent joint damage, and lead to remission. In addition to conventional medicine and drug regimens, lifestyle changes and complementary practices may also help you manage RA symptoms.
Remain active, balance physical activity with rest, use heat or cold treatments, and follow an anti-inflammatory diet to improve rheumatoid arthritis symptoms.
Acupuncture, mindfulness meditation, yoga, tai chi, and massage therapy may help you manage your response to RA pain and improve your stress levels and mood.
Some dietary supplements, such as fish oil, omega-3, and ginger, have shown promise in relieving symptoms of rheumatoid arthritis. But it's important to discuss supplements with your doctor before starting them.
While you should increase your intake of foods that are anti-inflammatory, you should also limit those that can cause inflammation: processed foods, those high in saturated fats, and sugary and salty foods and beverages.

The Takeaway

  • Natural approaches, in addition to your standard medical treatments, can ease symptoms and improve your quality of life when you have RA.
  • You might benefit from options like meditation, an anti-inflammatory diet, and gentle exercises such as yoga, which can support your physical and emotional well-being.
  • Remember, it’s essential to discuss any new therapies with your doctor before you try them.

Additional reporting by Deborah Shapiro.

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Beth Biggee, MD

Medical Reviewer
Member of American College of Lifestyle Medicine, Castle Connolly Top Doctor

Beth Biggee, MD, is medical director and an integrative rheumatologist at Rheumission, a virtual integrative rheumatology practice for people residing in California and Pennsylvania. This first-of-its-kind company offers whole person autoimmune care by a team of integrative rheumatologists, lifestyle medicine practitioners, autoimmune dietitians, psychologists, and care coordinators.

Dr. Biggee also works as a healthcare wellness consultant for Synergy Wellness Center in Hudson, Massachusetts. Teamed with Synergy, she provides in-person lifestyle medicine and holistic consults, and contributes to employee workplace wellness programs. She has over 20 years of experience in rheumatology and holds board certifications in rheumatology and integrative and lifestyle medicine. Dr. Biggee brings a human-centered approach to wellness rather than focusing solely on diseases.

Dr. Biggee graduated cum laude with a bachelor's degree from Canisius College, and graduated magna cum laude and as valedictorian from SUNY Health Science Center at Syracuse Medical School. She completed her internship and residency in internal medicine at Yale New Haven Hospital, completed her fellowship in rheumatology at Tufts–New England Medical Center, and completed training in integrative rheumatology at the University of Arizona Andrew Weil Center for Integrative Medicine. Following her training, she attained board certification in rheumatology and internal medicine through the American Board of Internal Medicine, attained board certification in integrative medicine through the American Board of Physician Specialties, and attained accreditation as a certified lifestyle medicine physician through the American College of Lifestyle Medicine. She is certified in Helms auricular acupuncture and is currently completing coursework for the Aloha Ayurveda integrative medicine course for physicians.

In prior roles, Dr. Biggee taught as an assistant clinical professor of medicine at Mary Imogene Bassett Hospital (an affiliate of Columbia University). She was also clinical associate of medicine at Tufts University School of Medicine and instructed "introduction to clinical medicine" for medical students at Tufts. She was preceptor for the Lawrence General Hospital Family Medicine Residency.

Dr. Biggee has published in Annals of Rheumatic Diseases, Arthritis in Rheumatism, Current Opinions in Rheumatology, Journal for Musculoskeletal Medicine, Medicine and Health Rhode Island, and Field Guide to Internal Medicine.

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Joseph Bennington-Castro

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Joseph Bennington-Castro is a science writer based in Hawaii. He has written well over a thousand articles for the general public on a wide range topics, including health, astronomy, archaeology, renewable energy, biomaterials, conservation, history, animal behavior, artificial intelligence, and many others.

In addition to writing for Everyday Health, Bennington-Castro has also written for publications such as Scientific American, National Geographic online, USA Today, Materials Research Society, Wired UK, Men's Journal, Live Science, Space.com, NBC News Mach, NOAA Fisheries, io9.com, and Discover.

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