Not a week goes by without a patient inquiring about the use of complementary and alternative medicine (CAM) in treating rheumatoid arthritis. Sometimes these are patients who have limited budgets and might not be able to afford the newer treatments for rheumatoid arthritis, or they are fearful of the potential toxicities of the prescribed drugs routinely used for rheumatoid arthritis.

As a medical doctor, I emphasize to my patients that CAM treatment should not replace the conventional rheumatoid arthritis treatments which are known to be effective, particularly in the initial, active stages of the disease, during which aggressive inflammation can cause irreversible damage to the joints.

That being said, it is worthwhile to briefly review some of the information that has been published regarding the more popular complementary and alternative treatments of rheumatoid arthritis (however, it should be noted that there are few well-done studies available):

1. Thunder God Vine. This is a vine found in Japan, China and Korea. The root of this vine has been used in traditional Chinese medicine to treat inflammation and autoimmune diseases. Pilot studies have indicated improvement in rheumatoid arthritis patients, but safe preparations are not easily available, and there are parts of this plant which are highly toxic.

2. Gamma-Linolenic Acid. This is an omega-6 fatty acid that is found in the oils of certain plant seeds. A review of studies using gamma-linolenic acid in rheumatoid arthritis concluded there was at least a potential for improvement in joint pain and stiffness.

3. Fish Oil. Just as the body can use omega-6 fatty acids to combat inflammation, so too it can use the omega-3 fatty acids found in fish oil. The studies done so far indicate that fish oil can reduce joint pain and stiffness in rheumatoid arthritis.

4. Valerian. This is an herb that some readers may recognize as being helpful for insomnia, anxiety, or depression. At this time, there is no good data showing valerian is helpful in rheumatoid arthritis. However, many patients turn to CAM therapies to help them with their sleep, which is so often interrupted due to arthritis pain. Perhaps valerian will be helpful in this regard.

5. Acupuncture. Practitioners use acupuncture to treat the pain of rheumatoid arthritis; some feel it can actually treat rheumatoid arthritis, but studies do not clearly bear this out.

6. Magnets. At this point, research does not support the utility of magnets in rheumatoid arthritis.

7. Hydrotherapy. This is the therapeutic use of water, including mineral baths. Most of the studies have involved sea-bath treatments in the Israeli Dead Sea. These studies reported benefit, but the quality of these studies begs skepticism.

8. Mind-Body Techniques. These are familiar techniques which attempt to harness the positive effects of the interactions between the mind and emotions and the body systems. Such techniques include meditation, tai chi, and relaxation techniques. There are some studies which indicated a possible benefit in rheumatoid arthritis with tai chi, a practice from traditional Chinese medicine which uses postures, slow movement and meditation.

In conclusion, there are still many studies which need to be completed before the various complementary and alternative medicine therapies can unequivocally be considered effective in rheumatoid arthritis. Some CAM therapies can actually be harmful, particularly in combination with certain prescription medications; it is important for a patient who chooses to use CAM therapy to let his or her doctor know every pill or powder they are taking so that adverse events do not occur. In this era of assuming everything "organic" is good, do not be fooled into spending good money on complementary and alternative medicine preparations which may do nothing except drain your bank account. There is nothing that I discussed today that can or should replace the conventional treatments for rheumatoid arthritis in those patients who need treatment.