Rheumatoid Arthritis

Summary - 

Rheumatoid Arthritis (RA) is a chronic inflammatory disease affecting primarily the joints and causes symptoms of swelling, stiffness, pain, joint deformity, disability, and limited range of motion. RA is considered an autoimmune disease because the immune system mistakenly regards the body's issues as foreign, producing antibodies (autoantibodies) which then damage the healthy tissues. Other musculoskeletal conditions that are considered autoimmune include systemic lupus erythematosus and scleroderma. Some research suggests that this autoimmune response is due to an infection in a genetically susceptible person.(1)

The pathophysiology of RA is characterized by periods of exacerbation and remission and the most common affected joints include the hands, wrists, knees, and feet. Some people with RA have mild to moderate symptoms lasting only a few days whereas others may progress to irreversible joint deformity and destruction with debilitating pain. As inflammation progresses, the growth and destruction of cells in the synovial membrane of the joint cause abnormal thickening known as pannus. A gradual build-up of pannus releases enzymes that digest the adjacent bone and cartilage, causing further problems like joint deformity, severe pain, and immobility of the joint which is known as ankylosis. Unfortunately many of these physiological changes in the joint are irreversible. 

Natural Remedies - 

The primary goals for RA are to reduce inflammation and pain and slow the progression of the disease. Some evidence suggests that lower intakes of vegetables, fruits, and vitamin C are associated with an increased risk for developing RA.2 This further illustrates the importance of consuming a nutrient dense diet for the treatment and prevention of several different health conditions. Further evidence shows the importance of omega-3 rich diets through foods like fatty fish (like salmon and sardines), fish oil, walnuts, chia seeds and flaxseeds.

An overall anti-inflammatory diet may be beneficial for those with inflammatory health conditions such as RA. Furthermore, many patients have reported improved RA symptoms after eliminating meat (especially red), dairy products, cereals, and wheat gluten.(2) Research on these benefits have been inconclusive due to the difficult nature for conducting research related to so many different food components. For example, eliminating meat from one's diet may mean increasing one's intake of more healthful foods like fruits and vegetables. In essence, it is difficult to determine the cause and effect nature. Regardless of the amount of research conducted between RA and certain foods, an anti-inflammatory diet will be beneficial, and that includes increasing ones intake of fruits, vegetables, nuts and seeds and decreasing pro-inflammatory foods like processed meats, alcohol, dairy, and other refined foods.

Further integrative treatment methods may include weight management (excess weight results in inflammation or more stress on one's joints), the management of food and medication interactions if one is taking pharmaceuticals to treat pain, and the referral or collaboration with other healthcare providers, such as physical therapists and acupuncturists. After analyzing a patients medical history and dietary assessment, certain supplements may be recommended such as probiotics, omega-3 fatty acids, and ginger or turmeric.

Resources - 

Citations - 

  1. Rizzo DB. Disorders of musculoskeletal function: rheumatic disorders. In Porth CM, Matfin G (eds) Pathophysiology: Concepts of Altered Health States. 8th ed. Philadelphia (PA): Lippincott Williams & Wilkins, 2009m 1519-43.

  2. Nelms, M, Sucher KP, Lacey K, Roth SL. Nutrition Therapy & Pathophysiology. Brooks/Cole Cengage Learning. 2011. p 791-793.