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Rheumatoid Arthritis

Rheumatoid arthritis is a problem with the joints. It causes pain, swelling, stiffness, and problems moving.

There is no cure. It is managed with medicine and healthy habits. Some people may need surgery. Natural therapies have been used to ease symptoms. They should not be used in place of standard care.

Natural Therapies

Likely Effective

  • Moxibustion is the burning of moxa on or near a person's skin. It is likely to ease pain.F1
  • Tripterygium wilfordii (thunder god vine) is a vine that is taken as a supplement. It is likely to ease soreness and pain. (Note: The blood system can be negatively affected.)C5, C6, C8-C10, C19, C21
  • Yoga may ease symptoms of depression.E1, E2

May Be Effective

These herbs and supplements may help ease symptoms and improve quality of life:

  • Andrographis is a plant that can be taken as a supplement. ( Note : It should not be taken by people who have problems with their immune system.)C3
  • Blackcurrant is a woody shrub that is grown for its berries. Its seeds are made into an oil.C21
  • Borage is an annual herb. It is used as an herb.C21
  • Cartilage is the flexible connective tissue found on the surface of joints.C2
  • Evening primrose is a plant with yellow flowers. It is used as an oil.C21
  • GuiZhi-ShaoYao-ZhiMu decoction is a traditional Chinese herb medicine.C16
  • Marine oil supplements are a source of omega-3 fatty acids that can be taken as a pill or oil.C7, C18
  • Rose Hips come from wild rose plants and can be taken as a supplement or applied to the skin.C4
  • Sinomenine is a compound found in the root of a climbing plant. It is used in herbal medicine.C20
  • Total glucosides of paeony are an extract from the roots of a Chinese herb. It may ease symptoms.C13, C15
  • Wormwood is a shrub that can be taken as a supplement or tea. It can also be applied to the skin as an oil or cream. ( Note : It should not be taken by people who have epilepsy.)C11

Other therapies that may help are:

  • Hydrotherapy is the use of water for health purposes.H2
  • Reflexology is a type of massage that may ease pain.D1

Unlikely to Be Effective

Acupuncture is not likely to improve symptoms.A1

Not Enough Data to Assess

  • Balneotherapy (spa therapy)B1, B2
  • Bee venom acupuncture A2
  • Cod liver oil C1
  • Massage therapy G1
  • Probiotics C12, C14
  • Vitamin D C17

Editorial process and description of evidence categories can be found at EBSCO NAT Editorial Process.

Herbs and Supplements to Be Used With Caution

Talk to your doctor about any supplements or therapy you would like to use. Some can interfere with treatment or make conditions worse, such as:

  • Andrographis may make the immune system more active. Talk to your doctor before taking it if you have problems with your immune system.
  • Tripterygium wilfordii may negatively affect the blood system.
  • Wormwood should not be taken by people who have epilepsy. It may interact with their medicines.
 

References

Acupuncture

A1. Ramos A, Domínguez J, et al. Acupuncture for rheumatoid arthritis. Medwave. 2018;18(6):e7284.

A2. Lee JA, Son MJ, et al. Bee venom acupuncture for rheumatoid arthritis: a systematic review of randomised clinical trials. BMJ Open. 2014 Nov 7;4(11):e006140.

Balneotherapy

B1. Verhagen AP, Bierma-Zeinstra SM, et al. Balneotherapy (or spa therapy) for rheumatoid arthritis. Cochrane Database Syst Rev. 2015;(4):CD000518.

B2. Verhagen AP, Bierma-Zeinstra SM, et al. Balneotherapy (or spa therapy) for rheumatoid arthritis. Cochrane Database Syst Rev. 2015 Apr 11;(4):CD000518.

Herbs and Supplements

C1. Galarraga B, Ho M, et al. Cod liver oil (n-3 fatty acids) as an non-steroidal anti-inflammatory drug sparing agent in rheumatoid arthritis. Rheumatology (Oxford). 2008;47(5):665-669.

C2. Wei W, Zhang LL, et al. A multicenter, double-blind, randomized, controlled phase III clinical trial of chicken type II collagen in rheumatoid arthritis. Arthritis Res Ther. 2009;11(6):180.

C3. Burgos RA, Hancke JL, et al. Efficacy of an Andrographis paniculata composition for the relief of rheumatoid arthritis symptoms: a prospective randomized placebo-controlled trial. Clin Rheumatol. 2009;28(8):931-946.

C4. Willich SN, Rossnagel K, et al. Rose hip herbal remedy in patients with rheumatoid arthritis – a randomised controlled trial. Phytomedicine. 2010;17(2):97-93.

C5. Jiao J, Jiang Q. [External application of compound Tripterygium wilfordii decreased the activity of rheumatoid arthritis]. Zhongguo Zhong Xi Yi Jie He Za Zhi. 2012;32(11):1470-1472

C6. Jiang M, Zha Q, et al. Predicting and verifying outcome of Tripterygium wilfordii Hook F. based therapy in rheumatoid arthritis: from open to double-blinded randomized trial. Sci Rep. 2015;5:9700.

C7. Proudman SM, James MJ, et al. Fish oil in recent onset rheumatoid arthritis: a randomised, double-blind controlled trial with algorithm-based drug use. Ann Rheum Dis. 2015;74(1):89-95.

C8. Jiao J, Tang XP, et al. [Effect of External Appling Compound Tripterygium wilfordii Hook F. on Joint Pain of Rheumatoid Arthritis Patients]. Zhongguo Zhong Xi Yi Jie He Za Zhi. 2016;36(1):29-34.

C9. Wang HL, Jiang Q, et al. Tripterygium wilfordii Hook F versus conventional synthetic disease-modifying anti-rheumatic drugs as monotherapy for rheumatoid arthritis: a systematic review and network meta-analysis. BMC Complement Altern Med. 2016;16:215.

C10. Wang X, Zu Y, et al. Treatment of rheumatoid arthritis with combination of methotrexate and Tripterygium wilfordii: A meta-analysis. Life Sci. 2017;171:45-50.

C11. Yang M, Guo MY, et al. Effect of Artemisia annua extract on treating active rheumatoid arthritis: A randomized controlled trial. Chin J Integr Med. 2017;23(7):496-503.

C12. Aqaeinezhad Rudbane SM, Rahmdel S, et al. The efficacy of probiotic supplementation in rheumatoid arthritis: a meta-analysis of randomized, controlled trials. Inflammopharmacology. 2018 Feb;26(1):67-76.

C13. Luo J, Jin DE, et al. Total glucosides of paeony for rheumatoid arthritis: A systematic review of randomized controlled trials. Complement Ther Med. 2017 Oct;34:46-56.

C14. Mohammed AT, Khattab M, et al. The therapeutic effect of probiotics on rheumatoid arthritis: a systematic review and meta-analysis of randomized control trials. Clin Rheumatol. 2017 Dec;36(12):2697-2707.

C15. Feng ZT, Xu J, et al. A systemic review and meta-analysis of the clinical efficacy and safety of total glucosides of peony combined with methotrexate in rheumatoid arthritis. Clin Rheumatol. 2018 Jan;37(1):35-42.

C16. Daily JW, Zhang T, et al. Efficacy and Safety of GuiZhi-ShaoYao-ZhiMu Decoction for Treating Rheumatoid Arthritis: A Systematic Review and Meta-Analysis of Randomized Clinical Trials. J Altern Complement Med. 2017 Oct;23(10):756-770.

C17. Franco AS, Freitas TQ, et al. Vitamin D supplementation and disease activity in patients with immune-mediated rheumatic diseases: A systematic review and meta-analysis. Medicine (Baltimore). 2017 Jun;96(23):e7024.

C18. Senftleber NK, Nielsen SM, et al. Marine Oil Supplements for Arthritis Pain: A Systematic Review and Meta-Analysis of Randomized Trials. Nutrients. 2017 Jan 6;9(1). pii: E42.

C19. Xu X, Li QJ, et al. Tripterygium Glycosides for Treating Late-onset Rheumatoid Arthritis: A Systematic Review and Meta-analysis. Altern Ther Health Med. 2016 Nov;22(6):32-39.

C20. Liu W, Qian X, et al. Effects and safety of Sinomenine in treatment of rheumatoid arthritis contrast to methotrexate: a systematic review and Meta-analysis. J Tradit Chin Med. 2016 Oct;36(5):564-577.

C21. Cameron M, Gagnier JJ, et al. Herbal therapy for treating rheumatoid arthritis. Cochrane Database Syst Rev. 2011 Feb 16;(2):CD002948.

Reflexology

D1. Bakir E, Baglama SS, et al. The effects of reflexology on pain and sleep deprivation in patients with rheumatoid arthritis: A randomized controlled trial. Complement Ther Clin Pract. 2018;31:315-319.

Yoga

E1. Gautam S, Tolahunase M, et al. Impact of yoga based mind-body interventions on systematic inflammatory markers and co-morbid depression in active Rheumatoid arthritis patients: A randomized controlled trial. Restor Neurol Neurosci. 2019;37(1):41-59.

E2. Ward L, Stebbings S, et al. Yoga for functional ability, pain and psychosocial outcomes in musculoskeletal conditions: a systematic review and meta-analysis. Musculoskeletal Care. 2013 Dec;11(4):203-17.

Moxibustion

F1. Shen B, Sun Q, et al. Effects of moxibustion on pain behaviors in patients with rheumatoid arthritis: A meta-analysis. Medicine (Baltimore). 2019 Jul;98(30):e16413.

G. Massage Therapy

G1. Nelson NL, Churilla JR. Massage Therapy for Pain and Function in Patients With Arthritis: A Systematic Review of Randomized Controlled Trials. Am J Phys Med Rehabil. 2017 Sep;96(9):665-672.

H. Other Therapies

H1. Cramp F, Hewlett S, et al. Non-pharmacological interventions for fatigue in rheumatoid arthritis. Cochrane Database Syst Rev. 2013 Aug 23;(8):CD008322.

H2. Al-Qubaeissy KY, Fatoye FA, et al. The effectiveness of hydrotherapy in the management of rheumatoid arthritis: a systematic review. Musculoskeletal Care. 2013 Mar;11(1):3-18.

H3. Macfarlane GJ, Paudyal P, et al. A systematic review of evidence for the effectiveness of practitioner-based complementary and alternative therapies in the management of rheumatic diseases: rheumatoid arthritis. Rheumatology (Oxford). 2012 Sep;51(9):1707-1713.

H4. Macfarlane GJ, El-Metwally A, et al. Evidence for the efficacy of complementary and alternative medicines in the management of rheumatoid arthritis: a systematic review. Rheumatology (Oxford). 2011 Sep;50(9):1672-1683.

Last reviewed October 2019 by EBSCO NAT Review Board Eric Hurwitz, DC  Last Updated: 5/15/2020