- • Movement therapy— Tai Chi has been shown to decrease falls in the elderly.
- • Magnets— Static magnets cause a localized magnetic field. Theorized to interact with the body’s nerve conduction and reduce pain perception. Magnet strength ranges between 300 and 4000 gauss (refrigerator magnet is 60 gauss). Little data to support use of this expensive therapy. May help localized joint pain.
- • Acupuncture —Theory is that good health is maintained by circulation of vital energy (known as Qi) in the body. Illness is due to disruption of this flow. In order to correct this disruption, insertion of needles at defined points along meridians causes discomfort that is necessary to elicit Qi. Actually, it has been shown that acupuncture causes endorphin and serotonin release, which can help pain.
Recently, there have been nine high-quality RCTs concerning acupuncture for patients with rheumatic diseases. Six RCTs reported no statistically signiﬁcant difference between experimental and control groups, whereas the remaining three RCTs showed that acupuncture had beneﬁcial effects for patients with rheumatic diseases, especially knee OA. For RA, the evidence seems to be clearly negative with all three available RCTs demonstrating no beneﬁcial effects.
There are also different modalities of acupuncture treatment, including traditional acupuncture without electricity, laser acupuncture, dry needling, gold bead implantation, electroacupuncture, and moxibustion. Moxibustion is a noninvasive procedure that involves burning moxa, the herb Artemisia vulgaris, at acupuncture points. Among patients with knee OA, moxibustion treatment may improve function and pain score. Similarly, laser acupuncture was reported to be beneﬁcial for patients with knee OA. Dry needling, which involves placing needles at trigger points, was found to lower pain among patients with myofascial pain syndrome.
- • Shark cartilage —reported to have antiinflammatory properties and to inhibit angiogenesis. No data to support its use. Because it may inhibit angiogenesis, it should not be used in pregnancy, children, or patients undergoing surgery or with coronary artery disease.
how should Complementary and Alternative Medicine remedies be approached?
CAM remedies are widely used by patients with rheumatic diseases. Some are safe and harmless, and others can be deadly. Some remedies have therapeutic potential and may unlock the door to the next treatment for rheumatic disease; these deserve the attention of the medical community. I would encourage all healthcare providers to discuss their use with patients. There are several internet resources to get additional information. One of these is the National Center for Complementary and Integrative Health at https://nccih.nih.gov .