Which Alternative Treatments Really Help Rheumatology Patients?

Patients, with or without their physician’s consent (and notwithstanding specific recommendations to the contrary), often turn to alternative medicines, such as herbal supplements and therapies like acupuncture, for help with symptoms of rheumatologic ailments. Most of the conflict relates to medicines and supplements, rather than treatments and therapies such as acupuncture or yoga. Because the latter two get the most praise from integrative medicine providers, let’s look at recent news about herbal medicines and supplements.

Individuals wanting relief from pain and depression often associated with conditions such as  fibromyalgia, lupus, gout, and rheumatoid arthritis turn to some beneficial (and some not-so-safe) complementary and alternative medicine (CAM) therapies in droves. A surge in popularity among CAM treatments can often be seen after major coverage in the mainstream media. Of course, the media typically cover those treatments and disease combinations that include headline material, including a celebrity patient, a TV “medical entertainment” star, or hot-button treatments like cannabis. Could a massive placebo effect be at work in many instances?

Study Found That CAM Medicines, Although Popular, Are a Waste of Money for Gout Sufferers


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Recent research found no effect on disease activity in gout patients

This study, published in the Journal of Clinical Rheumatology in January 2014, brought no surprise as far as the popularity of CAMs among the patient population. Nearly one-quarter of the study’s gout patients stated that they regularly used CAMs; however, the New Zealand–based researchers found no difference (either beneficial or negative) in disease activity between this group and a patent group who reported no CAM medicines used in a 1-year period. Nearly 60% of the group was taking preventive allopurinol. About 70% of the total group was male. There was one major difference noted between the CAM and non-CAM group: gout sufferers using CAMs racked up more treatment costs.

ACR Article: Cannabis Not Recommended for Rheumatologic Treatment

Safety not supported by medical evidence

Although human cannabinoid receptors may be linked to pain levels, and many individuals report using the herb for self-treatment, Arthritis Care and Research recently published study results advising that providers recommend against medical cannabis use in rheumatology. The study cites multiple risks outweighing benefits, including mental illness and dependence risks. As the New York Times reports, both DMS-5 (defining cannabis use disorder) and ICD-10 (listing significant withdrawal symptoms) may give physicians pause when considering medical marijuana use for anything, except perhaps for cancer pain. On the other hand, Dr. Sanjay Gupta has reconsidered his denunciation of cannabis, at least as of his mid-2013 CNN post. After all, cannabis is legal when used for medical purposes in 20 US states, including Washington, DC.

What’s the latest from your research or practice? Are CAM treatments hurting or helping segments of the patient population? What are your thoughts regarding cannabis and RA specifically?

Reference

  1. Chan E, House ME, Petrie KJ, Horne A, Taylor WJ, Dalbeth N. Complementary and alternative medicine use in patients with gout: a longitudinal observational study. J Clin Rheumatol. 2014;20(1):16-20. http://journals.lww.com/jclinrheum/Abstract/2014/01000/Complementary_and_Alternative_ Medicine_Use_in.3.aspx.
  2. Complementary and alternative medicine. Mayo Clinic website. October 20, 2011. http://www.mayoclinic.org/healthy-living/consumer-health/in-depth/alternative-medicine/art-20045267.
  3. Fitzcharles M-A, Clauw DJ, Ste-Marie PA, Shir Y.  The dilemma of medical marijuana use by rheumatology patients. Arthritis Care Res. 2013;66(6):797-801.
  4. Groopman J. Marijuana: the high and the low. The New York Review of Books website. February 20, 2014. http://www.nybooks.com/articles/archives/2014/feb/20/marijuana-high-and-low/?page=2.
  5. Gupta S. Why I changed my mind on weed. CNN website. August 8, 2013. http://www.cnn.com/2013/08/08/health/gupta-changed-mind-marijuana/.
  6. Herbal cannabis not recommended for rheumatology patients. Science Daily website. March 3, 2014. http://www.sciencedaily.com/releases/2014/03/140303083543.htm.
  7. Complementary, alternative, or integrative health: what’s in a name? National Center for Complementary and Alternative Medicine website. Updated July 1, 2014 http://nccam.nih.gov/health/whatiscam.