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To get the best results, you need to form close ties with

your health-care team and become a full partner in your


health-care treatment.
Learning daily living strategies to manage your
arthritis gives you a greater feeling of control and a
more positive outlook.

An Introduction to
Complementary and
Alternative Therapies

To support arthritis research or to learn more,


contact The Arthritis Society:

1.800.321.1433
www.arthritis.ca

This publication was reviewed and approved by


The Arthritis Society's Medical Advisory Committee and
the Therapeutics Committee of
The Canadian Rheumatology Association.

www.arthritis.ca
The Arthritis Society, May 2010

1.800.321.1433

What are complementary or


alternative therapies?
Complementary and alternative therapies are treatments that do not fall
within the scope of traditional western medicine. Examples include
naturopathic medicine, homeopathic remedies and osteopathy. You may
hear about special herbs, acupuncture, energy fields, meditation and
many others.
In some cases, complementary and alternative therapies may be helpful in
addressing arthritis pain and fatigue. It is helpful to find out which therapies
can be used safely as an adjunct to your current treatments. Your health-care
provider and this booklet
can help you navigate
this area.

Did you know?

It is important to
remember that many of
these treatments have
not yet been studied to
prove if they are effective.
Some of them may even
be harmful. There are
fraudulent and unproven
claims that certain
substances can cure
arthritis. Some of these
products may actually be
dangerous or interfere
with the treatment
prescribed by your
health-care provider.

In a recent study of
people with arthritis,
more than 80 per cent
of participants have
tried at least one
alternative therapy.1

1 More than 80 per cent have tried at least one alternative therapy: see Callahan et al. (2009). Use of complementary and
alternative medicine among patients with arthritis. Prev Chronic Dis. Apr 6(2): A44.

www.arthritis.ca

Introduction

Points to remember

Always inform your health-care provider of any complementary and alternative


therapies you are taking, receiving or would like to try. Your health-care
provider can offer valuable advice about these treatments, help you avoid
possible interactions with existing therapies and help you to successfully
manage your arthritis.

Common complementary and alternative therapies


An Introduction to Complementar y and Alternative Therapies

There are many types of complementary and alternative therapies that you
may have heard about. Some of these include:

Disciplines:
Homeopathy
Naturopathy
Osteopathy

Physical and Topical


Treatments:
Acupuncture
Biofeedback
Bracelets (copper, magnetic)
Lakota
Massage Therapy

Supplements:
Chondroitin sulphate
Devils claw
Glucosamine
MSM
(methylsulfonylmethane)

Psychological
Techniques:
Meditation
Relaxation exercises
Visualization

When assessing information on complementary and alternative therapies,


it is critical to verify that the sources are trustworthy and that the findings
are based on scientifically proven research. Treatments must be shown to
be effective in clinical studies where the treatments are tested on people
who have arthritis. These studies must be supervised and reviewed by
acknowledged experts in the field of arthritis. Patient testimonials or product
statements that are not backed by research evidence cannot be relied upon,
as these positions are often personal opinion rather than studied and
analyzed results.

Dont forget that there is still no known cure


for arthritis.
For more than 60 years, The Arthritis Society, along with other
organizations, has been funding researchers in their search for a cure for
arthritis. Although many effective medications and treatments have been
found, no cure has been discovered to date. As you search for information
about arthritis, you may encounter a number of claims stating that products
can cure arthritis. Always read the fine print and be cautious of the promises
these treatments make. Considering that there are more than 100 forms of
arthritis in adults and children, it is unlikely that there will be only one cure.

Keep in mind that a team approach to managing


arthritis produces better results.
Working with a health-care team composed of various specialists and
professionals helps ensure that you are receiving the most appropriate care
and treatments for you.
Your health-care team may include several of the following:
Family Physician
Nurse/Nurse Practitioner
Rheumatologist
Orthopedic Surgeon
Pharmacist
Physiotherapist
Occupational Therapist
Dietitian
Psychologist/
Psychiatrist
Social Worker
Kinesiologist
Athletic Therapist
Chiropractor

www.arthritis.ca

If there are non-traditional therapies


that you believe will help relieve your
symptoms, speak to your health-care
provider. The Arthritis Society also
offers programs to help you manage
pain, and understand arthritis and its
management. Call the Arthritis
Information Line at 1.800.321.1433 or
visit www.arthritis.ca to learn more
about the Chronic Pain Management
Workshop, Arthritis Self-Management
Program or other educational
programs in your area.

Although you are the leader of your health-care team, you should have one
health-care professional that you rely on as a co-captain. This person can
help clarify any questions or concerns you may have. If you are considering
complementary or alternative therapies, the risks and advantages should be
discussed with your health-care provider, especially if you are thinking of
changing or replacing prescribed treatments.

An Introduction to Complementar y and Alternative Therapies

If you see more than one health-care professional, its important to keep
track of the individual treatment advice and to share the advice of one team
member with another. This sharing of information helps ensure that your
treatment plan is the most effective. The Arthritis Society offers a free,
downloadable Pain Management Diary at www.arthritis.ca/paindiary that
works as a useful tool to keep track of your treatments, pain levels and
appointments. If you are using complementary or alternative treatments,
they should be included in this form.

Be savvy.

Learn about your type of arthritis.


There are more than 100 types of arthritis in adults and children, and various
ways to treat and manage them. Some types are inflammatory, such as
juvenile arthritis,
rheumatoid arthritis,
ankylosing spondylitis,
gout and psoriatic
arthritis. Other types
are degenerative, such
as osteoarthritis.
Being informed about
your specific type of
arthritis will help
you determine the
best treatment plan
for you.

While reading about your disease and complementary and alternative


therapies, consider some of the advice below to help you feel assured and
comfortable with the information you are using.
Finding credible sources on complementary and alternative therapies

Today, the Internet has become a primary source of information for


consumers. Verifying the credibility of the information can be difficult, but
there are several ways to be sure that what you are reading is trustworthy.

??

Be cautious of information that is passed on to you as a testimonial.


It helped me and my friends, so it will help you.

Avoid anything that results in monetary benefit for the promoter.

If you are considering purchasing a product, its important to be


cautious of items that are sold via multi-level marketing schemes.
These products are sold by people you may know or be acquainted
with, but they have a financial interest in getting you not only to buy
the product but to begin selling it as well.These opportunities are often
more about the sales pyramid rather than the product being sold.

Look for credible studies or proof that your complementary or


alternative choice is beneficial for your type of arthritis, works and is
safe for you to try.

Avoid therapies or treatments that use words such as miracle, cure


and guaranteed.
If it sounds too good to be true, it usually is.

www.arthritis.ca

Below
? are some questions to ask yourself when you are
learning about complementary and alternative therapies:

An Introduction to Complementar y and Alternative Therapies

??
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Is the author an expert in the field with recognized credentials


and a designation?

Understanding and trusting research information


When referring to research information, keep in mind that a single research
study may not be enough to support a finding. If results have been
substantiated by more than one study, there is more likelihood that they
are valid.

Is the information published on the website of a recognized,


well-known, highly regarded organization?

!
Is the!information sufficient to justify its use in children?
Is the information Canadian-based? If not, where did the study
!
take place?
Is the information current and relevant to your type of arthritis
and situation?

Is the resource easy to understand with user-friendly


language?

Does the resource provide well-balanced information that suits


your lifestyle?

Does the resource avoid promises of quick-fix solutions


or cures?

!
study funded by a company or person that sells
? Isthetheproduct?
!

Does the information encourage you to consult with your


health-care provider?

If you do try a complementary or


alternative therapy, try only one
at a time and give it at least a
three-month trial to determine its
effectiveness. However, remember
to discuss this decision with your
health-care team and report right
away any adverse effects you may
experience.

www.arthritis.ca

Recommended online resources


Below is a list of online resources
that can help you learn more
about complementary and
alternative therapies.This list was
prepared in conjunction with
The Arthritis Societys Medical
Advisory Committee.
An Introduction to Complementar y and Alternative Therapies

The Arthritis Society Website www.arthritis.ca


This site provides a wide range of
information in both English and
French about types of arthritis, tips
for living well with arthritis and
programs available across Canada.
There is also information about
arthritis research.
MedEffect - www.healthcanada.gc.ca/medeffect
Health Canadas Marketed Health Products Directorate operates the MedEffect
program that provides centralized access to new safety information about
health products. MedEffect informs the public about potential risks associated
with certain drugs or health products and provides access to adverse reaction
reports. Go online or call toll-free at 1.866.234.2345.
Cochrane Collaboration - www.arthritis.ca/cochranereviews
The Cochrane Musculoskeletal Review Group (CMSG) is a specialized group
of researchers and consumer representatives that belong to the Cochrane
Collaboration, an international not-for-profit organization that encourages
informed decisions about health care.This Group prepares, maintains and
promotes reviews of the effects of various health-care treatments. CMSG
members review the available literature to determine the best evidence to
support specific arthritis treatments.They explore the evidence for and against
the effectiveness and appropriateness of treatments in specific circumstances.
Health on the Net - www.hon.ch
The Health on the Net Foundation (HON) is the leading organization promoting
and guiding the use of reliable online medical and health information, and its
appropriate and efficient use. Created in 1995, HON is a non-profit,
non-governmental organization accredited to the Economic and Social
Council of the United Nations. Its website is a search portal that directs users
to reliable information based on search terms that they enter.

National Institute for Health: National Centre for Complementary &


Alternative Medicine - www.nccam.nih.gov
This is a United States government website with evidence-based,
peer-reviewed information on complementary and alternative therapies.
National Institute for Health: Office of Dietary Supplements http://dietary-supplements.info.nih.gov
This is a United States government website with evidence-based,
peer-reviewed information on dietary supplements.
Quackwatch - www.quackwatch.org
This is a United States-based website that focuses on providing accurate,
candid information in relation to health fraud or questionable medical
practices and treatments.
Arthritis Research Campaign - www.arthritisresearchuk.org
This website is from a United Kingdom-based arthritis charity. Under the
arthritis info tab in the publications section for people with arthritis, there
is an area called Other treatments and surgery. Here, information on
complementary and alternative treatments can be found.
Google - www.google.com
Google searches can be helpful when looking for information online. Look
for websites from medical sources or universities, as this will indicate there is
some research to support the information provided.
Wikipedia - www.wikipedia.org
Wikipedia is a free, web-based, multilingual encyclopedia written collaboratively
by volunteers from around the world. Anyone with Internet access can make
changes to Wikipedia articles. Because anyone can edit Wikipedia, it is important
when searching and reading topics on the site to look at the sources and
links provided to ensure the accuracy of the information. If you are unfamiliar
with Wikipedia, before getting started, you can visit the about section to
gain valuable insight to make the most of your Wikipedia search.

Online Publications:
The Arthritis Foundation in the US offers The Arthritis Supplement Guide, a
comprehensive online publication discusses arthritis supplements. Download
it at www.arthritistoday.org/treatments/supplement-guide/index.php
The Arthritis Research Campaign in the UK has prepared a report, Complementary
and Alternative Medicines for the Treatment of Rheumatoid Arthritis, Osteoarthritis
and Fibromyalgia, that examines many treatments scientifically and rates
them on their efficacy for specific types of arthritis.You can download it at
www.arthritisresearchuk.org/arthritis_information/complementary_
therapies.aspx
www.arthritis.ca

Online Medical Journals:

An Introduction to Complementar y and Alternative Therapies

Online medical journals are another


great source of information. This
information, however, is not written
for average consumers. Since it is
prepared for health-care professionals,
the terms and information can be
difficult to understand. These journals
do share some brief overviews of
recently published studies, although
access to the full site may be limited
to accredited members or health-care
professionals. Articles may be available
for purchase. If you see a study of
interest, this is a topic you may want
to discuss with your health-care
provider. Some popular online medical
journals related to arthritis are listed below.
The Journal of Rheumatology - www.jrheum.org
The Journal of Rheumatology is a monthly international publication owned
by the Canadian Rheumatology Association. The journal features research
articles on clinical subjects from scientists working in rheumatology and
related fields.
Arthritis & Rheumatism - www.rheumatology.org
Arthritis & Rheumatism is the monthly journal of the American College of
Rheumatology and contains peer-reviewed articles on diagnosis, treatment,
laboratory research and socio-economic issues related to all forms of
rheumatic disease. The magazine can be found under the Publications
section of the website. Registration is required.
Annals of the Rheumatic Diseases - www.ard.bmj.com
Annals of the Rheumatic Diseases is an international peer-reviewed journal
committed to promoting the highest standards of scientific exchange and
education. It covers all aspects of rheumatology, which includes the spectrum
of musculoskeletal conditions, arthritic disease and connective tissue disorders.
Registration is required.

Recommended Reading
This section provides information on books recommended by people who
have arthritis and that are available at your local library or bookstore.
Alternative Answers to Arthritis & Rheumatism
Anne Charlish and Peter Fisher, Grange Books PLC, UK, 2007
ISBN-10: 1840139315
This book includes an introduction on understanding arthritis and a review of
a variety of complementary treatments, such as acupuncture and acupressure,
reflexology and biofeedback, massage and the Alexander technique.
Conventional treatments are also covered and there is a living with arthritis
section that discusses exercise, diet, pain and adaptive equipment.
Alternative Treatments:
an A to Z Guide
Dorothy Foltz-Gray,
The Arthritis Foundation,
Atlanta, GA, 2007
ISBN-10: 0912423536
This book provides the most
up-to-date information on
more than 100 natural
treatments for arthritis in an
easy-to-use A to Z format.
Treatments included are:
glucosamine, chondroitin,
boswellia, SAM-e, shark
cartilage, Chinese medicine,
Alexander technique, rolfing
and craniosacral therapy.
Scientific evidence about these
treatments and information
about safety concerns and
side effects are investigated.
A-Z Guide to Drug-Herb-Vitamin Interactions
Alan R. MD Gaby and Healthnotes, Three Rivers Press, Roseville, CA, 2006,
2 Rev Exp Edition ISBN-10: 0307336646
This guide discusses how to improve health and avoid problems when
using common medications and natural supplements together. It provides a
description of prescription drugs and trade names, and the interactions
(both positive and negative) with vitamins, herbs, minerals and diet.

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www.arthritis.ca

11

Natural Health, Natural Medicine: The Complete Guide to Wellness and


Self-Care for Optimum Health
Andrew Weil, MD, Houghton Mifflin Company, New York, NY, 2004, Revised
Edition ISBN-10: 0618479031

Notes

An Introduction to Complementar y and Alternative Therapies

This book provides a basic collection of strategies and methods to maintain


optimum health and treat common ailments. Topics include: designing a
plan for a healthier lifestyle; learning how to maintain the immune system;
avoiding heart attacks and strokes; reducing the risk of cancer; choosing the
right vitamins and supplements to achieve maximum nutritional health; and
taking advantage of home remedies for common ailments.
Take Control of Your Health: The Essential Roadmap to Making the Right
Health Care Decisions
William Feldman, MD FRCPC, Key Porter Books Ltd, 2007
ISBN-10: 1552638804
This book is designed to help patients navigate through health information,
tests and health-care practices. The main objective is to ensure the decisions
patients make regarding their treatments are well informed.

Additional Resources:
The Arthritis Society offers a number of free information brochures on various
topics and specific types of arthritis.To receive your free copy, call the Arthritis
Information Line at 1.800.321.1433 or download them at
www.arthritis.ca/publications.

Make a Donation
The Arthritis Society is fighting for a world without arthritis and helps people
live their lives to the fullest by combating the limitations arthritis can impose.
We trust that you found this information valuable and helpful as you battle
arthritis. Please help us continue funding arthritis research, educational
programming and services by making a donation today. To donate, visit us
online at www.arthritis.ca, call 1.800.321.1433 or cut out the form below and
mail it to: The Arthritis Society, Attention: Data Services,
393 University Avenue, Suite 1700, Toronto, ON M5G 1E6.
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