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We all know what it’s like to wake up in the morning with an aching back or stiff knees. But for those with chronic inflammatory arthritis, a disease in which our immune system starts attacking healthy cells by mistake — manifesting in widespread pain and red, swollen, inflamed joints — the discomfort is very different. “The distinction has to do with the pervasiveness of the experience,” says Nortin Hadler, M.D., emeritus professor of medicine and microbiology/immunology at the University of North Carolina at Chapel Hill. “Without medicine, people with rheumatoid arthritis or psoriatic arthritis are lucky to feel good ever during the day. It is remittent: There are good days, and there are bad days.”
Getting the disease under control with drugs, such as disease-modifying antirheumatic drugs (DMARDs) or biologics, can significantly reduce the pain. “But while medication these days is very effective, it’s not completely effective,” says Nancy Shadick, M.D., a rheumatologist at Boston’s Brigham and Women’s Hospital and an associate professor at Harvard Medical School. “You’re dealing with the intermittent flares or some ongoing pain or disability.”
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For help where drugs leave off, and in an effort to deal with both problems of addiction and side effects that drugs for inflammatory pain can cause, doctors are increasingly turning to alternative and “non-drug therapies,” says Mark Bicket, M.D., an assistant professor of anesthesiology and critical care medicine at the Johns Hopkins University School of Medicine. Here are what a few experts recommend beyond the basics of a warm bath and gentle stretching.
Apply the pressure
If your muscles and joints aren’t feeling too tender, massage can offer sweet relief from the pain of inflammatory arthritis. The best hands-on approach: moderate pressure massage. “When you move the skin, you’re increasing the activity of the vagus nerve, a large nerve that connects the brain with other parts of the body, including the heart and lungs,” says Tiffany Field, a professor in the departments of pediatrics, psychology and psychiatry at the University of Miami Miller School of Medicine and director of the Touch Research Institute. “This slows down the production of cortisol, the body’s chief stress hormone. You’re also increasing the production of serotonin, a chemical in the brain that helps diminish pain.”
A fair amount of research backs up Field’s claim, including her own study published in the journal Complementary Therapy in Clinical Practice. During the study, participants afflicted with rheumatoid arthritis reported relief from pain and stiffness — as well as a stronger grip — after weekly moderate-pressure massages on their arms that were supplemented with daily self-massage at home. In another study, researchers found participants who received a moderate-pressure massage, this time to the knees, reported reduced pain and greater range of motion.
“It’s important to have a daily dose of some kind of pressure to the skin,” says Field, who suggests scheduling a once-a-week massage with a licensed massage therapist, as well as taking matters into your own hands by doing daily 10-minute self-massages at home between sessions.
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Turn up the heat
Inflammatory pain relief may be as easy as knocking back a capsule. “There are nutritional supplements that have been proven beneficial for inflammatory conditions,” says Chrystina Jeter, M.D., assistant clinical professor of pain medicine at the University of California, Los Angeles (UCLA), Comprehensive Pain Center. “One that has been best studied is turmeric.”
The bright yellow Indian spice, commonly used as an ingredient in curries, has long been embraced by Indian and Chinese medicine for its healing properties. In fact, it’s not turmeric that eases inflammation, but curcumin, the active chemical in turmeric, which researchers believe blocks certain enzymes and a large group of proteins known as cytokines that lead to inflammation.
In a small 2012 study, a curcumin product called BCM-95 proved better at reducing joint pain and swelling in patients with rheumatoid arthritis than a standard anti-inflammatory drug.
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