Complementary and alternative medicines or CAMs are a wide range of treatments that are not conventionally used by most doctors trained in medical schools. Many people use complementary therapies but it’s important to note that you should not stop a course of recommended conventional treatment without consulting your doctor first.

Although complementary therapies are generally harmless, they are not all completely safe and have been less thoroughly tested than conventional medicines.

Always tell your doctor and make sure you use a qualified therapist if you decide to try a complementary therapy to treat symptoms of arthritis.

Does Complementary and Alternative Medicine really work?

Most evidence regarding the benefits of complementary therapies for treating the symptoms of arthritis is anecdotal and has not been clinically proven to be effective. However some people find complementary therapies can help ease the pain and discomfort of arthritis. There are also complementary therapies that reportedly improve flexibility and mobility.

If you are in pain and arthritis is having a detrimental effect on your life, trying complementary therapies is a positive way of taking control of your symptoms, and it may help you to manage your pain.

Your GP or consultant will be able to advise about different treatment options, including some complementary therapies.

Are Complementary and Alternative Medicine safe?

Generally speaking, complementary and alternative medicine is relatively safe, although you should always talk to your doctor before you start treatment. There are some risks associated with specific therapies, for example some herbal therapies may be associated with significant side-effects and may interact with prescribed medication.

In many cases the risks associated with complementary and alternative medicine are more to do with the therapist than the therapy. This is why it’s important for you to go to a legally registered therapist or one who has a set ethical code and is fully insured.

The following checklist will help ensure that your treatment is safe and reliable.

  • Ask how long the treatment is likely to last and how much it will cost.
  • Find out if there is a governing body for the treatment you plan to receive and whether your chosen therapist is a member.
  • Make sure your therapist has insurance cover.
  • Ask about their training, how long they have practised and whether they have any particular areas of expertise.
  • Tell them about any medication that you are taking.
  • Do not stop taking any medication until you have discussed it with your GP or consultant.
  • Avoid miracle cures for arthritis, they do not exist (be suspicious of anyone, or any website, who promises a miracle cure).
  • If you don’t trust a therapist, don’t use them.

What to consider if you’re thinking of using complimentary and alternative medicine

  • What am I hoping to achieve? Pain relief? More energy? Better sleep? Reduction in medication?
  • Does this therapy suit me? For example you may be uncomfortable with the use of needles in acupuncture or having massage.
  • Are there any risks – are they safe?
  • What are the financial costs?
  • Is there any evidence for their effectiveness?

Therapists

There are two main groups of complementary and alternative therapists: those who are legally registered and those who are not:

Osteopaths and chiropractors are legally recognised professionals just like doctors, nurses, occupational therapists and physiotherapists. This means their training is regulated by a body set up by the government and by law they must register with this body in order to practice. They must be insured, and they can be struck off and prevented from practicing if they’re incompetent or unethical.

For other therapists it is very important they should:

  • have an agreed code of ethics
  • be insured in case something goes wrong with your treatment
  • be a member of an organisation that promotes self-regulation and doesn’t make unreasonable claims about their treatments

Below is some information on popular forms of complementary and alternative medicine.


Acupuncture

acupuncture

What is it?

Acupuncture involves inserting fine needles at particular points in your skin. The therapist may stimulate the needles manually, by heat (with a dried herb called moxa) or by a small electrical current (electro-acupuncture). The needles are very fine, so having them inserted is rarely painful. Sometimes you may have a sensation of heaviness or tingling at the insertion site, and this is considered a good sign. Acupuncture seems to relieve pain by diverting or changing the painful sensations that are sent to your brain from damaged tissues and by stimulating your body’s own pain-relieving hormones (endorphins and encephalins). This pain relief may only last a short time at the beginning, but repeated treatment (usually weekly for six or eight sessions) can bring long-term benefit, often for several months. If the pain returns, then more acupuncture may help for another few months.

If you can’t tolerate conventional drugs then acupuncture may help you get through a painful episode. There’s now clear scientific evidence that it can be beneficial if you have osteoarthritis in your knees and low back pain. For this reason acupuncture treatment is increasingly available on the NHS in physiotherapy departments or through your GP.

Is it safe?

Acupuncture generally has a very good safety record, but there are certain risks. It can transmit diseases if the therapist doesn’t use single-use needles every time, but disposable needles are now standard practice, and there are strict guidelines regarding their disposal.

Feeling dizzy or faint after a session of acupuncture is common, and it can occasionally cause bleeding and bruising.

Where can I find a therapist?

The British Acupuncture Council (BAcC) is the leading self-regulatory body for the practice of traditional acupuncture in the UK. You can search by postcode for a registered acupuncturist in your area:  www.acupuncture.org.uk


Aromatherapy

aromatherapy

What is it?

Aromatherapy is the therapeutic use of scented essential oils. You can inhale the oils, use them in the bath or massage them into your skin. When you use them for massage they’re diluted in a carrier oil.

There are many different oils you can use. If you have back pain, for instance, an aromatherapist might select lavender or marjoram to relieve muscle spasm, or ginger if you have a circulatory problem. Other oils such as rosemary or peppermint are thought to have stimulating properties.

Is it safe?

The oils are very concentrated and you should never apply them to your skin undiluted. They may be harmful in large quantities, particularly if you’re pregnant.

In practice aromatherapy is very safe, apart from occasional allergic reactions. There’s little evidence that aromatherapy is effective for arthritis, although there’s some evidence that it’s beneficial in other painful conditions and helpful with anxiety. Many people with chronic pain report that an aromatherapy massage gives relief for several weeks.

Where can I find an aromatherapist?

For therapists not currently required to register by law, such as aromatherapists there’s an independent self-regulatory body for complementary therapies, the Complementary and Natural Healthcare Council (CNHC), which was set up in 2008. It’s possible to search this site to find a registered therapist in your area:

www.cnhc.org.uk


Herbal medicine

herbal remedies

What is it?

Herbal medicine is the use of plants and plant extracts to treat disease. Many modern drugs were originally extracted from plant sources, even if they’re now made synthetically. Whereas conventional medicine now tries to use only the active ingredient of a plant, herbal remedies use the whole plant. Herbalists argue that the mixture of chemicals in the whole plant work together to give a better effect (called synergy) than a single active ingredient like in synthetic drugs.

Some of the most promising herbs for arthritis, all of which are backed by some research, are:

  • Devil’s claw (made from a plant which grows in Namibia)
  • Boswellia (from the frankincense tree)
  • Rosehip

These herbal medicines can be found in health food shops and chemists, but if you consult a medical herbal practitioner you’ll probably be prescribed a mixture of herbs, often in liquid form, tailored to your needs. This may include herbs which have anti-inflammatory and painkilling properties, and others to improve energy or aid relaxation and sleep, or even just to make the mixture taste better!

Is it safe?

Generally speaking, herbal remedies are safe but sometimes they cause side-effects. These can include stomach upsets, sleeplessness and pains in your muscles or joints. Some herbal remedies may also interact with your prescribed medication.

If you’re thinking of using these remedies, always buy them from a trusted manufacturer to make sure they’re a quality product, and discuss their use with your doctor first.

Where can I find a medical herbalist?

Contact the National Institute of Medical Herbalists:  www.nimh.org.uk

Clover House
James Court
South Street
Exeter
EX1 1EE
Telephone 01392 426022
E-mail: info@nimh.org.uk


Homeopathy

homeopathy

What is it?

Homeopathy (from the Greek words meaning similar suffering) is based on the idea of treating like with like. So for a hot, swollen and tender joint a homeopath might prescribe you a remedy made from bee stings, which can cause hot, swollen and tender swellings. The controversial aspect of homeopathy is its use of extremely dilute medicines (sometimes called remedies).  Homeopaths often advise changes in lifestyle, which could include changing your diet, more relaxation or exercise.

Two randomised controlled trials have suggested that homeopathy may be effective in reducing the number of tender points and the level of pain in fibromyalgia, although the evidence isn’t conclusive. Three trials for osteoarthritis and four trials for rheumatoid arthritis have given inconsistent results.

Is it safe?

Homeopathy is generally safe, although sometimes the right medicine can cause an ‘aggravation’ – a temporary flare-up of symptoms. However, this is usually seen as a good sign. Allergic reactions (e.g. a rash) have been reported in some cases. Dosage hasn’t been well studied. You should follow the dosage recommended by the homeopath or the homeopathic pharmaceutical company.

Where can I find a homeopathist?

The British Homoepathic Association has a list of homeopaths that are registered with them. For more information on homeopathy and how to find a registered homeopath in your area please go to:  https://homeopathy-uk.org/


 Manipulative therapies

manipulative therapy

What is it?

Manipulative therapies include chiropractic and osteopathy. They’re used mainly for:

  • musculoskeletal problems, including spine, neck and shoulder disorders
  • joint, posture and muscle problems
  • sciatica
  • sports injuries
  • whiplash
  • repetitive strain injury (RSI)

The best-known technique is the ‘high-velocity thrust’ – a short, sharp movement, usually applied to joints in the spine, which often produces the sound of a joint ‘cracking’ – but many other methods are also used.

These therapies can be carried out by many healthcare professionals including doctors, physiotherapists, osteopaths and chiropractors, who are now registered health professionals in the UK. These treatments should include advice on exercise and lifestyle as well as hands-on manipulative therapy.

Is it safe?

You shouldn’t use manipulative therapies if:

  • you have a circulatory problem affecting your spine
  • you have severe osteoporosis
  • you have malignant or inflammatory spine conditions
  • you have recent fractures or dislocations
  • you’re on anti-clotting drugs

The most serious risks of osteopathy and chiropractic are stroke and spinal cord injury after manipulation of the neck; however, these serious problems are very rare. Slight discomfort at the site of manipulation for a few hours afterwards is quite common.

Where can I find a registered chiropractor or osteopath?

The General Chiropractic Council (GCC) is an independent statutory body established by Parliament to regulate the chiropractic profession in the United Kingdom. It protects the health and safety of the public by ensuring high standards of practice in the chiropractic profession. The General Chiropractic Council provides a searchable database of registered chiropractors: https://www.gcc-uk.org/

The General Osteopathic Council (GOC)regulate the practice of osteopathy in the United Kingdom. By law osteopaths must be registered with the GOC in order to practice.

It is possible to find a registered osteopath in your area by searching the on-line register:  http://www.osteopathy.org.uk/register-search/


Massage

massage

What is it?

Massage involves a manual technique in which a rhythmic movement uses a variety of strokes, kneading or tapping to move your muscles and soft tissue of your body. Massage can be stimulating or sedating, vigorous or gentle, and can include your whole body or only part. The therapist may use oils, creams, lotions or talcum powder.

Massage can reduce your anxiety and stress levels, relieve muscular tension and fatigue, improve circulation and thus reduce your pain levels.

Is it safe?

Massage is generally safe and relaxing, and a trained massage therapist will always follow strict guidelines to avoid causing you injury.

Where can I find a massage therapist?

For therapists not currently required to register by law, such as massage therapists, there’s an independent self-regulatory body for complementary therapies, the Complementary and Natural Healthcare Council (CNHC), which was set up in 2008. It’s possible to search this site to find a registered therapist in your area: https://www.cnhc.org.uk/


Reflexology

reflexology

What is reflexology?

Reflexology (also known as zone therapy or reflex zone therapy) is a sophisticated system of touch, usually on the feet but sometimes on the hands, ears, face, tongue or back. Practitioners believe that it can be helpful in achieving and maintaining health and improving wellbeing, as well as relieving symptoms or causes of illness. A typical session lasts for 45–60 minutes, and it’s often provided weekly over six to eight weeks, with the possibility of follow-up sessions offered for chronic conditions.

Reflexology is based on the belief that the entire body can be mapped on to specific zones on the feet, hands and ears. Pressure applied in these areas is thought to affect the organ or body part related to this area in a way similar to acupuncture. Foot massage may have general health benefits regardless of any connection to reflexology.

Is it safe?

It’s generally considered safe to practice, but there’s currently no evidence of any effectiveness with respect to rheumatoid arthritis, osteoarthritis or fibromyalgia.

There’s no clinical evidence that suggests reflexology has any side-effects, but fatigue and changes in urine output or bowel function are possible. Talcum powder or oils used during treatment may cause reactions, but the therapist should ask about potential allergies before treatment.

Where can I find a reflexologist?

For therapists not currently required to register by law, such as reflexologists there’s an independent self-regulatory body for complementary therapies, the Complementary and Natural Healthcare Council (CNHC), which was set up in 2008. It’s possible to search this site to find a registered therapist in your area: https://www.cnhc.org.uk/

Further information can be found on the website of the Association of Reflexologists: https://www.aor.org.uk/