A Root Cause Medicine Approach
|
May 25, 2023

Integrative Approaches to Pain Management in Rheumatology Patients: Testing, Supplements, and Therapies

Medically Reviewed by
Updated On
October 14, 2024

If you've been living with rheumatology-related pain, you're not alone. According to the CDC, approximately 58.5 million adults have some form of rheumatic condition in the United States, with chronic pain being one of the most common symptoms. With such staggering numbers, it's no wonder that many people are seeking out integrative approaches to pain management. In this article, we dive into the world of rheumatology and integrative medicine, offering valuable insight into managing your pain and improving your overall health when managing these disorders.

[signup]

What is Rheumatology?

Rheumatology involves diagnosing and treating musculoskeletal diseases and systemic autoimmune conditions, collectively referred to as rheumatic diseases. These disorders affect the joints, bones, and muscles leading to pain, stiffness, and deformity. They may also affect the eyes, skin, nervous system, and internal organs. Common diseases include arthritis, rheumatoid arthritis, gout, lupus, or fibromyalgia (1).

What is Integrative Rheumatology?

Integrative Rheumatology, then, is a sub-discipline that combines conventional rheumatology practices with complementary therapies. This approach addresses not only physical symptoms but also psychological, social, and environmental influences that affect health. It's about looking at the patient in their entirety rather than zeroing in on a specific disease or symptom.

Common Functional Medicine Labs Used to Individualize Treatment Protocols in Integrative Rheumatology

Functional medicine labs offer a variety of tests that can help tailor treatment to patients with rheumatic diseases, allowing providers to optimize management strategies.

Arthritis Panel Testing

The Access Medical Labs Arthritis Panel is a key tool in individualizing treatment for patients with rheumatic diseases. By identifying and tracking specific inflammatory markers such as Rheumatoid Factor (RF) and C-reactive protein (CRP), this test helps to create a detailed understanding of a patient's specific disease profile. This can allow for a more targeted approach to treatment. For example, a patient with high levels of CRP may benefit from therapies focused on reducing inflammation, whereas another patient with elevated RF levels may need treatments aimed at modulating immune response.

hs-CRP Testing

The Boston Heart hs-CRP test measures the levels of C-reactive protein (CRP), a biomarker produced by the liver in response to inflammation. The test's high sensitivity allows for the detection of even minor increases in CRP levels, indicating inflammation often associated with rheumatic diseases. In the context of rheumatic conditions, the hs-CRP test provides insights into the patient's current inflammatory status. For instance, an increase in hs-CRP levels may signal a flare-up of rheumatoid arthritis or lupus, indicating that the patient may require an adjustment in their treatment protocol, such as dietary changes or enhanced physical therapy routines. Conversely, normal or decreasing hs-CRP levels might suggest effective management of the disease, possibly warranting a continuation or gradual reduction of treatments. Regular monitoring of hs-CRP levels can also provide a clearer picture of the disease's progression and the effectiveness of current treatment strategies.

Gastrointestinal Microbiome Analysis

The Diagnostic Solutions GI-MAP helps to individualize treatment by evaluating the gut microbiome's health and diversity. The gut's microbiome plays a significant role in overall health, including systemic inflammation that can exacerbate pain in rheumatic conditions. By identifying imbalances in the gut microbiota, this test provides a pathway to personalized interventions, such as specific dietary changes. These interventions can restore a healthy gut microbiome balance, potentially reducing systemic inflammation and enhancing overall pain management.

Organic Acids Testing

The Organic Acids Test (OAT) provides a look into a patient's metabolic health, examining different markers tied to systems like cellular energy production, detoxification, and gut microbiome health. In the context of integrative rheumatology and pain management, metabolic imbalances can play a significant role in the genesis and perpetuation of pain and inflammation. For instance, nutritional deficiencies can impair the body's natural anti-inflammatory mechanisms and energy production pathways, leading to heightened pain perception. Additionally, as discussed above, imbalances in gut microbiota can provoke systemic inflammation, which can exacerbate pain in rheumatologic conditions. Β 

[signup]

Conventional Treatment for Pain Management in Rheumatology

Conventional medicine plays a key role in managing rheumatic diseases. This includes nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, and disease-modifying antirheumatic drugs (DMARDs).

Integrative Approaches to Pain Management in Rheumatology Patients

Pain management for this patient population requires a holistic, multi-faceted approach. This approach blends conventional treatments, such as anti-inflammatory drugs or immunosuppressants, with integrative therapies like acupuncture and mindfulness practices, all designed to reduce inflammation and alleviate pain. Further, individualized nutritional strategies and lifestyle changes are specifically tailored to address the unique needs of each patient. This might involve adopting an anti-inflammatory diet or implementing regular exercise regimes. Each aspect of this strategy serves to target different components of rheumatologic conditions, working together to enhance overall pain management, improve quality of life, and promote health.

Integrative Nutrition That Helps With Pain Management in Rheumatology Patients

Integrative nutrition plays a significant role in managing pain in patients with rheumatic conditions. It blends principles from diets such as the Autoimmune Protocol (AIP) diet and the Mediterranean diet, both of which prioritize anti-inflammatory, nutrient-rich foods that support general wellness and specifically address symptoms associated with autoimmune diseases.

The AIP diet focuses on eliminating potential inflammatory triggers. By promoting the consumption of nutrient-dense, minimally processed foods and excluding potential irritants like grains, legumes, and processed oils, the AIP diet supports the body's anti-inflammatory pathways and can improve autoimmune symptoms, therefore potentially reducing pain in this population. In contrast, the Mediterranean diet emphasizes a balanced intake of fresh fruits and vegetables, heart-healthy fats, whole grains, and lean proteins. It provides numerous health benefits, including reduced inflammation and improved gut health through an improved microbiome. Key elements of the Mediterranean diet include fresh, organically-grown vegetables and fruits, unsalted nuts and seeds, extra-virgin olive oil, beans, pulses, legumes, whole grains, and fatty fish.

Recent research underlines the importance of certain nutrients and food types in arthritis management. For instance, a high intake of vitamins B1 and B2, polyunsaturated fatty acids, and omega-3 fatty acids can significantly lower the risk of arthritis development. Additionally, consuming more fruits and green vegetables has been linked to a lower presence of arthritis. These findings emphasize the importance of a nutrient-rich diet in managing arthritis symptoms and overall health. Avoiding processed foods, refined grains, factory-farmed meats, and trans-fats further helps reduce inflammation and improve autoimmune symptoms. It's important to note that dietary fiber has also been shown to produce anti-inflammatory effects and is also part of a healthy diet (25).

Supplements and Herbs That Helps With Pain Management in Rheumatology Patients

For patients interested in supplements, collagen, curcumin, rose hip, and omega-3s may help reduce symptomatology in patients with rheumatic disease.

Type II Collagen for Pain Management

Collagen, a substance naturally occurring in our cartilage, has shown promise in helping manage joint inflammation often seen in rheumatoid arthritis. In a scientific study, patients took different doses of this collagen orally for 24 weeks, and the most effective dose appeared to be 20 micrograms per day.

Collagen is also anti-inflammatory and has demonstrated the potential to improve symptoms in patients with osteoarthritis and osteoporosis.

Dose: 20 mcg/day

Duration: 24 weeks

Curcumin for Pain Management

Curcumin, the active ingredient in turmeric, is used in traditional medicine for its anti-inflammatory properties. A recent study suggested that curcumin can help improve the symptoms of rheumatoid arthritis. Participants in the study took either a low dose (250 mg) or a high dose (500 mg) of curcumin twice daily for 90 days. Both groups reported significant improvements in their clinical symptoms, and the improvements were confirmed by laboratory tests that measure inflammation.

Dose: 250-500mg (twice a day)

Duration: 90 days

Rose Hip for Pain Management

Rose hip has shown potential in managing symptoms associated with rheumatoid arthritis. In a study where patients consumed 5g of rose hip powder daily over six months, results highlighted improved overall health and better functioning, as measured by self-reported and physician-assessed scales. There was also some evidence of reduced pain levels and enhanced quality of life.

Dose: 5g

Duration: 6 months

Omega 3 for Pain Management

Fish oil, rich in omega-3 fatty acids, is a beneficial supplement for managing pain and inflammation associated with rheumatology conditions such as rheumatoid arthritis. The omega-3 fatty acids in fish oil, specifically EPA and DHA, are known to decrease inflammation, which can help minimize the pain and swelling in joints. According to research, consuming fish oil supplements can significantly reduce arthritis symptoms, including joint pain and stiffness. One study mentioned in the first link found that participants who took fish oil equivalent to at least 2.7 grams of omega-3 fatty acids daily for three months experienced notable reductions in morning stiffness and tender joints. Moreover, the anti-inflammatory effects of fish oil may not only help with symptoms but could potentially reduce reliance on non-steroidal anti-inflammatory drugs (NSAIDs) in some patients.

Dose: 2.7 grams/per day

Duration: At least three months

Acupuncture for Pain Management in Rheumatology Patients‍

Acupuncture, a traditional, complementary therapy, has been examined for its potential to aid pain relief for rheumatology patients. This practice involves the insertion of fine needles into specific points in the body, and its variants include electro-acupuncture (using electricity alongside acupuncture to increase benefit) and fire needle techniques (quickly piercing the acupoints with very hot needles). Combined with disease-modifying anti-rheumatic drugs (DMARDs), different acupuncture therapies show varying degrees of effectiveness in managing symptoms.

Research suggests that acupuncture could contribute to pain relief and a decrease in inflammation markers in rheumatoid arthritis (RA) patients. For instance, some studies found that a majority of participants experienced a reduction in joint pain after undergoing acupuncture, with changes in pain levels varying across individuals. In a comprehensive comparison of different acupuncture treatments combined with DMARDs, electro-acupuncture stood out for its efficacy in improving the DAS28 score, a measure of RA disease activity. Fire needle technique seemed most effective in improving pain scores and reducing inflammation markers. Another method, moxibustion (acupuncture with the burning of dried mugwort on different points of the body) combined with DMARDs, showed promising results in reducing rheumatoid factor, a blood marker often elevated in RA patients. In addition, acupuncture has shown promise in improving symptoms in patients with osteoarthritis, lupus, and gout. Β 

Exercise for Pain Management in Rheumatology Patients

Physical activity is a key element in managing discomfort for patients with rheumatic conditions. Despite fears that exercise could exacerbate joint pain, research indicates that a consistent exercise regimen can actually help to alleviate the disabilities often linked with these conditions. Through the mechanism of increasing muscle strength and flexibility, patients can enhance joint support and function. Exercise also offers additional health benefits such as fatigue reduction, depression alleviation, and overall fitness improvement, which is vital in warding off life-threatening conditions like cardiovascular diseases and diabetes that are often associated with rheumatic conditions. Importantly, weight-bearing activities, for instance, walking, are beneficial in combating the bone density loss which can be associated with these conditions. Research shows that exercise doesn't generally aggravate symptoms of rheumatic conditions, although patients with severe joint damage may benefit more from low-impact exercises. Even if it's not a formal exercise, incorporating movement into daily routines can also contribute significantly to pain management (not to mention overall health!) (39,40,41).

Physical Therapy for Pain Management in Rheumatology Patients

Physical therapy (PT) and occupational therapy (OT) are demonstrated to be effective interventions for managing pain in patients with rheumatic conditions. These interventions can combine a variety of strategies, including exercise, cognitive behavioral therapy, education, and the use of assistive devices or specialized splints. Compared to standard rheumatology care, PT and OT have shown more beneficial results in alleviating pain. In the context of osteoarthritis (OA), particularly in knee and hip cases, non-surgical treatments such as exercise therapy and education are recommended as primary care. These treatments, generally delivered by physical therapists, have shown to be as effective in relieving pain as pharmacological medications without the associated serious side effects. Importantly, the effectiveness of exercise therapy does not depend on baseline pain intensity or disease severity. However, to achieve significant clinical benefit, it's necessary to have at least 12 supervised sessions, with two sessions per week initially (43). Β 

Hot and Cold Therapy for Pain Management in Rheumatology Patients

Hot and cold therapies serve as useful, non-pharmacological strategies for managing pain and stiffness in rheumatology patients. Heat therapy, for instance, works by dilating blood vessels, enhancing blood circulation, reducing muscle spasms, and altering pain sensation, achieved through dry methods like heating pads or heat lamps or moist methods such as warm baths or heated washcloths. In contrast, cold therapy helps reduce swelling and inflammation by constricting blood vessels and numbing deep pain using tools like cold packs or local sprays (44).

While individual preference between heat and cold therapy may differ, some patients find the best relief through alternating between the two, and it’s generally recommended to apply heat or cold therapy at least twice a day. For acute injuries, cold therapy is typically recommended initially to prevent inflammation. Heat therapy can be beneficial in the morning when joints are usually stiffest or before exercise to facilitate joint movement. Cold therapy is especially useful during symptom flare-ups, providing relief from inflammation and swelling (44,45).

[signup]

Summary

In summary, integrative rheumatology offers a holistic approach to managing pain in patients with rheumatic conditions. Labs such as stool testing and inflammation testing can help to individualize treatment further and manage the progression of the disease. This personalized approach is further bolstered by conventional treatments, improving nutrition, using acupuncture, and modifying physical activity. The combination of these therapies and strategies can help patients who are looking to manage their symptom burden and improve overall health within their rheumatic diagnosis.

If you've been living with rheumatology-related discomfort, you're not alone. According to the CDC, approximately 58.5 million adults have some form of rheumatic condition in the United States, with ongoing discomfort being one of the most common experiences. With such significant numbers, it's no wonder that many people are exploring integrative approaches to managing their well-being. In this article, we explore the world of rheumatology and integrative medicine, offering valuable insights into supporting your health and managing discomfort associated with these conditions.

[signup]

What is Rheumatology?

Rheumatology involves diagnosing and managing musculoskeletal diseases and systemic autoimmune conditions, collectively referred to as rheumatic diseases. These disorders affect the joints, bones, and muscles, leading to discomfort, stiffness, and changes in form. They may also affect the eyes, skin, nervous system, and internal organs. Common diseases include arthritis, rheumatoid arthritis, gout, lupus, or fibromyalgia (1).

What is Integrative Rheumatology?

Integrative Rheumatology is a sub-discipline that combines conventional rheumatology practices with complementary therapies. This approach addresses not only physical experiences but also psychological, social, and environmental influences that affect well-being. It's about looking at the patient in their entirety rather than focusing solely on a specific condition or symptom.

Common Functional Medicine Labs Used to Individualize Support Protocols in Integrative Rheumatology

Functional medicine labs offer a variety of tests that can help tailor support to individuals with rheumatic conditions, allowing providers to optimize management strategies.

Arthritis Panel Testing

The Access Medical Labs Arthritis Panel is a key tool in individualizing support for individuals with rheumatic conditions. By identifying and tracking specific markers such as Rheumatoid Factor (RF) and C-reactive protein (CRP), this test helps to create a detailed understanding of a person's specific condition profile. This can allow for a more targeted approach to support. For example, a person with high levels of CRP may benefit from approaches focused on managing inflammation, whereas another person with elevated RF levels may need strategies aimed at modulating immune response.

hs-CRP Testing

The Boston Heart hs-CRP test measures the levels of C-reactive protein (CRP), a biomarker produced by the liver in response to inflammation. The test's high sensitivity allows for the detection of even minor increases in CRP levels, indicating inflammation often associated with rheumatic conditions. In the context of rheumatic conditions, the hs-CRP test provides insights into the individual's current inflammatory status. For instance, an increase in hs-CRP levels may signal a flare-up of rheumatoid arthritis or lupus, indicating that the individual may require an adjustment in their support protocol, such as dietary changes or enhanced physical therapy routines. Conversely, normal or decreasing hs-CRP levels might suggest effective management of the condition, possibly warranting a continuation or gradual reduction of strategies. Regular monitoring of hs-CRP levels can also provide a clearer picture of the condition's progression and the effectiveness of current strategies.

Gastrointestinal Microbiome Analysis

The Diagnostic Solutions GI-MAP helps to individualize support by evaluating the gut microbiome's health and diversity. The gut's microbiome plays a significant role in overall health, including systemic inflammation that can exacerbate discomfort in rheumatic conditions. By identifying imbalances in the gut microbiota, this test provides a pathway to personalized interventions, such as specific dietary changes. These interventions can support a healthy gut microbiome balance, potentially reducing systemic inflammation and enhancing overall discomfort management.

Organic Acids Testing

The Organic Acids Test (OAT) provides a look into a person's metabolic health, examining different markers tied to systems like cellular energy production, detoxification, and gut microbiome health. In the context of integrative rheumatology and discomfort management, metabolic imbalances can play a significant role in the genesis and perpetuation of discomfort and inflammation. For instance, nutritional deficiencies can impair the body's natural anti-inflammatory mechanisms and energy production pathways, leading to heightened discomfort perception. Additionally, as discussed above, imbalances in gut microbiota can provoke systemic inflammation, which can exacerbate discomfort in rheumatologic conditions. Β 

[signup]

Conventional Approaches for Discomfort Management in Rheumatology

Conventional medicine plays a key role in managing rheumatic conditions. This includes nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, and disease-modifying antirheumatic drugs (DMARDs).

Integrative Approaches to Discomfort Management in Rheumatology Patients

Discomfort management for this population requires a holistic, multi-faceted approach. This approach blends conventional treatments, such as anti-inflammatory drugs or immunosuppressants, with integrative therapies like acupuncture and mindfulness practices, all designed to support inflammation management and alleviate discomfort. Further, individualized nutritional strategies and lifestyle changes are specifically tailored to address the unique needs of each person. This might involve adopting an anti-inflammatory diet or implementing regular exercise regimes. Each aspect of this strategy serves to target different components of rheumatologic conditions, working together to enhance overall discomfort management, improve quality of life, and promote health.

Integrative Nutrition That Supports Discomfort Management in Rheumatology Patients

Integrative nutrition plays a significant role in managing discomfort in individuals with rheumatic conditions. It blends principles from diets such as the Autoimmune Protocol (AIP) diet and the Mediterranean diet, both of which prioritize anti-inflammatory, nutrient-rich foods that support general wellness and specifically address experiences associated with autoimmune conditions.

The AIP diet focuses on eliminating potential inflammatory triggers. By promoting the consumption of nutrient-dense, minimally processed foods and excluding potential irritants like grains, legumes, and processed oils, the AIP diet supports the body's anti-inflammatory pathways and can improve autoimmune experiences, therefore potentially reducing discomfort in this population. In contrast, the Mediterranean diet emphasizes a balanced intake of fresh fruits and vegetables, heart-healthy fats, whole grains, and lean proteins. It provides numerous health benefits, including reduced inflammation and improved gut health through an improved microbiome. Key elements of the Mediterranean diet include fresh, organically-grown vegetables and fruits, unsalted nuts and seeds, extra-virgin olive oil, beans, pulses, legumes, whole grains, and fatty fish.

Recent research underlines the importance of certain nutrients and food types in arthritis management. For instance, a high intake of vitamins B1 and B2, polyunsaturated fatty acids, and omega-3 fatty acids can significantly lower the risk of arthritis development. Additionally, consuming more fruits and green vegetables has been linked to a lower presence of arthritis. These findings emphasize the importance of a nutrient-rich diet in managing arthritis experiences and overall health. Avoiding processed foods, refined grains, factory-farmed meats, and trans-fats further helps reduce inflammation and improve autoimmune experiences. It's important to note that dietary fiber has also been shown to produce anti-inflammatory effects and is also part of a healthy diet (25).

Supplements and Herbs That Support Discomfort Management in Rheumatology Patients

For individuals interested in supplements, collagen, curcumin, rose hip, and omega-3s may help support symptom management in individuals with rheumatic conditions.

Type II Collagen for Discomfort Management

Collagen, a substance naturally occurring in our cartilage, has shown promise in helping manage joint inflammation often seen in rheumatoid arthritis. In a scientific study, participants took different doses of this collagen orally for 24 weeks, and the most effective dose appeared to be 20 micrograms per day.

Collagen is also anti-inflammatory and has demonstrated the potential to improve experiences in individuals with osteoarthritis and osteoporosis.

Dose: 20 mcg/day

Duration: 24 weeks

Curcumin for Discomfort Management

Curcumin, the active ingredient in turmeric, is used in traditional practices for its anti-inflammatory properties. A recent study suggested that curcumin can help improve the experiences of rheumatoid arthritis. Participants in the study took either a low dose (250 mg) or a high dose (500 mg) of curcumin twice daily for 90 days. Both groups reported significant improvements in their experiences, and the improvements were confirmed by laboratory tests that measure inflammation.

Dose: 250-500mg (twice a day)

Duration: 90 days

Rose Hip for Discomfort Management

Rose hip has shown potential in managing experiences associated with rheumatoid arthritis. In a study where participants consumed 5g of rose hip powder daily over six months, results highlighted improved overall health and better functioning, as measured by self-reported and physician-assessed scales. There was also some evidence of reduced discomfort levels and enhanced quality of life.

Dose: 5g

Duration: 6 months

Omega 3 for Discomfort Management

Fish oil, rich in omega-3 fatty acids, is a beneficial supplement for managing discomfort and inflammation associated with rheumatology conditions such as rheumatoid arthritis. The omega-3 fatty acids in fish oil, specifically EPA and DHA, are known to decrease inflammation, which can help minimize the discomfort and swelling in joints. According to research, consuming fish oil supplements can significantly reduce arthritis experiences, including joint discomfort and stiffness. One study mentioned in the first link found that participants who took fish oil equivalent to at least 2.7 grams of omega-3 fatty acids daily for three months experienced notable reductions in morning stiffness and tender joints. Moreover, the anti-inflammatory effects of fish oil may not only help with experiences but could potentially reduce reliance on non-steroidal anti-inflammatory drugs (NSAIDs) in some individuals.

Dose: 2.7 grams/per day

Duration: At least three months

Acupuncture for Discomfort Management in Rheumatology Patients‍

Acupuncture, a traditional, complementary therapy, has been examined for its potential to aid discomfort relief for rheumatology patients. This practice involves the insertion of fine needles into specific points in the body, and its variants include electro-acupuncture (using electricity alongside acupuncture to increase benefit) and fire needle techniques (quickly piercing the acupoints with very hot needles). Combined with disease-modifying anti-rheumatic drugs (DMARDs), different acupuncture therapies show varying degrees of effectiveness in managing experiences.

Research suggests that acupuncture could contribute to discomfort relief and a decrease in inflammation markers in rheumatoid arthritis (RA) patients. For instance, some studies found that a majority of participants experienced a reduction in joint discomfort after undergoing acupuncture, with changes in discomfort levels varying across individuals. In a comprehensive comparison of different acupuncture treatments combined with DMARDs, electro-acupuncture stood out for its efficacy in improving the DAS28 score, a measure of RA disease activity. Fire needle technique seemed most effective in improving discomfort scores and reducing inflammation markers. Another method, moxibustion (acupuncture with the burning of dried mugwort on different points of the body) combined with DMARDs, showed promising results in reducing rheumatoid factor, a blood marker often elevated in RA patients. In addition, acupuncture has shown promise in improving experiences in individuals with osteoarthritis, lupus, and gout. Β 

Exercise for Discomfort Management in Rheumatology Patients

Physical activity is a key element in managing discomfort for individuals with rheumatic conditions. Despite fears that exercise could exacerbate joint discomfort, research indicates that a consistent exercise regimen can actually help to alleviate the disabilities often linked with these conditions. Through the mechanism of increasing muscle strength and flexibility, individuals can enhance joint support and function. Exercise also offers additional health benefits such as fatigue reduction, mood improvement, and overall fitness enhancement, which is vital in supporting overall health. Importantly, weight-bearing activities, for instance, walking, are beneficial in supporting bone density. Research shows that exercise doesn't generally aggravate experiences of rheumatic conditions, although individuals with severe joint changes may benefit more from low-impact exercises. Even if it's not a formal exercise, incorporating movement into daily routines can also contribute significantly to discomfort management (not to mention overall health!) (39,40,41).

Physical Therapy for Discomfort Management in Rheumatology Patients

Physical therapy (PT) and occupational therapy (OT) are demonstrated to be effective interventions for managing discomfort in individuals with rheumatic conditions. These interventions can combine a variety of strategies, including exercise, cognitive behavioral therapy, education, and the use of assistive devices or specialized splints. Compared to standard rheumatology care, PT and OT have shown more beneficial results in alleviating discomfort. In the context of osteoarthritis (OA), particularly in knee and hip cases, non-surgical approaches such as exercise therapy and education are recommended as primary care. These approaches, generally delivered by physical therapists, have shown to be as effective in relieving discomfort as pharmacological medications without the associated serious side effects. Importantly, the effectiveness of exercise therapy does not depend on baseline discomfort intensity or condition severity. However, to achieve significant benefit, it's necessary to have at least 12 supervised sessions, with two sessions per week initially (43). Β 

Hot and Cold Therapy for Discomfort Management in Rheumatology Patients

Hot and cold therapies serve as useful, non-pharmacological strategies for managing discomfort and stiffness in rheumatology patients. Heat therapy, for instance, works by dilating blood vessels, enhancing blood circulation, reducing muscle spasms, and altering discomfort sensation, achieved through dry methods like heating pads or heat lamps or moist methods such as warm baths or heated washcloths. In contrast, cold therapy helps reduce swelling and inflammation by constricting blood vessels and numbing deep discomfort using tools like cold packs or local sprays (44).

While individual preference between heat and cold therapy may differ, some individuals find the best relief through alternating between the two, and it’s generally recommended to apply heat or cold therapy at least twice a day. For acute experiences, cold therapy is typically recommended initially to support inflammation management. Heat therapy can be beneficial in the morning when joints are usually stiffest or before exercise to facilitate joint movement. Cold therapy is especially useful during symptom flare-ups, providing relief from inflammation and swelling (44,45).

[signup]

Summary

In summary, integrative rheumatology offers a holistic approach to managing discomfort in individuals with rheumatic conditions. Labs such as stool testing and inflammation testing can help to individualize support further and manage the progression of the condition. This personalized approach is further bolstered by conventional treatments, improving nutrition, using acupuncture, and modifying physical activity. The combination of these therapies and strategies can help individuals who are looking to manage their experiences and improve overall health within their rheumatic diagnosis.

The information in this article is designed for educational purposes only and is not intended to be a substitute for informed medical advice or care. This information should not be used to diagnose or treat any health problems or illnesses without consulting a doctor. Consult with a health care practitioner before relying on any information in this article or on this website.

Learn more

No items found.

Lab Tests in This Article

  1. Elgaddal, N., Kramarow, E., Weeks, J., & Reuben, C. (2024). Arthritis in adults age 18 and older: United States, 2022. https://doi.org/10.15620/cdc:145594
  2. What is a Rheumatologist. (n.d.). https://rheumatology.org/rheumatologist
  3. 5 things you can do to find relief for arthritis. (2024, September 17). Rupa Health. https://www.rupahealth.com/post/a-functional-medicine-approach-to-osteoarthritis
  4. A Functional Medicine Systemic Lupus erythematosus (SLE) protocol: Testing, diagnosing, and treatment. (2024, September 17). Rupa Health. https://www.rupahealth.com/post/a-functional-medicine-systemic-lupus-erythematosus-sle-protocol-testing-diagnosing-and-treatment
  5. Fibromyalgia: causes, symptoms, & alternative treatments. (2024, September 17). Rupa Health. https://www.rupahealth.com/post/fibromyalgia-causes-symptoms-treatments
  6. 7 natural treatments for gout that you can start today. (2024, September 17). Rupa Health. https://www.rupahealth.com/post/natural-treatments-for-gout
  7. An Integrative Medicine approach to rheumatology. (2024, September 17). Rupa Health. https://www.rupahealth.com/post/6-common-types-of-arthritis
  8. Arthritis panel by Access med Labs. (n.d.). Rupa Health. https://www.rupahealth.com/lab-tests/access-medical-labs-arthritis-panel
  9. Inflammatory Markers 101: How to Interpret. (2024, September 17). Rupa Health. https://www.rupahealth.com/post/inflammatory-markers-101-what-do-they-mean
  10. High sensitivity C-Reactive Protein (HS-CRP) by Boston Heart Diagnostics. (n.d.). Rupa Health. https://www.rupahealth.com/lab-tests/bostonheart-high-sensitivity-c-reactive-protein-hs-crp
  11. 4 things that helped Laura get her rheumatoid arthritis under control. (2024, September 17). Rupa Health. https://www.rupahealth.com/post/rheumatoid-arthritis
  12. A Functional Medicine Systemic Lupus erythematosus (SLE) protocol: Testing, diagnosing, and treatment. (2024b, September 17). Rupa Health. https://www.rupahealth.com/post/a-functional-medicine-systemic-lupus-erythematosus-sle-protocol-testing-diagnosing-and-treatment
  13. GI-MAP by Diagnostic Solutions. (n.d.). Rupa Health. https://www.rupahealth.com/lab-tests/diagnostic-solutions-gi-map
  14. The Microbiome-Joint Axis: Exploring the gut’s influence on joint pain. (2024, September 17). Rupa Health. https://www.rupahealth.com/post/the-guts-role-in-joint-inflammation
  15. Organic Acids (OAT) | RUpa Health Patient Help Center. (n.d.). https://support.rupahealth.com/article/74-organic-acids-oat
  16. International Association for the Study of Pain. (2021, July 11). Nutrition and Chronic Pain - International Association for the Study of Pain (IASP). International Association for the Study of Pain (IASP). https://www.iasp-pain.org/resources/fact-sheets/nutrition-and-chronic-pain/
  17. Johns Hopkins Arthritis Center. (2020, April 14). Rheumatoid arthritis treatment options | Johns Hopkins Arthritis Center. https://www.hopkinsarthritis.org/arthritis-info/rheumatoid-arthritis/ra-treatment/
  18. How to manage and treat autoimmune disorders with functional testing and nutrition. (2024, September 17). Rupa Health. https://www.rupahealth.com/post/how-to-manage-and-treat-autoimmune-disorders-with-functional-nutrition
  19. Fundaro, G. (2022, December 14). Autoimmune Protocol (AIP) diet. Examine.com. https://examine.com/diets/aip-diet/
  20. 4 Science backed health benefits of the Mediterranean diet. (2024, September 17). Rupa Health. https://www.rupahealth.com/post/4-science-backed-health-benefits-of-the-mediterranean-diet
  21. Nguyen, H. D., Oh, H., & Kim, M. (2021). An increased intake of nutrients, fruits, and green vegetables was negatively related to the risk of arthritis and osteoarthritis development in the aging population. Nutrition Research, 99, 51–65. https://doi.org/10.1016/j.nutres.2021.11.005
  22. Testing B vitamin levels: what you need to know. (2024, September 17). Rupa Health. https://www.rupahealth.com/post/testing-b-vitamin-levels-what-you-need-to-know
  23. Omega 3s: the superfood nutrient you need to know about. (2024, September 17). Rupa Health. https://www.rupahealth.com/post/omega-3s-the-superfood-nutrient-you-need-to-know-about
  24. Iddir, M., Brito, A., Dingeo, G., Del Campo, S. S. F., Samouda, H., La Frano, M. R., & Bohn, T. (2020). Strengthening the Immune System and Reducing Inflammation and Oxidative Stress through Diet and Nutrition: Considerations during the COVID-19 Crisis. Nutrients, 12(6), 1562. https://doi.org/10.3390/nu12061562
  25. Mazzucca, C. B., Raineri, D., Cappellano, G., & Chiocchetti, A. (2021). How to Tackle the Relationship between Autoimmune Diseases and Diet: Well Begun Is Half-Done. Nutrients, 13(11), 3956. https://doi.org/10.3390/nu13113956
  26. Treatment of rheumatoid arthritis with oral type II collagen. Results of a multicenter, double-blind, placebo-controlled trial. (1998). PubMed. https://doi.org/10.1002/1529-0131(199802)41:2
  27. Are collagen supplements helpful for arthritis? | Arthritis Foundation. (n.d.). https://www.arthritis.org/health-wellness/treatment/complementary-therapies/supplements-and-vitamins/can-collagen-supplements-help-arthritis
  28. Khakham, C. (2024, September 16). Top Medical Evidence Supporting Curcumin's Health Benefits. Rupa Health. https://www.rupahealth.com/post/top-medical-evidence-supporting-curcumins-health-benefits
  29. Amalraj, A., Varma, K., Jacob, J., Divya, C., Kunnumakkara, A. B., Stohs, S. J., & Gopi, S. (2017). A novel highly bioavailable curcumin formulation improves symptoms and diagnostic indicators in rheumatoid arthritis patients: a randomized, Double-Blind, Placebo-Controlled, Two-Dose, Three-Arm, and Parallel-Group study. Journal of Medicinal Food, 20(10), 1022–1030. https://doi.org/10.1089/jmf.2017.3930
  30. Willich, S., Rossnagel, K., Roll, S., Wagner, A., Mune, O., Erlendson, J., Kharazmi, A., SΓΆrensen, H., & Winther, K. (2010). Rose hip herbal remedy in patients with rheumatoid arthritis – a randomised controlled trial. Phytomedicine, 17(2), 87–93. https://doi.org/10.1016/j.phymed.2009.09.003
  31. Cox, C. (2024, June 2). Fish oil for rheumatoid arthritis. WebMD. https://www.webmd.com/rheumatoid-arthritis/ra-fish-oil
  32. Using acupuncture for chronic pain management. (2024, September 17). Rupa Health. https://www.rupahealth.com/post/using-acupuncture-for-chronic-pain-management
  33. What is electroacupuncture? (2023, July 7). WebMD. https://www.webmd.com/pain-management/what-is-electroacupuncture
  34. Wang, C., De Pablo, P., Chen, X., Schmid, C., & McAlindon, T. (2008). Acupuncture for pain relief in patients with rheumatoid arthritis: A systematic review. Arthritis Care & Research, 59(9), 1249–1256. https://doi.org/10.1002/art.24009
  35. Wan, R., Fan, Y., Zhao, A., Xing, Y., Huang, X., Zhou, L., & Wang, Y. (2022). Comparison of Efficacy of Acupuncture-Related therapy in the Treatment of Rheumatoid Arthritis: A Network Meta-Analysis of Randomized Controlled Trials. Frontiers in Immunology, 13. https://doi.org/10.3389/fimmu.2022.829409
  36. Selfe, T. K., & Taylor, A. G. (2008). Acupuncture and osteoarthritis of the knee. Family & Community Health, 31(3), 247–254. https://doi.org/10.1097/01.fch.0000324482.78577.0f
  37. Mooventhan, A., & Nivethitha, L. (2014). Effects of acupuncture and massage on pain, quality of sleep and health related quality of life in patient with systemic lupus erythematosus. Journal of Ayurveda and Integrative Medicine, 5(3), 186. https://doi.org/10.4103/0975-9476.140484
  38. Lee, G., Cho, F. Y., Goo, B., & Park, Y. (2020). Acupuncture for gouty arthritis. Medicine, 99(49), e23527. https://doi.org/10.1097/md.0000000000023527
  39. Rheumatoid arthritis: Is exercise important? (2023, September 21). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/rheumatoid-arthritis/in-depth/rheumatoid-arthritis-exercise/art-20096222
  40. Metsios, G. S., & Kitas, G. D. (2020). Should patients with rheumatic diseases take pain medication in order to engage in exercise? Expert Review of Clinical Immunology, 16(3), 235–237. https://doi.org/10.1080/1744666x.2020.1714438
  41. Ye, H., Weng, H., Xu, Y., Wang, L., Wang, Q., & Xu, G. (2022). Effectiveness and safety of aerobic exercise for rheumatoid arthritis: a systematic review and meta-analysis of randomized controlled trials. BMC Sports Science Medicine and Rehabilitation, 14(1). https://doi.org/10.1186/s13102-022-00408-2
  42. Park, Y., & Chang, M. (2016). Effects of rehabilitation for pain relief in patients with rheumatoid arthritis: a systematic review. Journal of Physical Therapy Science, 28(1), 304–308. https://doi.org/10.1589/jpts.28.304
  43. https://sport-physiotherapie-halle41.ch/wp-content/uploads/2021/03/9-Physical-therapy-for-patients-with-knee-and-hip-osteoarthritis-2019.pdf
  44. Bruce, D. F., PhD. (2024, March 4). Heat and cold therapy for arthritis pain. WebMD. https://www.webmd.com/arthritis/heat-and-cold-therapy-for-arthritis-pain
  45. Heat therapy helps relax stiff joints | Arthritis Foundation. (n.d.). https://www.arthritis.org/health-wellness/healthy-living/managing-pain/pain-relief-solutions/heat-therapy-helps-relax-stiff-joints
Order from 30+ labs in 20 seconds (DUTCH, Mosaic, Genova & More!)
We make ordering quick and painless β€” and best of all, it's free for practitioners.

Latest Articles

View more on A Root Cause Medicine Approach
Subscribe to the magazine for expert-written articles straight to your inbox
Join the thousands of savvy readers who get root cause medicine articles written by doctors in their inbox every week!
Thanks for subscribing!
Oops! Something went wrong while submitting the form.
Are you a healthcare practitioner?
Thanks for subscribing!
Oops! Something went wrong while submitting the form.
Subscribe to the Magazine for free to keep reading!
Subscribe for free to keep reading, If you are already subscribed, enter your email address to log back in.
Thanks for subscribing!
Oops! Something went wrong while submitting the form.
Are you a healthcare practitioner?
Thanks for subscribing!
Oops! Something went wrong while submitting the form.
Trusted Source
Rupa Health
Medical Education Platform
Visit Source
Visit Source
American Cancer Society
Foundation for Cancer Research
Visit Source
Visit Source
National Library of Medicine
Government Authority
Visit Source
Visit Source
Journal of The American College of Radiology
Peer Reviewed Journal
Visit Source
Visit Source
National Cancer Institute
Government Authority
Visit Source
Visit Source
World Health Organization (WHO)
Government Authority
Visit Source
Visit Source
The Journal of Pediatrics
Peer Reviewed Journal
Visit Source
Visit Source
CDC
Government Authority
Visit Source
Visit Source
Office of Dietary Supplements
Government Authority
Visit Source
Visit Source
National Heart Lung and Blood Institute
Government Authority
Visit Source
Visit Source
National Institutes of Health
Government Authority
Visit Source
Visit Source
Clinical Infectious Diseases
Peer Reviewed Journal
Visit Source
Visit Source
Brain
Peer Reviewed Journal
Visit Source
Visit Source
The Journal of Rheumatology
Peer Reviewed Journal
Visit Source
Visit Source
Journal of the National Cancer Institute (JNCI)
Peer Reviewed Journal
Visit Source
Visit Source
Journal of Cardiovascular Magnetic Resonance
Peer Reviewed Journal
Visit Source
Visit Source
Hepatology
Peer Reviewed Journal
Visit Source
Visit Source
The American Journal of Clinical Nutrition
Peer Reviewed Journal
Visit Source
Visit Source
The Journal of Bone and Joint Surgery
Peer Reviewed Journal
Visit Source
Visit Source
Kidney International
Peer Reviewed Journal
Visit Source
Visit Source
The Journal of Allergy and Clinical Immunology
Peer Reviewed Journal
Visit Source
Visit Source
Annals of Surgery
Peer Reviewed Journal
Visit Source
Visit Source
Chest
Peer Reviewed Journal
Visit Source
Visit Source
The Journal of Neurology, Neurosurgery & Psychiatry
Peer Reviewed Journal
Visit Source
Visit Source
Blood
Peer Reviewed Journal
Visit Source
Visit Source
Gastroenterology
Peer Reviewed Journal
Visit Source
Visit Source
The American Journal of Respiratory and Critical Care Medicine
Peer Reviewed Journal
Visit Source
Visit Source
The American Journal of Psychiatry
Peer Reviewed Journal
Visit Source
Visit Source
Diabetes Care
Peer Reviewed Journal
Visit Source
Visit Source
The Journal of the American College of Cardiology (JACC)
Peer Reviewed Journal
Visit Source
Visit Source
The Journal of Clinical Oncology (JCO)
Peer Reviewed Journal
Visit Source
Visit Source
Journal of Clinical Investigation (JCI)
Peer Reviewed Journal
Visit Source
Visit Source
Circulation
Peer Reviewed Journal
Visit Source
Visit Source
JAMA Internal Medicine
Peer Reviewed Journal
Visit Source
Visit Source
PLOS Medicine
Peer Reviewed Journal
Visit Source
Visit Source
Annals of Internal Medicine
Peer Reviewed Journal
Visit Source
Visit Source
Nature Medicine
Peer Reviewed Journal
Visit Source
Visit Source
The BMJ (British Medical Journal)
Peer Reviewed Journal
Visit Source
Visit Source
The Lancet
Peer Reviewed Journal
Visit Source
Visit Source
Journal of the American Medical Association (JAMA)
Peer Reviewed Journal
Visit Source
Visit Source
Pubmed
Comprehensive biomedical database
Visit Source
Visit Source
Harvard
Educational/Medical Institution
Visit Source
Visit Source
Cleveland Clinic
Educational/Medical Institution
Visit Source
Visit Source
Mayo Clinic
Educational/Medical Institution
Visit Source
Visit Source
The New England Journal of Medicine (NEJM)
Peer Reviewed Journal
Visit Source
Visit Source
Johns Hopkins
Educational/Medical Institution
Visit Source
Visit Source

Hey practitioners! πŸ‘‹ Join Dr. Chris Magryta and Dr. Erik Lundquist for a comprehensive 6-week course on evaluating functional medicine labs from two perspectives: adult and pediatric. In this course, you’ll explore the convergence of lab results across different diseases and age groups, understanding how human lab values vary on a continuum influenced by age, genetics, and time. Register Here! Register Here.

Hey practitioners! πŸ‘‹ Join Dr. Terry Wahls for a 3-week bootcamp on integrating functional medicine into conventional practice, focusing on complex cases like Multiple Sclerosis. Learn to analyze labs through a functional lens, perform nutrition-focused physical exams, and develop personalized care strategies. Register Here.