If you are among the millions of individuals living with rheumatology-related pain, you understand the challenges of managing these conditions. According to the CDC, a significant portion of adults in the United States, approximately 58.5 million individuals, are affected by various rheumatic conditions. Chronic pain stands out as a prevalent and distressing symptom experienced by many.

Given the widespread impact of rheumatological disorders, it is not surprising that individuals are increasingly seeking integrative approaches to pain management. In this article, we delve into rheumatology and explore the potential role of acupuncture as part of an integrative medicine approach. We will explore the integration of acupuncture as adjunctive care for managing rheumatological-related symptoms and its potential benefits in relieving the pain associated with these conditions.

[signup]

What is Acupuncture?

Acupuncture, a traditional Chinese technique with a rich history, is a therapeutic practice that involves delicately inserting slender needles into specific points on the body, called meridians. The foundation of this ancient art lies in the concept of Qi, the vital life force that flows throughout our bodies. By promoting the harmonious flow of Qi, acupuncture aims to enhance overall well-being. Recently, acupuncture has gained recognition as a complementary therapy for addressing various health concerns, particularly chronic pain. The precise stimulation of the needles in the meridians triggers the release of endorphins and natural pain-relieving substances, leading to pain reduction.

Furthermore, acupuncture facilitates improved circulation and blood flow throughout the body, promoting healing. Acupuncture's impact goes beyond pain management. It may positively influence the immune system, modulating immune responses and reducing inflammation—a common characteristic of rheumatic conditions. By addressing these underlying factors, acupuncture contributes a comprehensive approach to managing complex conditions. It is crucial to seek guidance from a certified acupuncturist to ensure a safe and effective treatment experience.

What is Integrative Rheumatology?

Rheumatology encompasses the medical field dedicated to diagnosing and managing musculoskeletal and systemic autoimmune conditions, collectively called rheumatic diseases. These conditions primarily affect the joints, bones, and muscles, resulting in pain, stiffness, and deformities. Additionally, they can impact other parts of the body, including the eyes, skin, nervous system, and internal organs. Common examples of rheumatic diseases include osteoarthritis, rheumatoid arthritis (RA), gout, lupus, and fibromyalgia.

There is a specialized sub-discipline within rheumatology known as integrative rheumatology. This approach combines conventional rheumatology practices with complementary therapies. It recognizes that addressing the patient's overall health involves considering the physical symptoms and the psychological, social, and environmental factors that play a significant role. Rather than just focusing on a particular symptom or disease, integrative rheumatology adopts a comprehensive perspective that views the patient as a whole. Its objective is to promote the patient's well-being by integrating various modalities and approaches that contribute to their overall health and quality of life.

How Does Acupuncture Help With Rheumatic Diseases?

The potential benefits of acupuncture in rheumatology have been explored as a complementary therapy for pain relief. This ancient practice involves precisely inserting fine needles into specific points on the body. Variants of acupuncture include electro-acupuncture, which incorporates electricity to enhance its effects, and fire needle techniques, where hot needles are swiftly inserted into acupoints. When combined with disease-modifying anti-rheumatic drugs (DMARDs), different acupuncture therapies have demonstrated varying levels of effectiveness in managing symptoms.

Studies indicate that acupuncture may reduce pain and decrease inflammatory markers in patients with RA. For example, research has shown that most participants experienced joint pain reduction after undergoing acupuncture, although the extent of pain relief varied among individuals. A comprehensive comparison of various acupuncture treatments combined with DMARDs revealed that electro-acupuncture was effective in improving the DAS28 score, a measure of RA disease activity. The fire needle technique showed promise in improving pain scores and reducing inflammation markers. Another approach, moxibustion (applying heat by burning dried mugwort on specific body points) combined with DMARDs, demonstrated promising results in lowering rheumatoid factor, a blood marker often elevated in RA patients. Additionally, acupuncture has shown the potential to improve symptoms for individuals with osteoarthritis, lupus, and gout.

While acupuncture holds promise as a complementary therapy for pain management in rheumatology, further research is needed to understand its mechanisms and effectiveness across different rheumatic conditions fully. Integrating acupuncture alongside conventional treatments may provide a holistic approach to improve symptom management and enhance the well-being of individuals with rheumatic diseases.

What Kind of Evidence or Studies Are There on Acupuncture and Rheumatology?

While the concepts of "qi" and meridians in traditional Chinese medicine are not recognized by Western medicine, scientific evidence provides alternative explanations for how acupuncture may offer symptomatic relief in rheumatology, with many studies completed on RA.

According to Brian Berman, MD, a family and community medicine professor and Center for Integrative Medicine director at the School of Medicine at the University of Maryland, acupuncture triggers various physiological mechanisms when a needle is inserted into the body. This trigger sends a signal to the brain, prompting the release of neurotransmitters like endorphins and enkephalins, which are believed to reduce pain sensations. Research also suggests that acupuncture stimulates the production of cortisol, a hormone that helps regulate inflammation. Additionally, acupuncture may activate other pain-relieving chemicals in the body.

To investigate the effects of acupuncture on arthritis, a study led by Dr. Berman found that after 26 weeks, patients receiving real acupuncture experienced significantly less pain and improved functioning compared to those who received sham acupuncture. However, not all studies have yielded such positive results, and establishing the benefits of acupuncture in arthritis has been challenging due to limited high-quality research in this area.

Recent research suggests that acupuncture may benefit some individuals with RA. An analysis of 43 studies conducted between 1974 and 2018 deduced that acupuncture, alone or combined with other treatments, could improve the clinical conditions of RA, enhancing function and quality of life. The review identified possible mechanisms such as the anti-inflammatory effect, antioxidative effect, and regulation of immune system function. However, inconsistencies among trial findings highlight the need for further research to evaluate acupuncture's effects and mechanisms in RA.

Functional Medicine Labs That Can Help Acupuncturists Individualize Treatment With Rheumatology Patients

Certain labs can be utilized to help individualize treatment for those with rheumatic conditions. Below are some that are particularly helpful:

Arthritis Panel

Functional medicine labs, like this Arthritis Panel, can aid acupuncturists in personalizing treatments for rheumatology patients. Tracking inflammatory markers (RF and CRP), this test reveals disease profiles, enabling targeted approaches: reducing inflammation for high CRP levels and modulating immune response for elevated RF levels.

hs-CRP

The hs-CRP test detects minor CRP level increases in rheumatic diseases. Elevated levels signal flare-ups, prompting treatment adjustments. Normal or decreasing levels indicate effective management. Regular monitoring provides insights into disease progression and treatment effectiveness, guiding therapy modifications.

Gut Microflora Analysis

This comprehensive stool test aids acupuncturists in customizing nutritional protocols for rheumatology patients. It assesses the gut microbiome's health and diversity, significantly affecting overall health and inflammation in rheumatological conditions. By identifying microbiome imbalances, this test allows personalized interventions.

Organic Acids Test (OAT)

The OAT evaluates metabolic health, including energy production, detoxification, and gut microbiome markers. In integrative rheumatology, metabolic imbalances impact pain and inflammation. Nutritional deficiencies hinder anti-inflammatory mechanisms and energy production, intensifying pain. Imbalances in gut microbiota trigger systemic inflammation, worsening rheumatologic pain. Analyzing the OAT results guides personalized protocols to address imbalances.

Micronutrient Panel

Rheumatology symptoms are often related to inflammation. This micronutrient panel and Omega profile can analyze nutrients like Omega-3 fatty acids, Vitamins C, D, and E, and minerals that have been shown to have anti-inflammatory effects providing practitioners with insights to further personalize their nutritional interventions for their patients.

Best Nutrition For Rheumatology Patients?

Integrative nutrition offers effective strategies for managing rheumatology symptoms. Clinical approaches include the Autoimmune Protocol (AIP) diet, the Mediterranean diet, increasing specific nutrients like vitamins B1, B2, and omega-3 fatty acids, and avoiding processed foods.

One recommended dietary approach for rheumatology patients is the Autoimmune Protocol (AIP) diet. This protocol focuses on consuming nutrient-dense, minimally processed foods while eliminating potential inflammatory triggers such as grains, legumes, and processed oils. By prioritizing whole, unprocessed foods, the AIP diet supports the body's anti-inflammatory pathways, helping to reduce inflammation and alleviate autoimmune symptoms.

Another beneficial dietary pattern for rheumatology patients is the Mediterranean diet. The Mediterranean diet's emphasis on fruits and green vegetables, which provide antioxidants, vitamins, and minerals, has been associated with lower arthritis risk. By incorporating these nutritious food choices, patients can reduce inflammation, improve gut health, and provide essential nutrients to support their rheumatology symptoms.

Increasing specific nutrients is also vital for rheumatology patients. Studies have identified that a higher intake of vitamins B1 and B2 can significantly lower the risk of arthritis development. These vitamins are found in lean meats, whole grains, nuts, and legumes. Omega-3 fatty acids, an essential nutrient, have also been shown to manage inflammation and pain associated with rheumatic conditions. Including fatty fish like wild-caught salmon, flaxseeds, chia seeds, and walnuts in the diet can provide these beneficial fats.

On the other hand, avoiding processed foods is crucial for managing rheumatology symptoms. Processed foods, refined grains, factory-farmed meats, and trans fats are pro-inflammatory and can worsen symptoms. Opting for whole, unprocessed foods and choosing organic options when possible can help reduce inflammatory processes often linked to rheumatology conditions.

Individuals with rheumatology conditions need to consult a functional healthcare provider specializing in rheumatology. These professionals can offer personalized recommendations tailored to individual needs, goals, and health conditions. By working with a healthcare provider, patients can receive guidance on integrating nutrition choices into their treatment plans.

Common Supplements and Herbs Used in Integrative Rheumatology

Certain supplements have been shown to be useful for those with rheumatic conditions. Below are some examples:

Boswellia Serrata

Boswellia serrata, or Frankincense, is a traditional herb with anti-inflammatory properties for arthritis treatment. A meta-analysis of seven studies showed significant pain reduction and improved joint function in over 500 osteoarthritis patients. Recommended dose: 100-1,000 mg for at least four weeks. Consider Boswellia for relief and better joint health.

Omega-3

Omega-3 fatty acids in fish oil relieve pain and inflammation in arthritis and fibromyalgia. Taking at least 2.7 grams of omega-3 supplements daily for three months reduces morning stiffness and tender joints. These effects may reduce reliance on NSAIDs.

Vitamin C

Vitamin C, a potent antioxidant, can aid in managing rheumatoid conditions such as gout by reducing inflammation. Studies show that supplementing 200-2,000 mg of vitamin C daily, with 500 mg being common, lowers serum uric acid levels in gout patients. Optimal results are seen with short-term supplementation of less than one month.

Vitamin D

Research indicates an association between low vitamin D levels and chronic pain, including rheumatic conditions like fibromyalgia. Supplementation with vitamin D can alleviate pain and enhance mood. Testing vitamin D levels is recommended for fibromyalgia patients. A daily dose of 2,400 IU (as D3) is suggested for low levels, while moderate levels may benefit from 1,200 IU.

Curcumin

Curcumin, derived from turmeric, offers potent anti-inflammatory and antioxidant benefits for rheumatic conditions like arthritis. A recent study found that taking 250-500 mg of curcumin twice daily for 90 days significantly improved symptoms and reduced inflammation markers.

[signup]

Summary

Integrative rheumatology takes a holistic approach to improving the health of individuals with rheumatic conditions. With millions affected by these disorders, effective pain management strategies incorporating methods such as acupuncture can be helpful. By combining functional medicine and personalized approaches, integrative rheumatology offers valuable insights and practical tips to enhance overall well-being. Stool testing, inflammation testing, and other lab evaluations help individualize treatment and manage disease progression. Alongside conventional treatments, incorporating acupuncture can effectively manage symptoms and improve patients' overall health with rheumatic diagnoses. This integrative approach provides a pathway for individuals suffering from rheumatic diseases seeking to alleviate their symptom burden and lead healthier lives.