Alternative Therapies for Arthritis

Therapy	Best Evidence *	Probably Useful †	Least Evidence ‡
Herbals	Boswellia (150–400 mg t.i.d.); capsaicin (topically); ginger concentrate (500 mg t.i.d.).	White willow (60–120 mg/day salicin; 1–2 ml t.i.d. tincture).	Aromatherapy; devil's claw; horsetail; sea cucumber; yucca.
Diet and Nutrition/Lifestyle	Weight loss; exercise; vitamin C (500–1000 mg t.i.d.); vitamin E (400–800 IU/day).	Vitamin B 3 (niacinamide): (1–3 g/day), check liver enzymes; boron 6 mg/day; omega-3 fatty acids (fish oil) 3 g/day.	Eliminate solanine from diet (found in nightshade plants: tomatoes, white potatoes, peppers [except black pepper], eggplant, tobacco); copper bracelet or supplement; d-phenylalanine; pantothenic acid; zinc.
Mind-Body Interventions	Cognitive-behavioral therapy.	Biofeedback; qi gong; relaxation; social support; tai chi; yoga.	Guided imagery; meditation; music.
Pharmacological and Biological Treatments	Glucosamine sulfate (500 mg t.i.d. or as single dose); S-adenosyl- l -methionine (SAMe) (400 mg t.i.d.).	Chondroitin sulfate (400 mg t.i.d.).	DMSO; chelation therapy; shark and bovine cartilage.
Bioelectromagnetic Therapies		Static magnet therapy; pulsed electromagnetic fields; TENS.
Alternative Systems of Care	Acupuncture; acupressure; ayurveda; traditional Chinese medicine.		Homeopathy: Gout: nux vomica 6C; belladonna 6C; calcarea 6C; colchicum 6C. Osteoarthritis: Rhus toxicodendron 6C t.i.d. for 2 weeks; ledum 6C q.i.d. for 2 weeks; belladonna 6C q.i.d for 2 weeks; Apis millifica 6C t.i.d. for 2 weeks. Rheumatoid arthritis: Rhus toxicodendron 6C for 2 weeks; bryonia 6C q.i.d. for 2 weeks; ruta graveolens 6C q.i.d. for 2 weeks; pulsatilla 30C t.i.d. for 2 weeks; arnica ointments and gels.
Hands-On Healing Techniques	Physical therapy.	Massage; chiropractic; osteopathy.	Craniosacral therapy; rolfing.

^*Therapies with the highest degree of scientific support for efficacy and safety.
^†Therapies that are often helpful but that do not have the highest degree of supporting evidence for efficacy and safety.
^‡Therapies that may be useful but that have limited scientific evidence for efficacy and safety.
NOTE: C denotes the number of times that a substance is diluted at a ratio of 1:100.
SOURCE: Sierpina, VS: Integrative Health Care: Complementary and Alternative Therapies for the Whole Person, FA Davis, Philadelphia, 2000.