This is Grace’s (Grace Pintabona, RN) monthly column.  Part I of this article ran in June. 

Last month I emphasized that what you eat is critical to regain health when dealing with rheumatoid arthritis. This month I want to focus on alternative/natural therapies.

Rheumatoid arthritis is a chronic inflammatory disorder that typically affects the small joints in your hands and feet. Unlike the wear-and-tear damage of osteoarthritis, rheumatoid arthritis affects the lining of your joints causing a painful swelling that can eventually result in bone erosion and joint deformity. Early rheumatoid arthritis tends to affect your smaller joints first - the joints in your hands, wrists ankles and feet. As the disease progresses, your shoulders, elbows, knees, jaw and neck also can become involved. It is two to three times more common in women than in men and generally occurs between the ages of 20 and 60. If a family member has rheumatoid arthritis, you may have an increased risk of the disease.

What natural physical things can you do to help yourself?  Acupuncture to relieve pain; Tai chi because it is combines gentle exercise with stretching and deep breathing; Walking – make sure you walk some every day – it doesn’t have to be a great distance; Massage to relieve stress and reduce pain; Transcutaneous electrical nerve stimulation (TENS). TENS is a therapy that uses electrical current delivered through electrodes to the skin for pain relief; Occupational therapy to help you find ways to approach everyday tasks; and Physical hot and cold therapy and exercise to improve joint function.

Yes, there are herbs and dietary supplements that can help: Evening primrose, borage and black currant oils may help with the pain and morning stiffness; essential fatty acids from fish oil may help with pain and inflammation; Lactobacilli (friendly gut bacteria) are critical; vitamins C and E, and quercetin are antioxidants that can help (they’re needed in relatively high doses); ginger, curcumin (from turmeric), Kaprex by Metagenics, Zyflamend by New Chapter, nettle leaf, and white willow bark all help with pain and inflammation.  Yes, there are other formulas that are helpful too.

It’s important to work with someone who understands the disease process and how the supplements work.  But once again, all of the above can only work well if you have the right diet in place.  Remember that refined sugar and a high fat diet will cause continual inflammatory flare-ups.  If you don’t eat right, you’re making things worse and making it hard for any herb or supplement to help.

In addition, know your limits and rest when you are tired.  Take charge of the management of your disease.  Connect with family and friends.  When you’re feeling overwhelmed, talk with them.  And, finally, take time for yourself because that helps to relieve stress and stress makes things worse.　

Suffice it to say that the medications used to treat rheumatoid arthritis are powerful drugs with side-effects.  One usually starts with a low dose and increases that dosage over time as the flare-ups keep happening.  I urge you to try everything else before you start on these drugs.  Again THE DIET is the single most important thing you can do to improve your disease.  Read last month’s column again!

This is taken directly from(shortened slightly) the Environmental Working Group’s annual report.

1. Celery:  Celery has no protective skin, which makes it almost impossible to wash off the chemicals (as many as 64 different ones were found!) that are used on crops. Buy organic celery, or choose alternatives like broccoli, radishes, and onions.

2. Peaches: Multiple pesticides (as many as 62 of them) are regularly applied to these delicately skinned fruits in conventional orchards. Can't find organic? Safer alternatives include watermelon, tangerines, oranges, and grapefruit.

3. Strawberries: 59 pesticides have been detected in residue on strawberries. Safer alternatives: kiwi and pineapples.

4. Apples: Like peaches, apples are typically grown with poisons to kill a variety of pests, from fungi to insects. Tests have found 42 different pesticides as residue on apples. Scrubbing and peeling doesn't eliminate chemical residue completely, and peeling a fruit or vegetable also strips away many of it’s beneficial nutrients.

5. Blueberries: New on the Dirty Dozen list in 2010, blueberries are treated with as many as 52 pesticides, making them one of the dirtiest berries on the market.

6. Nectarines:  With 33 different types of pesticides found on nectarines, they rank up there with apples and peaches among the dirtiest tree fruits. Can't find organic? Safer alternatives include watermelon, papaya, and mango.

7. Bell peppers:  Peppers have thin skins that don't offer much of a barrier to pesticides. They're often heavily sprayed with insecticides. (Tests have found 49 different pesticides on sweet bell peppers.) Can't find organic? Safer alternatives include green peas, broccoli, and cabbage.

8. Spinach:  New on the list for 2010, spinach can be laced with as many as 48 different pesticides, making it one of the most contaminated green leafy vegetable.

9. Kale:  Kale is known as a hardier vegetable that rarely suffers from pests and disease, but it was found to have high amounts of pesticide residue this year. Can't find organic? Safer alternatives are cabbage, asparagus, and broccoli.

10. Cherries:  Even locally grown are not necessarily safe. In one survey in recent years, cherries grown in the U.S. were found to have three times more pesticide residue then imported cherries. Government testing has found 42 different pesticides on cherries. Can't find organic? Safer alternatives include raspberries and cranberries.

11. Potatoes:  America's favorite vegetable can be laced with as many as 37 different pesticides. Can't find organic? Safer alternatives include eggplant, cabbage, and earthy mushrooms.

12. Grapes:  Imported grapes run a much greater risk of contamination than those grown domestically. Only imported grapes make the 2010 Dirty Dozen list. Vineyards can be sprayed with different pesticides during different growth periods of the grape, and no amount of washing or peeling will eliminate contamination because of the grape's thin skin. Remember, wine is made from grapes, which testing shows can harbor as many as 34 different pesticides. Can't find organic? Safer alternatives include kiwi and raspberries.