• Acupuncture - Originating in China, this age-old practice involves inserting long, extremely slender needles into specific points along the body to relieve pain and discomfort.

• Biofeedback - This involves a learning process whereby certain visual or auditory (sound-based) feedback allows you to train yourself to initiate responses that help control or normalize your psychological response to pain.

• Chiropractic - According to the International Chiropractic Association, the primary focus of chiropractic is the detection, reduction and correction of spinal misalignments and nervous system dysfunction. Doctors of chiropractic attempt to get to the root cause of a health problem, rather than just treat the symptoms. Chiropractic seeks to maximize the natural strengths of the body and its capacity to heal itself without the use of drugs or surgery.

• Hypnosis - This involves entering an altered state of consciousness whereby suggestions inserted while in that state can lead to changes in behavior or, in the case of pain, altered physical sensations. Self-hypnosis involves inducing an altered state of consciousness — and thus controlling pain sensation — by yourself.

• Visual Imagery - The practice of using one's imagination to create mental pictures can help relieve pain – why it works isn't understood. Typically, this involves closing your eyes and imaging something like a healing energy washing over your body, or the "wires" to the pain being severed.

Complementary therapies used to supplement medications, alone or in combination with other forms of therapy. Complementary techniques to manage pain include diet, exercise, biofeedback, massage, chiropractic care, acupuncture, and self-regulation techniques such as self-hypnosis, relaxation training, yoga, reiki (a natural healing process using the hands to tap a universal life energy) and Jin Shin Jyutsu (a process to balance the body's energies to bring optimal health and well-being).

The quality of research supporting these approaches varies from therapy to therapy.  In some cases, the research is of better quality than that supporting the use of some medications and many surgical procedures.  In other cases, the research is not as strong.  As with any treatment approach, use of complementary therapies should be discussed with your doctor.

Homeopathic Medicine - Homeopathy is an alternative, non-toxic approach used to treat illness and relieve discomfort in a wide range of health conditions. Founded in Germany in the late-1860s, the practice of homeopathy is based on using the "law of similars" to stimulate a healing response — a principle that goes back to the days of Hippocrates. The law of similars states that a substance that will cause disease symptoms in a normal person can, when given in homeopathic dilutions to an ill individual, prompt the same set of symptoms to initiate a healing response. Homeopathic preparations, called remedies, must be prepared in a certain way, and the dilution used will depend on the symptoms being treated. Make sure you consult with your physician before taking traditional and homeopathic remedies at the same time. Mixing medications can result in harmful medical interactions.

Following are complementary pain-management approaches for the most common types of arthritis:

Osteoarthritis

Diet. Following are some dietary changes people with osteoarthritis have found helpful. However, be patient! Changing your diet may not provide immediate relief.

• Fish Oils. These have long been part of arthritis treatment.  More than 100 years ago, British doctors gave their patients cod liver oil to alleviate rheumatism. Today, researchers have validated that fish oils are important for relieving arthritis pain. Seafoods rich in Omega-3 fatty acids, the type of oil shown to be beneficial, include salmon, tuna, sardine, herring, anchovies and mackerel.  Omega-3-enriched eggs, pasta and other products also are coming on the market.

• Vegetarian Diets. In addition to helping to reduce the risk of heart disease and other maladies, vegetarian diets also appear to play a positive role in arthritis, according to several studies. One study found that 90 percent of the patients studied found their grip strength improved, and they had less pain and swelling, morning stiffness and tenderness after one month on vegetarian diets.

Exercise.  Until recently, arthritis sufferers were advised to rest their painful, inflamed joints.  But gradually, doctors have learned that exercise can be beneficial. Exercise strengthens muscles, ligaments and tendons, which compensates for weakened joints; flushes fluids cartilage, drawing nutrients in and toxins out; stimulates healthy cell regeneration, and limbers and tones the entire body. Many forms of exercise are beneficial, including stretching, bicycling, low-impact aerobics, dancing, golf, walking, water calisthenics, yoga, tai chi and even climbing stairs. 

Comments: Go slowly but consistently. Three to four times a week, for a total of three to four hours, is the ultimate goal.  Start easy.  Build up gradually. Listen to your body and don't force it to do something that is painful, such as sitting cross-legged for yoga.  If you are suffering from severe arthritis, heart disease or other health problems, work with your healthcare professional to develop a safe exercise program. Most experts agree that if exercise causes pain that lasts more than one hour, you have exercised too much.

Topical (Rub-on) Analgesics.  Salves, creams and ointments can provide relief for muscle aches or mild pain in a few joints, according to the Arthritis Foundation.  They also can be an adjunct to oral arthritis medications.  The active ingredients in such preparations include: counterirritants, such as menthol, eucalyptus oil or wintergreen oil, which essentially distract the brain from feeling arthritis pain; salicylates, which like salicylates (aspirin) found in oral painkillers, inhibit prostaglandins, the substances that contribute to inflammation and pain; and capsaicin, extracted from cayenne peppers, which acts on the substance that sends pain messages to the brain.

Rheumatoid Arthritis

Diet.  Avoiding certain foods — such as dairy products, wheat, corn and tomatoes and their relatives — may help prevent rheumatoid arthritis attacks. As a result, many doctors suggest that their arthritis patients eliminate milk, cheese and other dairy products from their diets. Tofu cheeses and soymilk can be substituted. Wheat and corn, used as main ingredients, additives and fillers in food and over-the-counter and prescription drugs, can be hard to avoid, but eliminating them from the diet also helps some rheumatoid arthritis sufferers. It's important to check all food labels and medical packages for wheat and corn ingredients. Some rheumatoid arthritis patients also feel better and have fewer flare-ups when they eliminate from their diets members of the "nightshade" family, which includes tomatoes, eggplants and bell peppers.

Foods also may help arthritis sufferers. Fish oils have long been part of arthritis treatment.  More than 100 years ago, British doctors gave their patients cod liver oil to alleviate rheumatism. Today, researchers have validated that certain fish oils help relieve rheumatoid arthritis pain.  Seafood rich in Omega-3 fatty acids, the type of oil shown to be beneficial, include salmon, tuna, sardine, herring, anchovies and mackerel. Omega-3-enriched eggs, pasta and other products also are coming on the market.

Vegetarian diets, in addition to reducing the risk of heart disease and other maladies, also appear to play a positive role in relieving arthritis pain, according to several studies.  One report found that 90 percent of the patients studied had better grip strength and less pain and swelling, morning stiffness and tenderness after one month on vegetarian diets.

Comments:  Be patient!  Changing one's diet may not provide immediate relief.

Exercise. Gentle exercise can help rheumatoid arthritis patients stay healthy and flexible.  The Arthritis Foundation recommends putting joints through their full range of motion once a day, with periods of rest during acute systemic or local joint arthritis flare-ups.  Consult your doctor about what type and how much exercise is best for your particular condition.

Ankylosing Spondylitis

Early diagnosis and treatment of this condition is critical to controlling pain and stiffness, and perhaps plays a part in preventing the bones in the neck and back from fusing. In women, ankylosing spondylitis (AS), or spinal arthritis, often is mild and difficult to diagnose.  Treatment is tailored to the individual.

Diet.  AS patients may be helped by eating less starchy foods (bread, pasta and potatoes) and more protein.

Comments:  Be patient! Changing one's diet may not provide immediate relief.

Exercise.  Deep breathing exercises and aerobic conditioning help keep the rib cage and chest flexible.  Swimming is often recommended for AS patients, as is sleeping on a firm mattress. 

Gout

Diet. To help prevent recurrences, gout patients should drink plenty of fluids, avoid alcohol, and eat less protein and purines (found in yeast extracts, fish roe and herrings).  Some overweight individuals find that if they lose weight, their uric acid levels decrease.

Comments:  Be patient! Changing one's diet may not provide immediate relief.

Systemic Lupus Erythematosus (SLE)

Diet. SLE patients may benefit from fish oil and from diets that are low calories and low fat.  Avoiding animal proteins can help protect the kidneys. Researchers also are investigating compounds called indoles, also known as mustard oil, which are found in broccoli, cabbage, Brussels sprouts, cauliflower, kale, kohlrabi, collard and mustard greens, rutabaga, turnips and bok choy. Indoles stimulate enzymes that convert estrogen – which has been linked to SLE flare-ups — to a more benign type.

Comments:  Be patient! Changing one's diet may not provide immediate relief.