Learn the pros and cons of adding chiropractor care to your rheumatoid arthritis treatment.

Many people with rheumatoid arthritis (RA) feel aches and pains and think about going to see a chiropractor as one way to relieve some of their pain. There are pros and cons to including a chiropractor in your rheumatoid arthritis treatment plan. Let's explore.

What Is a Chiropractor?

A chiropractor is a professional who is trained, through a four-year training program, to adjust or manipulate the spine. For many people, visiting a chiropractor regularly can be very helpful for such medical issues as back pain and related symptoms. Chiropractors can also help you plan exercise and diet changes that may help with pain and inflammation. In the United States, the majority of insurance carriers provide at least some coverage for chiropractic care.

Another type of health care professional, an osteopathic physician (DO), is similar to a chiropractor in that a DO is also trained in manual therapies such as spinal manipulation. An osteopathic physician receives additional training comparable to that for an MD degree.

The Pros of Chiropractic Care for Rheumatoid Arthritis

The American Chiropractic Association recommends that chiropractors focus on helping people with rheumatoid arthritis by:

• Helping them improve their range of motion.
• Improving flexibility and endurance.
• Increasing muscle tone and strength.
• Providing diet and nutritional advice and supplements to address inflammation (a key part of the pain and worsening of rheumatoid arthritis).

Debra DeMarco, DC, of Monroe Chiropractic Care in Monroe, N.J., who has been in practice for more than 25 years, says working with a chiropractor can indeed make people with RA more comfortable. The "first thing that I would say is that I would never profess to cure it, but I do treat the symptoms by trying to mobilize joints and slowing the progression of the disease," she says.

Most chiropractors use other treatments in addition to manipulation, including massage, heat and ice, ultrasound, electronic stimulation, rehabilitative exercises, and magnet therapy. Such therapies might be helpful in someone with RA who has other conditions that could benefit: massage therapy for tight muscles, for example, or ultrasound for a condition of the feet called plantar fasciitis, which causes pain on the bottom of your foot because of tight and inflamed tissues.

The Cons of Chiropractic Care for Rheumatoid Arthritis

"I think that chiropractors provide a very useful service for many different problems," says John M. Stuart, MD, professor of medicine and rheumatology at the University of Tennessee Health Science Center. "However, their role in RA is somewhat limited."

Dr. Stuart explains that the pain and disability in rheumatoid arthritis are due to inflammation in the joints, instead of vertebrae that are out of alignment. Medication remains the best way to treat inflammation, says Stuart. Chiropractors cannot prescribe the medications that are needed to treat rheumatoid arthritis.

Robert W. Hoffman, DO, professor and chief of the Division of Rheumatology and Immunology in the Department of Medicine at the University of Miami Miller School of Medicine, expresses concern about seeing a chiropractor if your rheumatoid arthritis is affecting your cervical spine (neck).

"Manipulation in RA can be dangerous because of RA involving the cervical spine," he says. This concern relates to the fact that one of the side effects of some medications for RA is deterioration of bones, including vertebrae — the bones that protect your spinal cord. It is possible that aggressive manipulation of vertebrae that are losing bone density could result in fractures and breaks. While any vertebrae damage is concerning, involvement of the cervical spine is particularly so because damage to the bones protecting your spinal cord in the neck area increases the risk that the upper spinal cord could be hurt, which could lead to paralysis from the neck down.

Finding a Chiropractor for Rheumatoid Arthritis

If you decide that a visit to the chiropractor is right for you, Demarco advises finding a reputable chiropractor with experience treating someone with rheumatoid arthritis. Conduct Internet research (the American Chiropractic Associations has a searchable database) and talk to people who have used chiropractors.

As with all health care choices you make, check with your health insurance provider to find out what kind of chiropractic care benefits are covered by your specific policy before you make an appointment. And talk to your primary care doctor or rheumatologist. "Communication is the most important thing," says Stuart, who emphasizes that patients should always tell their rheumatologist if they are trying any alternative or complementary therapies.