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Integrative Rheumatology

Integrative Rheumatology takes a more whole-life approach and examines all the underlying factors that lead to chronic pain and inflammation.

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About Integrative Rheumatology:

Rheumatic and immune system-related issues are excellent candidates for an integrative approach for many reasons. Stress and lifestyle play a major role in these conditions. Thus, when they are left out of more conventional treatment, healing is less able to be achieved in totality as the root causes or contributing factors go unchecked. It means also that the conditions are particularly responsive to dietary and lifestyle shifts, taking the body from a state of inflammation and toxicity to a place of balance where true healing can occur.

What is Integrative rheumatology?

We cannot get the full scope of integrative rheumatology without defining the words separately. Integrative refers to the approach used in managing the condition. In other words, it considers your overall wellness (physical, psychological, social, and spiritual) and combines several therapies to ensure, maintain, and improve health. Treatment plans are drawn to suit your personal needs. In integrative medicine, the treatment approach combines conventional western medicine which includes medications, surgical interventions, and lifestyle changes, and complementary and alternative medicine (CAM). Therapies under complementary and alternative medicine (CAM) include natural remedies, mind-body practices, and bodywork. 

Natural remedies are treatment options that use natural substances to improve nutrient levels. They include diet therapy (paleo diet, keto diet, vegan diet, Mediterranean diet, etc.), herbal supplements from roots, seeds, plant oils, berries, nuts, flowers, etc., probiotics, and vitamins. Mind-body practices are techniques that facilitate the connection between your mental, emotional and physical health. Therapies under this domain include meditation, yoga, hypnotherapy, biofeedback, relaxation, mindfulness, guided imagery, reiki (energy healing), Qi gong, and tai chi. Bodywork involves therapies that use the body to improve health and well0being. Examples include acupuncture, therapeutic massage, chiropractic adjustments and manipulation, craniosacral therapy, integrative body psychotherapy, somatic experiencing, exercise, and reflexology.

On the other hand, rheumatology is a branch of medicine concerned with the diagnosis and treatment of rheumatic diseases. Rheumatic diseases affect your bones, joints, ligaments, tendons, and muscles. They may also be called musculoskeletal diseases.

Hence, integrative rheumatology is a branch of medicine that deals with the diagnosis and treatment of rheumatic diseases using both conventional (western) medicine and complementary and alternative medicine (CAM) with the aim of ensuring the overall wellness of the patient.

What conditions can integrative rheumatology help to treat?

Integrative rheumatology treatment is available for a variety of conditions, including autoimmune, inflammatory, and rheumatic conditions such as:

  • Systemic lupus erythematosus (SLE)
  • Inflammatory arthritis, for example, rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, gout and pseudogout, Lyme disease, lupus.
  • Osteoarthritis
  • Osteoporosis/Osteopenia
  • Chronic fatigue syndrome
  • Crohn’s disease
  • Psoriasis
  • Autoimmune thyroiditis
  • Thyroid disorders
  • Fibromyalgia
  • Bursitis
  • Plantar Fasciitis
  • Carpal Tunnel Syndrome
  • Systemic Sclerosis (scleroderma)
  • Tendonitis
  • Polymyositis
  • Polymyalgia Rheumatism (PMR)
  • Dermatomyositis
  • Vasculitis
  • Wegener’s Granulomatosis (Granulomatosis with Polyangiitis)
  • Reactive Arthritis
  • Sjogren’s Syndrome
  • Giant Cell Arteritis (Temporal Arteritis)
  • Mixed Connective Tissue Disease
  • Antiphospholipid Syndrome
  • Behcet’s Disease
  • Undifferentiated Connective Tissue Disease
  • Takayasu’s Arteritis
  • Raynaud’s Phenomenon
  • Uveitis

 

What are the benefits of integrative rheumatology?

Integrative rheumatology has been proven to have the following benefits. They include:

  • Is a comprehensive approach to care
  • Aims at overall wellness including your physical, mental, emotional, social, and spiritual health
  • Is healing-oriented and not disease-focused
  • Improves disease-related symptoms such as pain, inflammation, and fatigue
  • Improves quality of life of patients with rheumatic diseases
  • Improves sleep quality
  • Boosts appetite
  • Improves cognitive functioning
  • Reduces disease-related anxiety and depression 
  • Manages stress efficiently
  • Employs various modalities of care beyond medications and surgery
  • Facilitates patient involvement in his/her care
  • Encourages patient-physician relationship and satisfaction

 

How effective is integrative rheumatology in treating rheumatic conditions?

Integrative rheumatology involves the use of conventional treatment approaches and complementary medicine to treat rheumatic conditions. Studies have proven that several integrative approaches have been successful in treating rheumatic diseases.

According to a study, Chinese medicine (CM), a form of complementary medicine was integrated into the treatment of primary Sjogren’s Syndrome (pSS). It was proven to relieve clinical symptoms, improve treatment outcomes, reduce anxiety and depression, and improve the quality of life of patients with pSS.

A similar study that assessed the integrative approach of traditional Chinese medicine and western medicine in the treatment of rheumatoid arthritis found out that it was an effective and safe approach. Results showed reductions in the tender joint count, swollen joint count, duration of morning stiffness, disease activity score in 28 joints, rheumatoid factor, anti-cyclic peptide containing citrulline, erythrocyte sedimentation rate, C-reactive protein, and adverse events. The adverse effects included gastrointestinal disorders, abnormal liver function, leukopenia, skin allergies and rashes, headaches and dizziness, and alopecia. There was a significant improvement in grip strength (GS) and better therapeutic effects. 

On knee osteoarthritis (KOA), a study found out that elderly patients living with the condition could experience pain relief by combining conventional treatments with alternative therapies. A similar study reported that massage therapy increased the abilities of patients with knee osteoarthritis (KOA) to perform activities of daily living. 

A 2018 review on integrative care for patients with psoriasis and psoriatic arthritis reported that the combined rheumatology-dermatology approach and integrative care model had significant benefits. Benefits included improved outcomes, patient and physician satisfaction, and efficiency. 

In another 2018 study, integrated psychotherapy was found to help reduce body image anxiety among female patients with systemic sclerosis (scleroderma and its effects lasted beyond three months.

A 2010 review reported that psychological distress associated with rheumatoid arthritis required a multidisciplinary approach involving conventional treatment and alternative therapies. In the review, it was stated that cognitive-behavioral therapy, meditation, and exercise enabled patients with rheumatoid arthritis to better manage psychological distress associated with the chronic condition.

What to expect from the integrative rheumatology approach?

The start of your treatment will begin with taking a full inventory of your diet, lifestyle, and habits plus understanding any conventional or other treatment you have or are receiving or medications you are taking. A treatment plan aims to take into account your needs and values so that your healing is achievable and tailor-made specifically for you. You might undertake some diagnostic tests to understand any deficiencies, irregularities in your blood or chemical levels, undiagnosed conditions, intolerances, or allergies. You may be prescribed infusions or additional herbs or supplements under the advice of your expert, all of which will be safe to use alongside any other medication you are on. The clearer a picture we are able to capture of what is happening in your body on a deep chemical and cellular level, the more accurate and effective an integrative treatment plan will be for you.

You’ll be working with a team of experts including nutritionists and dietitians to amend your diet appropriately, likely with the intention to reduce inflammation, boost immunity, enhance organ health, promote gut health, and balance your macro and micronutrients for optimal blood sugar and hormonal regulation. The more regulated the body is, the more the body is able to heal. Mind-body medicine also plays a big role in your integrative treatment, including practices such as mindfulness for stress management and gentle movement or exercise suitable for your condition as required. If you are suffering from pain, you may also be encouraged to trial acupuncture, therapeutic massage, or craniosacral therapy to relax the central nervous system. You’ll begin to understand what foods and exercise work best for you and for your condition. The goal is to manage pain, improve sleep quality and stress so that you might manage symptoms and enjoy a better quality of life and feel better in your mind, body, and energy even with a chronic condition present.

Is integrative rheumatology appropriate for anyone?

Integrative rheumatology will benefit anyone with rheumatic disorders, particularly chronic musculoskeletal conditions. In integrative rheumatology, complementary therapies do not replace conventional treatments, instead, they work hand-in-hand in treating the whole person; body, spirit, and mind.

Is integrative rheumatology covered by insurance?

It depends. Your doctor visits may be covered by your insurer as they may be categorized as medical care. However, most complementary therapies may require ‘out-of-pocket” payments as they are mostly not covered (or fully covered) by insurance. 

Additionally, integrative rheumatology may require the services of other health professionals such as a chiropractor, massage therapist, acupuncturist, energy healer, or nutritionist. These are either not covered or partially covered by insurance.

Conclusion

An integrative approach seeks a partnership between patient and doctor, combining conventional and complementary medical approaches. It is our intention to educate and empower you around your condition, with your body being the guide in the experience as opposed to a dogmatic regimen that does not work for you. A treatment plan is as tailor-made and unique as you are. After might have been a long time of feeling out of control with your health and symptoms, we want you to feel back in control of your health and healing, whilst utterly supported by a team of experienced specialists.

 

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