By John M. de Castro, Ph.D.
“Drugs are effective for rheumatoid arthritis, but they don’t affect the stress pathways that are so fundamental to the condition. Stress symptoms activate inflammation and even heighten the perception of pain. “A mindfulness-based intervention, which targets the multiple components of the body’s stress response, can decrease overall pain severity and increase quality of life.” – Michael Irwin
Arthritis is a chronic disease that most commonly affects the joints. Depending on the type of arthritis, symptoms may include pain, stiffness, swelling, redness, and decreased range of motion. It affects an estimated 52.5 million adults in the United States. It is associated with aging as arthritis occurs in only 7% of adults ages 18–44, while 30% adults ages 45–64 are affected, and 50% of adults ages 65 or older. Due to complications associated with rheumatoid arthritis (RA), the lifespan for people with RA may be shortened by 10 years. This is due to a higher incidence of cardiovascular disease in rheumatoid arthritis (RA) patients, with the risk more than double that of non-RA individuals.
Obviously, there is a need to explore alternative treatments for rheumatoid arthritis. One possibility is contemplative practice. A variety of which have been shown to have major mental and physical benefits including a reduction in the inflammatory response and have been shown to improve arthritis. In today’s Research News article “Systematic Review and Meta-analysis: Mindfulness-Based Interventions for Rheumatoid Arthritis.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6233984/ ), DiRenzo and colleagues review and summarize the published randomized clinical trials of mindfulness-based interventions for patients with rheumatoid arthritis.
They found only 5 published studies which produced inconclusive results regarding the effectiveness of mindfulness-based interventions on the physical symptoms of rheumatoid arthritis such as pain and inflammation. On the other hand, the research suggests that mindfulness-based interventions improve the psychological states of patients with rheumatoid arthritis including depression, anxiety, and psychological distress. The results, although inconclusive are sufficiently suggestive of positive outcomes that further research is warranted. It is clear that larger better controlled studies are needed before unambiguous conclusions can be reached.
So, improve the psychological state of patients with rheumatoid arthritis with mindfulness.
“The other thing I think is important to note about our study is that mindfulness meditation can be combined with any rheumatological therapy. It is truly complementary medicine in that sense, done in addition to pharmacological or other intervention. So, for physicians and patients who wonder what they can do to improve well-being, beyond taking medications, this study offers evidence for a beneficial approach to dealing with the psychological distress of RA.” – Elizabeth Pradhan
CMCS – Center for Mindfulness and Contemplative Studies
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DiRenzo, D., Crespo-Bosque, M., Gould, N., Finan, P., Nanavati, J., & Bingham, C. O. (2018). Systematic Review and Meta-analysis: Mindfulness-Based Interventions for Rheumatoid Arthritis. Current rheumatology reports, 20(12), 75. doi:10.1007/s11926-018-0787-4
Purpose of Review
To determine the efficacy of mindfulness-based interventions (MBIs) on clinical and patient-reported outcomes in rheumatoid arthritis (RA).
We identified randomized clinical trials from inception through April 2018 from MEDLINE, PsycINFO, EMBASE, CINAHL, Web of Science, the Cochrane Library, and hand searches. After screening 338 references, we included five trials with one post-hoc analysis that evaluated MBIs and collectively included 399 participants. Outcome instruments were heterogeneous across studies. Three studies evaluated RA clinical outcomes by a rheumatologist; one study found improvements in disease activity. A limited meta-analysis found no statistically significant difference in the levels of DAS28-CRP in the two studies that evaluated this metric (− 0.44 (− 0.99, 0.12); I2 0%). Four studies evaluated heterogeneous psychological outcomes, and all found improvements including depressive symptoms, psychological distress, and self-efficacy. A meta-analysis of pain Visual Analog Scale (VAS) levels post intervention from three included studies was not significantly different between MBI participants and control group (− 0.58 (− 1.26, 0.10); I2 0%) although other studies not included in meta-analysis found improvement.
There are few trials evaluating the effect of MBIs on outcomes in patients with RA. Preliminary findings suggest that MBIs may be a useful strategy to improve psychological distress in those with RA.