Stress and Arthritis

The importance of stress

A person's overall nutritional intake is the most important single factor for preventing sickness and achieving wellness, and it is fundamental to every disease condition. Good dietary habits are a most necessary condition for reversing or controlling all disease states, but may not, in themselves, be a sufficient condition.

Absence of stress, like the presence of a good nutritional status, is also a necessary condition for preventing and achieving wellness, and, like good dietary habits, may also not be sufficient.

There is such a strong interplay between many basic factors that none can be overlooked when seeking wellness. For example, one of the causes of stress can be poor nutritional habits, while poor nutritional habits can also lead to physical and emotional stress. Both fasting and long-term or chronically stressful lifestyles can lead to hormonal unbalances which lead to many different disease states.

Aside from the interactive, underlying and pervasive nature of good nutrition, however, stress becomes the most important single factor in virtually every disease state. It's also a subject that physicians tend to ignore, and patients wish to avoid.

Just as physicians are generally not taught nutrition, so they are not taught the skills of stress management in medical school. Most of their education is heavily oriented toward drug treatments. Even those who later specialize in mental, emotional and psychic disciplines are not provided with techniques that work effectively; and so, having at best a failed technology, psychiatrists resort to the use of damaging, mood-altering drugs.

The best that drugs can do for a distraught mental/emotional state is to temporarily occlude painful effects, and delay the individual's need to confront "real-world" stimuli. A continual drugging of sensitive mental/emotional problems continually delays solutions to the problems. Meanwhile, the physical aspect of the problem – which, like two faces of a coin, is the obverse side of the mental/emotional state – continues to seek resolution, that is, restoration to the normal state. Failing this, a "disease" process is established, and whatever we are genetically susceptible to kicks in.

L. Ron Hubbard early in his researches discovered that hypnotism, while appearing to be effective in allaying physical or mental problems, was deceptively dangerous. He was able to demonstrate that the act of suppressing an unwanted emotional response via hypnotic command actually turned on a corresponding physical ailment; and vice versa, the act of suppressing a physical ailment by hypnotic command turned on a corresponding mental/emotional problem. After this research, he abandoned the use of any kind of hypnotic commands or positive suggestions on patients in favor of a technology that would permit and teach each individual to confront his or her innermost emotional pain, and to resolve the pain so that it's founding memory-experience was confrontable, and comfortable thereafter. By doing so, he learned that, as a byproduct, people became free of their recorded trauma, sickness and stress, and also became better human beings.

Some physicians who do recognize the importance of stress reduction in bringing about the disease-free state have learned to use techniques that will hopefully reduce their patient's stress. Among techniques used are bio-feedback training, visualizations or guided imageries, aroma therapy, light and sound therapies, meditation, Yoga, qigong, Alcoholics Anyonymous, religion, and so on. All of these can be important, if they satisfy the patient, and if they work. C. Norman Shealy, M.D., Ph.D. writing in Miracles Do Happen: A Physician's Experience with Alternative Medicine, says, "Nothing is more important or powerful in stress management than physical exercise."

It is no deep, complex psychological mystery that our greatest source of stress is from personal relationships and from our work. These, after all, thrust at the very heart of survival. The impact of stress on our bodies was neatly demonstrated by Hans Selye, who described the bio-physical details of the "flight or fight" syndrome, and the exhaustion of adrenaline and its effect on our systems.

In simplified form, what happens is that a threat to survival triggers production of cortisol, a substance from the adrenal gland (cortex) very much like cortisone. Cortisol activates the body to produce quick energy, which we need during our emergency state. We are programmed to convert certain T-cells – microorganism protecting cells found in the blood stream that are also part of our immunological system – into a form of quick energy. While this T-cell conversion is excellent for a real emergency, like running away from a saber-toothed tiger or an automobile that is bearing down on us, the tragic effect of a sustained emergency state soon becomes evident. If we continue to unbalance our immunological system by converting some of its defense factors (specialized T-cells) into quick energy, we also permit organisms-of-opportunity to utilize their new opportunity, and infection – a cold or other pathogenically "derived disease" -hits us. There are also other effects, such as those which stem from an unbalanced hormonal system, and perhaps even other effects not yet categorized.

In any case, a continuous emergency state – threat to survival, flight or fight syndrome – is a continuing stress, and continuing stress is damaging mentally, emotionally and physically.

How the body adapts to stress to create arthritis

Canadian physiologist Hans Selye described a generally accepted physical model of the effects of prolonged stress at different stages on the human body, called the general adaptation syndrome (GAS). There are three stages (1) Alarm Stage; (2) Resistance Stage; and (3) Exhaustion Stage.

Alarm stage of stress

A young person filled with vitality and health will often overwork muscles and come home with "aches and pains" that soon disappear, as the ability to bring nourishment to individual cells, to dispose of excess cellular wastes, and to repair tissue proceeds rapidly. An older person, however, may take considerably longer and, if the muscles are continually overworked or subjected to additional strain from other stress factors, the body will began to adapt in other mechanical and biochemical ways. One example of such adaptation has been described by Canadian Carl Reich, M.D., who has shown through his research and clinical practices that biological stress from persistent lack of vitamin D3, calcium, and sunshine causes the body to adapt to any of dozens of different disease states including various forms of arthritis. Rex E. Newnham, N.D., D.O., Ph.D., England, has shown a similar result when the body lacks boron. Repetitive stress factors beyond the individual's ability to swiftly compensate leads to the second stage, or resistance stage in the general adaptation syndrome (GAS).

Resistance stage

The middle aged man or woman who works two jobs and who also leads a very stressful life at home because of the absolute need to take care of small children during periods when rest, peace and recovery are demanded of the mind, emotions and body may think that, though often fatigued, s/he is coping rather well. Years may go by with such super-stress at home and work as the body slowly uses up resources and also functions with less efficiency due to aging. Circulation decreases minutely year by year, as does the secretion of hormones from aging glands. The heart, kidneys, liver and pancreas function with less efficiency – meanwhile the body like a very good soldier continues to attempt to repair itself from daily stress.

Additional stress may be acquired in the form of nutritional deficiencies; emotional trauma such as loved ones who've died; toxicity from traditional drug therapy that treats symptoms and not the causes, thus providing the illusion that with the drug one is coping; surgeries that interrupt the natural flow of energy – qi – along meridian lines, or incapacitate organs by destroying or deleting them; and other forms of stress – all take their toll.

Soon minor symptoms are acquired and small complaints begin: "I feel tired all the time." "My skin has broken out, and nothing I use clears it up." "When I get up in the morning, my joints ache and I feel stiff all over, but I'm OK after I've moved around a bit." "I get headaches at work, and my back and wrist hurt all the time." – and so on! When treated by means that simply hide symptoms – which is a way of saying "left untreated and hidden" – a persistently overworked muscle manifests pain, stiffness, and often inflammation, becoming less and less elastic and more fibrous. Additional stress is placed on tendon and ligament attachments to bones and muscles, which creates additional pain and structural mal-adaptations. Left untreated with appropriate rest and nourishment, muscles and joint structures finally reach the exhaustion stage of the general adaptation syndrome.

Exhaustion stage

Joints are not just places where bones move in well-oiled sacs. Joints consist of interacting bones, muscles, skin, nerve tissue, fluids and so on. All components must be healthy and working well with one another. When certain peripheral nerves leading to joints become biochemically unstable, they can fire impulses that signal both as a spinal reflex action back to the joint and also to the brain and back to the same joint as a pain signal. This can create a condition in the joint of insufficiency of nourishment which factor, in turn, leads to cartilage degeneration, free radical chemical damage, and finally inflammation, swelling, and permanent joint damage. Muscular imbalances that derive from tendon and ligament imbalances lead to further structural stress. Although we're not aware of the fact – as we have no internal sensing mechanisms to tell us – our body's attempt to compensate creates calcium spurs and further joint damage.

Two adverse factors also become evident at this stage, viewed especially in rheumatoid arthritis, but also seen in some osteoarthritis: (1) various forms of microorganisms gain entrance to bodily tissues. The resulting tissue sensitivity to the toxins or protein products of the microorganisms sets up an internal "allergy" reaction, an antigen/ antibody response. If the protein substances have a DNA structure -a genetic sequencing of basic protein molecules – similar to the tissues infected, the body's immunological system apparently attacks both the foreign agents and its own joint tissues; (2) "external" immunocomplexes, substances formed from other forms of antigen/antibody combinations, usually from food allergies, also lodge in joint tissues creating additional irritating foreign substances that lead to pain, inflammation, swelling and general cartilage (that is, joint) destruction. By this time the lymph system (designed to sweep out impurities) is often overloaded and backed up, like a clogged house drain, and the concentrated toxicity problem simply cascades, looming ever larger. Pain, swelling, and joint destruction, of course, lead to more stress. Thus is established a well-known positive feed-back loop, where stress has initiated a physiological/emotional/mental sequence which creates more stress.

The many faces of stress

Stress has an infinite number of faces. No one knows how many life forms have inhabited our planet, Earth. There must be trillions, if not an order of magnitude or so more. Life has adapted to deserts and oceans; to extreme cold and excessive humidity; to the depths of long-buried oil pools and sulphur-bearing rocks; it is found amidst scalding heat and caustic chemicals spewed up by hydrothermal vents; life is found far beneath the earth in solid rock; it is present in oxygen deficient environments, algae live out their complete existence in the swiftly vanishing, fleecy white clouds above us – life is everywhere on earth, and, for all we know, may be a fundamental characteristic of the universe itself.

The powerful engine that drives life into every niche and cranny is stress: biochemical, mechanical, nutritional, mental and emotional, environmental, electromagnetic, radioactive, and so on. A supreme beingness has devised a small DNA molecule that through various mechanisms can adapt or change successive progeny so that survivors can live comfortably, indeed, demand, the particular factors that previously represented serious stress factors for their parents.

This powerful engine – stress – is a wonderful force for species' development and evolution, but an extremely costly one for individuals within the species. Billions of individual bacterium must die before one microbial form is produced that can survive the onslaught of a new antibiotic. This individual then propagates a whole new genus from which springs certain individuals that can only live in the presence of the formerly deadly antibiotic.

As each species' adapts in response to radically changing environments, eventually a totally new species is born, one that cannot cross-breed with the original, and so life spreads, filling every possible niche and cranny.

From the preceding perspective it's easy to visualize that now, today, all of us are undergoing tremendous stress factors that may be producing a human species that can live in an oxygen deficient environment surrounded by deadly automobile fumes, pesticides, fluorides and herbicides, nourished by foods without enzyme content, vitamins or minerals or essential fatty acids: eggless eggs, fatless fats, creamless ice cream, and so on being the norm of the diet for those who survive all the deadly present-day stress factors.

But, oh, at what a cost to each of us as individuals. . . !

Advice for the arthritic

Although there's no known special set of stress factors that apply to other forms of disease-states that do not also apply to the arthritic, there are some important mental and emotional problems that should be understood and ways to confront these problems that are appropriate for the arthritic.

The only difference between stress-relieving principles that apply to the osteoarthritic as compared to those that apply to the rheumatoid arthritic may be a much higher incidence of infectious microorganism in the rheumatoid victim.

Physician-Approved Advice for Reducing Stress

Seven physicians (Jack M. Blount, M.D., Ronald Davis, M.D., Paul Jaconello, M.D., Warren Levin, M.D., Rex E. Newnham, D.O., N.D., Ph.D., Gus J. Prosch, Jr., M.D. , John Parks Trowbridge, M.D.) were asked to review the subject of stress, and reduce advice for the arthritic to its most elemental form. Here is their consensus:

Not only can controlling the stress in your life help prevent contracting arthritis but if you get the disease, controlling stress can help lessen the pain and its impact on the body.

Be conscious of stress in your life and use the following guidelines to reduce stress:

  • Develop a positive attitude about everything you do; associate with "positive attitude" people,
  • Learn to relax,
  • Learn proper breathing exercises,
  • Cultivate a good sense of humor,
  • Listen to relaxing music,
  • Visit with friends and do things that you enjoy,
  • Exercise, get outside in the sunlight, take really brisk walks,
  • Permit yourself to yawn when required, and to stretch from time to time,
  • Take enjoyable vacations, at least get away from humdrum routine,
  • Always get proper rest,
  • Learn about your inner spirit, pray according to your conscience and beliefs. Stay in control, don't just become a drug user, as happens to many patients.

Drugs – any kind of drugs – contain a hidden danger that lay unknown until recently, with the work of biochemist Hermona Soreq of Hebrew University, and Alan Friedman, physician at Soroka Hospital in Beersheva, Israel. Fatty tissues surround the blood vessels that nourish the brain. These specialized layers prevent infectious agents and large chemical molecules from passing through what is called the "blood-brain barrier," adversely affecting brain cells, our health, and behavior. Medical scientists have assumed that most drugs taken by mouth do not pass through this protective barrier. Indeed, few, if any, drugs are tested with patients under stressful conditions. Now, it's clear from the work of Soreq and Friedman that under stress the fatty sheath around brain vessels is affected, and various drugs can pass through blood vessels, affecting brain cells, health, and behavior. It follows, therefore, that all of the carefully reported listing of possible adverse affects described in required FDA "counter-indications," is incomplete and may, in fact, be vastly understating the dangers of both common and uncommon drugs, especially whenever stress – a common life factor – is experienced simultaneously with drug usage.

Biofeedback training

Biofeedback training is a means of learning how to control nerve impulses and muscles that we would normally not be conscious of controlling. Usually, safe electronic mechanisms are used that help bring to our conscious awareness what our thought and muscle patterns are doing under a given stimulus. Although biofeedback training is useful in eliminating headaches, controlling asthmatic attacks, reconditioning injured muscles, and relieving pain, it can be particularly useful for relieving stress, and emotions behind the stress.

Before the 1960s it was a commonly accepted Western belief that autonomic functions, such as the heart rate and pulse, digestion, blood pressure, brain waves, and muscle behavior were beyond our awareness control." They just happened." Now it is well known that many of these functions can be placed under conscious control, or modified if desired, to the benefit of the body's health. Of course, a few seekers after spiritual mysteries, some Yoga practitioners (an ancient healing discipline using breathing exercises, physical postures, and meditation), some who follow the spiritual path of Qigong teachings, and others have been able to control their autonomic nervous system in centuries past, but it was only the few who placed themselves under intense, long, usually life-time study, who obtained the ability. Modern instrumentation makes this chore relatively easy, often pleasant, and swift.

For example, once the physical attribute – heart rate, pulse, skin electrical conductivity, etc. – is chosen, a training signal is wired into the desired attribute – such as a bell, moving needle, light, or other feedback stimuli – and these signals will change according to changes in the chosen physical attribute. The individual will observe the training signal, and through practice, an individual soon learns to "think" or otherwise change internal signals so that the formerly autonomic function can now be consciously controlled.

One way that biofeedback might help the arthritic is in reducing the sensation of pain by reducing one's emotional response to the pain. Biofeedback can also be used with visual imagery to reduce stress and also to reduce levels of destructive chemicals in the blood stream.

Exercise for the relief of stress

Exercise is absolutely essential for optimum bodily functioning. Physical exercise places demands on all of the body's systems, pumping blood faster, bringing nutrients to the cells, disposing of cellular wastes, breaking down and repairing tissues, and so on. When the metabolism operates efficiently throughout, suppressed emotions and other stress factors dissipate.

Arthritics are often pain-filled, and what is "moderate" exercise to such a person may be "excessive" exercise to another. Although the goal may be to exercise for the purpose of stimulating the overall metabolism, the over-production of undisposed cellular waste products and the tearing down of more tissue than is rebuilt can place the arthritic in a position where the arthritis and its accompanying pain is increased, rather than decreased.

An additional factor must be considered in the event that arthritis is actually a by-product of sensitivity to microorganisms (as is surely the case with many of those suffering from rheumatoid arthritis, other rheumatoid diseases, and may possibly be the case for about 1 out of 10 of those suffering from osteoarthritis). One of us (Gus J. Prosch, Jr., M.D.) therefore, would caution that exercising without first eliminating these potential organisms may serve to spread the disease faster, as increased blood flow enhances the rate, hence scope, of microorganism distribution.

Aside from the possibility of an infectious organism, however, exercise is a must for all individuals, even if it is no more than twisting and bending fingers and hands.

Although many health professionals will advise the employment of "moderate" exercise, the definition of what constitutes "moderate," may be between you and your health professional in consideration of your present health circumstances.

The arthritic's best goal is to slowly, safely increase physical exercise without also creating further damage to joints, and more lasting pain. Although pain will inevitably be present before joints have completely healed, there should be continued improvement for every kind of exercise employed. Start with a pad and pencil and record your ability to exercise by, say, counting the number of finger bends, or wrist twists, or even the number of attempts to stretch and touch your toes. From this information:

  1. Set yourself a first safe goal.
  2. Tomorrow, equal or exceed the goal, but not by so much that you create more suffering.
  3. The third day, equal or exceed the goal of the second day.

If you can't, don't be disappointed, as everyone's body has ebbs and flows in efficiency. Simply go back to day one, equaling or exceeding your accomplishment, if possible. Continue as above, always recording your accomplishment – or even graphing it against the number of days of trial. Your graph will wiggle up and down, which is natural, but overall it will rise, giving the appearance of a jagged outcropping reaching toward the clouds. When you're satisfied with what you've done with one set of exercises, choose another, but don't forget the first. Now record both of them. Continue expanding your abilities as above, adding number of movements, or attempts, and new exercises as your body permits.

Many arthritics are advised to exercise in water, because the water holds off the toll of gravity, allowing more movements for a given energy exertion and with lessened weight on joints. If you're one of the fortunate ones, you'll want to take up a more active form of exercise: trampolining (which moves lymph faster); walking fast, or even running, dancing, swimming, etc. Taking individual differences into account, then, John Hibbs, N.D. of Bastyr College, Seattle, Washington, recommends what he calls tissue aerobic exercise: relaxing exercise that allows blood flow to continue to the tissues. "The heart rate should increase and you should wind up sweating, but many doctors are switching over to a lower heart rate now. You don't need to go up to 140." Don't pick an exercise that you despise, or even dislike, pick an exercise you enjoy, but try never to overdo, never over-achieve. Pamper your body, pet it, be nice to it – and it'll one day return the favor with improved health, lessened suppressed emotion, and certainly lowered stress.

Guided imagery for stress relief

After a stressful day at work, filled with withering emotions, it is sometimes difficult to fall immediately to sleep, no matter the urgency of sleep. Many have learned that they can invent a scenario inside their mind somewhat more complex than counting sheep, but rather including something quite pleasant they'd like to do. Placing all of one's attention on the play-acting inside the mind quickly dissipates the wrought-up energies, and often one will fall asleep before finishing the scenario.

While nowhere nearly as beneficial as that obtained when releasing huge stores of undesirable, pent-up pain and emotion, the use of guided imagery by itself has been sufficiently positive to attract many health professionals.

Guided imagery relies on a natural function discovered to be common to all people from childhood upward: the ability to focus thoughts, and to either recall or imagine a specific time when the body and emotions were at ease.

Meditation for the relief of stress

The art of meditation is perhaps as old as modern man, for it is the tribal shamans (healers) and primitive tribesmen who learned its value for many purposes, including that of healing. According to Joan Borysenko, Ph.D., pioneer in the field of mind/ body medicine, meditation is defined as any activity which keeps the person's attention anchored in present time without being influenced by past memories, nor preoccupied with future considerations.

Another way of describing such meditation is that we learn to "key out," all currently functioning stimulus-response mechanisms of the body, whether these are triggered by past, recorded memories, or were conditioned under painful and emotional experiences.

There are many systems for achieving appropriate meditation which are beyond the scope of this article. Some will advise sitting quietly while concentrating on the breath, image, or a sound, while others advise becoming aware of our sensory impressions, such as feelings, images, sounds, thoughts, odors, and so on, without becoming involved with them.

Many stimulus-response mechanisms – or as some have phrased it, "automatic circuits" – operate daily to cause us to move our hands, head, and other body parts in almost random, meaningless behavior patterns (such as the desire – sometimes overriding desire – to scratch a particular place on the face, or behind the neck). To some extent we've all identified our personality, our beingness, our awareness-of-beingaware unit with these patterns, and if asked why we scratched, we'd answer that "I itched there," which is more of a justification after the fact than a statement of cause.

One of the easily observed phenomena when attempting meditation is the number of these overwhelming distractions that must be ignored in order to be in present time without computing conclusions about past events, or analytically predicting future actions or probabilities.

At the point where all these distractions disappear – and they will – one has usually achieved a meditative state.

There are physiological, psychological, and spiritual benefits from the daily practice of meditation.

Meditation lowers the body's core temperature, which is one of two factors that have been shown to extend life, the other being restriction of calorie intake.

Stress is more easily confronted, or handled, when we permit ourselves to simply "be," the distinguishing outcome of meditation. Of course, with stress under control, all disease states – including arthritis – are better handled, including pain and the emotional components of pain.

Jom Kabat-Zinn, Ph.D., founder and director of the Stress Reduction Clinic at the University of Massachusetts Medical Center, has taught meditation and Yoga to thousands of patients, mostly referred to him by other physicians. "In one study overseen by Dr. Kabat-Zinn, 72 percent of the patients with chronic pain conditions achieved at least a 33 percent reduction after participating in an eight-week period of mindful meditation, while 61 percent of the pain patients achieved at least a 50 percent reduction." Additionally these patients improved their self-esteem and held more positive views about their bodies.

Meditative practices are quite easy to learn, and once the discipline takes hold, with frequency and time, the more benefits are received.

Meditation is not a substitute for medical or stress-related physical disorders. Although people can easily practice meditation by themself, physical problems should be attended to by those best trained in the art of healing.

Stress in personal relationships – The suppressive personality

According to the research of L. Ron Hubbard, often there is one or more persons in the close work or home environment who are suppressive to the one who is sick, such suppression expressing itself in a way that constantly invalidates the sick person’s actions, thoughts or emotions. It is a negative stimulus that depresses our beingness, our will to want to engage in friendly exchange of ideas or activities. Hubbard called these people "antisocial personalities." He estimated that about 15-20% of all humans have characteristics that can be called antisocial. An individual's intelligence, educational level or manner of earning a wage has no relationship to whether or not he or she is antisocial. Judges, administrators, physicians, ditch-diggers, taxi-drivers, editors, homemakers, teachers, any nationality, any race, any creed, any or all walks of life may fall into the 15-20% category.

A person who is so affected by another will often suppress his or her emotions and behavior in ways that express outwardly in the form of hormonal changes and accompanying clinical sicknesses. The medical terminology is “psychosomatic,” indicating that the person’s state of mind governs his emotions and bodily condition. This is true to the extent that a person permits suppressive conditions and “suppressive” people to influence his or her mind and body. As few physicians have training in recognizing the causative patterns, and would probably be resisted by their patients if they mentioned them, interpersonal stress sources are often ignored in treatment, although they may be the largest component of all diseases, acute or chronic.

Yoga for stress

Yoga, one of the oldest known systems for health, is the practice of physical postures, breathing exercises, and meditation. Its practice in modern times has demonstrated the lowering of stress and blood pressure, regulation of heart rate, and even retardation of the aging process.

Yoga teaches an integration of the mind and body. The mind and body are one and the same, and should be written with a new symbol, as mind/body. The modern view of psychosomatic medicine may have stemmed from this ancient art, where whatever affects the body, also affects the mind, and vice-versa. Spelling out such a cause effect relationship is, in itself, inaccurate, as the true Yoga practitioner would view physical disease of the body, or aberrant behavior patterns, as being symptomatic of our forgetting the unity known as mind/body.

The thyroid gland, and its hormonal production, is basic to the stoking up of our cellular metabolic engines, which in turn is basic to the efficient utilization of enzymes, which is fundamental to good health for all disease states, including the arthritic. Indeed, many arthritic symptoms do stem from insufficiency of thyroid hormone, or in its conversion to a form that slows down the metabolic heat engine. The practice of Yoga has been shown to normalize the production of thyroid hormone.

As the thyroid is the master regulator of all the other glands (with the pituitary being the master gland over all, including the thyroid), and as the glands are intimately tied in with stress and emotion, the ability to increase or decrease thyroid activity without taking drugs can be an important self-help process.

There have been more than a thousand well-designed studies (since the 1970s) of meditation and Yoga. These studies have demonstrated that Yoga can bring about stress and anxiety alleviation, blood and heart rate reduction, improved memory and intelligence, pain alleviation, improved motor skills, relief from addiction, heightened visual and auditory perceptions, enhanced metabolic and respiratory functions, and many other benefits.

In The 1983-1984 Yoga Biomedical Trust survey, 90% or 530 out of 589 people with either arthritis or rheumatism (a cluster of symptoms resembling several different kinds of arthritis) reported improvement with the use of Yoga practices involving physical postures, breathing exercises, and meditation.

by Anthony di Fabio, M.A. and Gus J. Prosch, Jr., M.D. From a chapter in Arthritis: Osteoarthritis and Rheumatoid Disease Including Rheumatoid Arthritis, The Arthritis Trust of America.® All rights reserved. Copyright 1997.

The Rheumatoid Disease Foundation / The Arthritis Trust of America was dissolved in 2020 and all website content was transferred to the Foundation for Alternative and Integrative Medicine.

About the Author

The Arthritis Trust of America

The Arthritis Trust of America® / The Rheumatoid Disease Foundation was dedicated to helping the public. The Trust closed in June 2020 and generously donated the articles and resources published on their website to the Foundation for Alternative and Integrative Medicine for republication.