Non-Pharmacologic Treatment Options in Rheumatologic Disease

Non-pharmacologic treatments (NPT) for patients with rheumatologic disease aim to enhance overall health and bodily function. This chapter reviews exercise (including hydrotherapy and balneotherapy), acupuncture, manipulation, massage, and assistive devices as adjunct therapy for different painful diseases including rheumatoid arthritis and fibromyalgia. While some NPTs are justified through numerous studies, others may lack evidence. The most studied non-pharmacologic treatment is exercise. Patients with osteoarthritis, rheumatoid arthritis, fibromyalgia, SLE, and Sjogren's all receive benefit from exercise. Acupuncture is one of the oldest non-pharmacologic treatments, but randomized controlled trials supporting its efficacy are generally lacking. The art of manipulation is practiced by osteopathic physicians and chiropractors. Literature supporting manipulation is also sparse but patient satisfaction remains high. Other treatments such as massage and assistive devices lack consistant evidence. This chapter hopefully proves that exercise is a vital treatment in all rheumatologic and painful conditions and other non-pharmacologic treatments need further research study.