# Alternative treatment approaches for rheumatoid arthritis with organ involvement
Acupuncture and moxibustion
Acupuncture and moxibustion are traditional Chinese therapies in which fine needles are inserted into the skin or herbs (artemisia) are burned on or above the skin. For rheumatoid arthritis, these techniques have been studied in some clinical trials, particularly focused on pain relief and emotional complaints that often occur alongside the condition.
ResearchediPositive results in clinical studies, not yet standard treatment
What is known: Studies suggest that moxibustion may have effects on gut bacteria (the microbiota), which may be involved in inflammatory reactions in rheumatoid arthritis. Research is also being conducted into whether these treatments contribute to better coping with feelings such as depression or anxiety, which many patients experience. The mechanisms are not yet fully understood and the studies are in an early stage.
What is not known: There is insufficient evidence that acupuncture or moxibustion can reduce inflammation in the joints themselves or prevent joint damage. The studies are still small and not all have been conducted according to international standards. Whether these treatments in combination with regular medications are safer or more effective is still unclear.
Important note: These treatments should only be undertaken under expert guidance and always alongside (not instead of) regular arthritis treatment.
Chinese herbal formulas
Various Chinese herbal combinations are traditionally used to combat inflammation and relieve symptoms of rheumatoid arthritis. Recent laboratory studies and animal trials are investigating how certain formulas might work.
ExperimentaliOngoing in study setting, outcome still unknown
What is being researched: Laboratory studies show that certain herbal mixtures may be able to influence inflammatory proteins and alter gut microbiota (gut bacteria). Some studies focus on how these formulas might help with muscle loss (sarcopenia) that can occur in rheumatoid arthritis, or how they might counter bone loss. However, this research takes place in laboratory conditions or animal models, not in patients.
What is not proven: There are no large, well-controlled clinical trials demonstrating that these herbal formulas are effective in people with rheumatoid arthritis. Whether they are safe in combination with regular biological therapies (such as TNF inhibitors) is unclear. Many formulas are highly concentrated and may have side effects or drug interactions.
Warning: Herbal preparations are not the same as medicines and are not subject to the same strict controls. The composition can vary between brands. Always consult your doctor before using herbal formulas.
Nanovesicles derived from Chinese herbs
These are microscale particles extracted from Chinese herbs and used as 'packaging' for active substances. They represent a new field of research in the treatment of joint disorders.
ExperimentaliOngoing in study setting, outcome still unknown
What is being researched: Researchers are studying whether these nanovesicles can deliver the active substances from herbs more effectively into the body and potentially reduce inflammation. The concept is borrowed from modern biomedical technology. So far, research is limited to laboratory studies and animal experiments.
What is still unclear: No clinical trials have yet been conducted in people with rheumatoid arthritis. How safe these particles are in the long term, how efficiently they actually deliver active substances, and whether they perform better than regular medicines, is completely unknown. This is still purely research territory.
Isoliquiritigenine
This is a natural substance that can be extracted from licorice root. Laboratory studies are investigating whether it can reduce inflammation.
ExperimentaliOngoing in study setting, outcome still unknown
What is being researched: Laboratory tests show that isoliquiritigenine may be able to block certain inflammatory pathways in body cells. Specifically, effects on so-called inflammasomes (inflammatory proteins) and radicals, both of which play a role in rheumatoid arthritis, are being examined.
What is not proven: So far, all research is limited to cell cultures in the lab. No clinical trials have been conducted in patients. Whether the substance has the same effect in the human body, in what quantity it would be effective, and how safe it is, is completely unknown.
Pain management according to the guidelines of the British Society for Rheumatology
The latest guidelines (2026) emphasize treating pain in inflammatory rheumatism as an integral part of disease treatment, not just as an incidental symptom.
ProveniIncluded in official guidelines, or approved by EMA or FDA
What is known: Research supports that good pain management not only improves quality of life, but also contributes to better adherence to medication schedules and healing. The guidelines emphasize a broad range of approaches: exercise, physical therapy, appropriate medication choice, psychological support, and where necessary adjustments to daily life.
Practical implication: This means that pain relief should be a full part of your treatment plan, not something that just 'comes with it'. If pain is hindering you, this can be discussed with your doctor—both via medication and other targeted interventions.
What you need to know about alternative approaches
**Caution with 'alternative' versus 'complementary':** Many patients replace regular medications with alternative treatments, even though regular medications such as DMARDs and biologicals are necessary to prevent permanent joint damage. This can have serious consequences, especially if organs (lungs, heart, kidneys) are already involved.
**Interactions:** Many natural products can have interactions with biological therapies, anti-inflammatory agents, or blood thinners.
**Quality and composition:** Unregulated products may contain impurities or may not contain what the label states.
**Research gap:** The fact that something has been used 'traditionally' does not mean it works, and the fact that laboratory studies are promising does not mean it works in patients.
While many alternative approaches can indeed help as complementary measures (for example, acupuncture for pain relief, physical therapy, rest periods), none of them replace evidence-based medications that suppress inflammation and prevent damage. When organ involvement is present, rapid and effective suppression of inflammation is essential.
_This information never replaces a doctor's judgment. Always discuss your situation with your own healthcare provider._