Dr. Arthritis Shares: A New Way To Treat Rheumatoid Arthritis—Vagus Nerve Stimulation

Perhaps one of the biggest challenges after being diagnosed with Rheumatoid Arthritis (RA) is that while there are numerous treatment options, finding the right one for individual patients can be difficult. 

Drug combinations and dosages vary from one patient to another. While some respond quite well to disease-modifying antirheumatic drugs (DMARDS), others suffer through terrible side effects. Biologics are another option to achieve low disease activity and even remission, however not all respond well to it. Some patients aren’t able to take specific medication because of their medical history or personal risk factors. The point is, there’s a lot of trial and error involved in the treatment of RA; and while some successfully find their right medication cocktail, others continue to try drug after drug and fail to find a combination that’s effective.

The Vagus Nerve

In the quest to find an alternative, maybe even better, treatment option, scientists are looking into something called vagus nerve stimulation.

The treatment isn’t dependent on drugs, which could be a welcome respite for many RA patients who are used to taking numerous pills, injections, or infusions to manage disease activity. Instead, this method uses electrical impulses to stimulate the vagus nerve—a cranial nerve that runs from the brain through the face and neck, all the way down to the abdomen.

As the longest of the cranial nerves, it’s a critical part of the body’s overall autonomic nervous system. It’s responsible for controlling essential bodily functions that we don’t even have to worry about such as breathing, beating of our heart, or digesting food.

What does it have to do with RA? The vagus nerve is also home to the body’s inflammatory reflex—which is responsible for detecting and regulating inflammation. So for example, if you get injured or get infected by a virus or bacteria, the vagus nerve helps determine the level of your body’s immune response to fight it. When the response is well-regulated and appropriate, it manages to kill off the virus or bacteria, allowing our body to heal. But there are instances when it gets too aggressive and goes on overdrive; that’s when you end up with chronic inflammation. In RA, this results in joint and tissue damage.

An Experimental Approach

To date, the scientific community doesn’t exactly know what causes RA. However, they can confirm that inflammatory substances called cytokines—including tumor necrosis factor (TNF) and interleukin (IL)–play a major part in tissue damage. This is why RA drugs like biologics are designed to target these specific cytokines. But these treatments don’t always work for everyone.

That’s where the vagus nerve comes in. The vagus nerve is known for reducing the production of cytokines and the theory of this new approach is, stimulating the vagus nerve could help minimize the production of cytokines that cause inflammation.

As described by Arthritis.org:

       “The silver dollar-sized device is implanted into the chest and delivers electrical signals (via an electrode that runs up to the neck) that in essence tells the immune system “enough inflammation already!””

A Promising Treatment

Current studies are small but promising.

In addition to efforts to determine the safety of the device, most of the patients who used the MicroRegulator used to stimulate the vagus nerve reported significant improvements to their RA disease activity scores. Lowered cytokines were also noted.

While there were some adverse effects, including pain and swelling at the incision site and one patient who experienced vocal cord paralysis, all these were fortunately, temporary.

A separate study is also looking into how a vibrational device that you can hold to your ear could also help stimulate the vagus nerve and limit the production of cytokines.

Simultaneous to these studies, researchers are also looking into understanding how they can best determine whether or not RA patients will respond to available medication. Again, the key could lie in the vagus nerve as research has shown that low vagal tone is linked to higher inflammation and greater risk of autoimmune conditions. This means RA patients with low vagal tone could be ideal candidates for vagus nerve stimulation.

A device currently being developed could be used by rheumatologists to help assess whether a patient is more likely to respond to biologics or have better chances with emerging treatment options such as vagus nerve stimulation.

Bottom Line?

Should future studies prove to be positive, vagus nerve stimulation can be a viable treatment option or RA patients who don’t respond to DMARDs or biologics. Additional research is also looking into how electrical nerve stimulators can be used in tandem with drug therapies to help boost their efficacy.

It’s a promising new option for millions of RA sufferers–one that could potentially be life-changing for improving disease activity and quality of life. 

Dr. Arthritis Asks: Is the COVID-19 Vaccine Safe for Immunocompromised Patients?

If you suffer from an autoimmune version of arthritis such rheumatoid arthritis or psoriatic arthritis, then you’re probably wondering how the newly released COVID-19 vaccines affect those who take immunosuppressants.

The biggest question is, can you get the vaccine even if you suffer from autoimmune conditions or are taking medication designed to suppress your immune system?

While there is currently no advisory that says you can’t vaccinate people with autoimmune diseases, experts assert that there is no reason to believe that COVID-19 vaccines available now are unsafe.

As reported by Arthritis.org:

“Both the Pfizer/BioNTech and Moderna, Inc. vaccines are made with mRNA technology, which contain genetic instructions for one part of the coronavirus instead of the entire virus itself. Experts, including Wilbur Chen, MD, vaccine researcher, professor of medicine at the University of Maryland School of Medicine, and Ted Mikuls, MD, MSPH, Umbach Professor of Rheumatology at the University of Nebraska, expect that vaccines made with this technology to be safe for immunocompromised patients and those on immunosuppressant drugs.”

Of course, additional research and data is still needed to definitively understand how the COVID-19 vaccines will interact with immunosuppressant medications, or even unchecked disease activity. However, the medical community is optimistic that by the time the vaccine is ready to be rolled out in the public on a larger scale, there will be more reliable information regarding its safety and efficacy for immune-compromised patients as well those suffering from rheumatic conditions.

Additionally, studies conducted by CreakyJoints and the Global Healthy Living Foundation reports that rheumatologists they have spoken to so far have recommended getting the vaccine as soon as it is available to the public.

“The general consensus is that there is no reason to expect that an mRNA COVID-19 vaccine —such as from Pfizer or Moderna — would be less safe in people who are immunocompromised. There may be a chance that the vaccine is less effective in those taking immunosuppressant medication — which dampens the immune system response — but there is not yet data that shows this. However, even a theoretically less effective vaccine is better than no vaccine.

Bottom line?

If you have a rheumatoid condition or suffer from an autoimmune inflammatory disease; if you’re immunocompromised or taking immunosuppressant medication, start a dialogue with your health care provider to know if getting the vaccine is right for you.

It’s easy to get overwhelmed by the misleading and inaccurate information circulating online about COVID-19 so it’s important that you speak to a trusted physician who can give you a better idea of what your options are.

As always, we will be on the lookout for the latest updates regarding the COVID-19 vaccine so we can share and report trusted news as more information comes to light.

And if you’re looking to find easy and non-invasive ways to manage common arthritis symptoms, do check out our best-selling cotton compression gloves, ideal for osteoarthritis, rheumatoid arthritis, Raynaud’s phenomenon, carpal tunnel syndrome, Dupuytren’s contracture, psoriatic arthritis and even soft tissue and sport-related injuries.

What Are the Best Gloves for Raynaud’s Disease?

What Are the Best Gloves for Raynaud’s Disease?

Raynaud’s disease is a relatively common condition that affects your body’s ability to circulate blood to areas with thinner blood vessels – like your fingers and toes. Those that suffer from Raynaud’s disease often experience discomfort when they are cold or stressed, while the symptoms include numbness, throbbing pain, pins and needles, and more. If you live in a colder climate, you are likely more susceptible to bouts of the disease. If you have Raynaud’s, one of the best ways to avoid experiencing these symptoms is to wear gloves specifically made for the condition. By keeping your hands warm, you can live an unhindered and normal lifestyle. But with such a wide range of gloves available on the market for countless uses, whether it be skiing, general-purpose, or fashion, how do you choose the right pair?

Different choices on the market

Without knowing much about current Raynaud’s gloves on the market, you should be aware of more common types like skiing gloves, leather gloves and cotton. While these will definitely help with your Raynaud’s, they aren’t specifically designed to do so and will therefore have downsides. Ski gloves, for example, might keep you nice and warm – but they aren’t really suited for board meetings and other formal occasions where you want to make great first impressions. Cotton gloves, on the other hand, might lend themselves to looking a bit more stylish, but they will not keep you as warm as you need to be – especially if you live in a freezing cold climate. There are in fact, other options on the market that have battery-operated heaters embedded into the glove or are made to be microwaved prior to wearing them. All of these can be effective solutions but can also be a bit of a nuisance and effort to use properly.

Copper and silver gloves for Raynaud’s sufferers

Some of the best gloves for Raynaud’s disease sufferers are made out of copper and silver. There are several benefits associated with gloves made out of these materials. Firstly, they don’t have to be too thick, and therefore don’t inhibit your movement anywhere near as much as some other gloves with similar warming capabilities. Secondly, copper gloves and silver gloves, like those we sell at Dr. Arthritis, are great for keeping you warm as they reflect heat given from your hand back inside the glove. Developed by our doctors, our copper compression gloves are great for a number of conditions, including Raynaud’s and are made from 88% copper nylon and 12% spandex. Additionally, both silver and copper have antibacterial properties. Since people with Raynaud’s disease will want to wear the gloves throughout the day, this makes them one of the best choices as they won’t start smelling or become unhygienic. Our gloves also double up as compression gloves for those with arthritis and various injuries. This greatly helps with circulation, which is a vital aspect when it comes to the best gloves for sufferers of Raynaud’s disease. Better circulation means your hands will stay warmer and, combined with the reflective and warming properties of copper gloves, you will be living a much more comfortable life.

A mix between dexterity and warmth

As with all gloves, there is always a trade between dexterity and warmth. For some gloves, dexterity is not nearly as important as keeping warm – think about mittens. But try typing or use your smartphone with them, and you’ll soon give up. At Dr. Arthritis, we understand that those who need to wear gloves for Raynaud’s disease still need to go about their daily business unhindered. Our selection of copper compression gloves features both fingerless and fingered options, allowing you to choose what suits your needs the most.

So, what type of gloves should you choose?

In short, the answer depends on what you want to use them for. When it comes to gloves, there is always a trade-off between warmth, style, and dexterity. What you value the most will dictate which glove is best for you. However, for someone suffering from Raynaud’s disease, copper compression gloves are a clear winner when it comes to an all-rounded option that will provide relief from painful symptoms without hindering your quality of life.

Get in touch with us today

Browse our full range of gloves or supports for Raynaud’s disease and related conditions here. If you have any further questions or inquiries, don’t hesitate to get in touch with us today.

Dr. Arthritis Asks: How Do You Exercise When You Suffer From Chronic Pain?

Exercise is critical for easing arthritis pain and stiffness.

This may seem counterintuitive for anyone who deals with chronic joint pain. After all, it’s hard to get up and get moving when you can barely get yourself out of bed. But exercise when you have arthritis doesn’t mean you have to train for a marathon or follow a cross fit program. Simple, moderate exercise is enough to make a world of difference for your pain and maintaining your weight.

When Arthritis Threatens to Immobilize You, Exercise Can Help Keep You Moving

We get it, dealing with painful and stiff joints day in and day out because of arthritis makes exercise the very last thing that we want to do. However, lack of exercise can actually make your symptoms worse.

Keeping the muscles and surrounding tissue around your joints strong is essential to ensuring long term support for your bones. When you don’t exercise, these muscles weaken and that leads to additional stress on your joints. Additionally, lack of exercise makes it harder for arthritis sufferers to maintain a healthy weight, which is crucial for ensuring less stress on joints.

Finding the right exercise program and sticking to it can help you improve your overall health and fitness without aggravating your joints. Combined with a comprehensive treatment program, incorporating exercise into your daily routine can:

  • Strengthen muscles around your joints that help with flexibility and mobility
  • Help you maintain bone strength
  • Contribute to giving you more energy throughout the day
  • Help give you better quality sleep
  • Improve your balance
  • Help you control your weight
  • Help you manage your mood better
  • Enhance your quality of life

Work Closely With Your Doctor To Find the Right Exercise Program

Because you’re dealing with chronic pain, it’s important that you work closely with your healthcare team to learn how you can incorporate a consistent exercise program with your current treatment plan.

What types of exercises are best suited for you will depend on the kind of your arthritis that you suffer from and what joints are affected by your condition. A doctor or physical therapist can help determine what programs will maximize benefits while minimizing the stress on your joints.

  • Strengthening Exercises: To help strengthen muscles that are essential to supporting and protecting your joints, strengthening exercises such as weight training is crucial. Some tips to remember—avoid exercising the same muscle groups two days in a row, listen to your body and allow yourself to rest in between workouts. And if your joints are feeling extra stiff and swollen, it’s ok to take some extra time to rest. When it comes to strength-training, a three-day a week program is usually sufficient to help you jump-start a regimen that you can stick to long-term and start seeing results.
  • Aerobic Exercises: For overall fitness, aerobic exercise is great for improving cardiovascular health, controlling your weight, and helping you gain more stamina and energy despite your condition. Choose low-impact aerobic exercises that are easy on the joints—walking, cycling, swimming, or using an elliptical machine. Generally, the goal is to do 150 minutes of moderately intense aerobic exercise weekly, but it’s important to listen to your body and do only what you reasonably can. Don’t push yourself too much—the important thing is for you to safely carry out exercises that get you moving.
  • Range of Motion Exercises: These are exercises designed to help relieve stiffness in your joints and increase your flexibility by exercising their full range of motion. Usually, these are simple movements using gentle, repetitive sequences and can be done daily.

Remember, any movement, no matter how small can help if you have arthritis. Aerobic, range of motion, and strengthening exercises done along with your daily activities are essential to maintaining your flexibility and improving quality of life despite your arthritis.

If needed, using compression products for additional support can help when doing these exercises.

Some Tips To Help Protect Your Joints

It’s important that you slowly ease into your exercise routine and that you follow a program that’s sustainable for consistency. Don’t overdo it—especially if you haven’t been active for a while. Avoid overworking your muscles, which can only worsen your joint pain.

Keep the following in mind:

  • Keep it low impact—elliptical trainers, exercising in water, using recumbent bikes—all these help minimize stress on your joints while moving.
  • A hot compress can help relax your joints and muscles, even ease pain before you begin exercising. Remember, a hot pack should be warm, not hot. It should never at any point scald or burn you and should be applied for at least 10-20 minutes.
  • Allow your joints to gently warm up—you can start with range of motion exercises to prime your joints before moving on to more intense aerobic or strengthening exercises.
  • Apply a cold compress or ice bag after your exercise if needed, this can help prevent joint swelling.
  • Listen to your body and respect its boundaries. Don’t push yourself too much, there will be time to increase your intensity as you progress.

Dr. Arthritis Asks: Do You Experience Fatigue Because Of Your Arthritis?

Arthritis and Fatigue

Fatigue is an ever-present and persistent challenge when you have arthritis. While it can sometimes be caused by inflammation, arthritis disease activity or pain; it can also be caused by other contributing factors such as limited physical inactivity, sleep disruptions, depression, or weight changes.

Recognizing the possible causes of your fatigue is important as this will be critical to you regaining your vigor and managing your fatigue better, despite your illness. 

Here are some possible causes–

Medication Side Effects

Medications, including those that you may be taking for your arthritis are known to cause drowsiness and fatigue. Some DMARDs such as azathioprine and methotrexate, NSAIDs, blood pressure medication, and narcotic pain relievers are common culprits. Corticosteroids also contribute to fatigue because it tends to keep you up at night.

Limited Activity

Pain is a common symptom for arthritis patients. As a result, arthritis sufferers tend to hold back from physical activity. The more inactive you are however, the more overwhelming the feeling of exhaustion becomes. Unused muscles, including the heart muscle, can weaken, leading to you getting tired faster.

Anemia

Statistics say that up to two-thirds of arthritis sufferers also have a condition called anemia of chronic disease—which is caused by inflammatory chemicals interfering with the body’s natural production of red blood cells. A shortage of red blood cells can cause muscles to get tired easily, which leads to fatigue.

Lack of Sleep

Sleep is a challenge for many arthritis sufferers. The discomfort of swollen and stiff joints, chronic pain, and medication side effects tends to interfere with your ability to get restful and refreshing sleep. Sometimes, it can lead to insomnia that leads to fatigue.

Obesity

A combination of lack of physical activity and medication side effects often lead to weight gain and additional weight problems. This can sometimes contribute to fatigue.

Poor Nutrition

When you’re not getting enough healthy food and fluids, your body could experience vitamin deficiency and dehydration, which could manifest as fatigue.

Depression

Arthritis can take you away from doing a lot of things that you used to love. Additionally, the stress of dealing with a chronic illness can affect your hormones and brain activity that could lead to depression. One of the most telling signs of depression is fatigue.

 

Fatigue caused by arthritis can be unpredictable. It can start any time of the day, can sometimes last from the moment you wake up to when you end the night, an hour, or even for several days. When it does, you feel an extreme, sometimes overwhelming feeling of physical and mental tiredness—one that can’t be remedied by getting more rest or sleep.

A combination of lifestyle changes and medication can help you manage your fatigue better.

Medication

Anemia Medications

If your fatigue is being caused by anemia, additional iron supplements may help improve the symptoms of fatigue.

Sleep Aids

Sleeping pills could help promote better and more restful sleep, particularly if your fatigue is being caused by depression or insomnia. Talk to a trusted physician about what possible medications are available for you.

Vitamins

If your fatigue is caused by a poor diet, it’s likely that your fatigue is caused a vitamin deficiency. Speak to your doctor about it—they may be able to prescribe vitamins or supplements to help fill in nutritional gaps and boost your overall wellness and give you a boost of energy.

Psychoactive Medications

Talk to your doctor if you could potentially benefit from medications that are meant to increase energy.

 

Lifestyle Changes

Incorporate More Exercise In Your Daily Routine

Exercise can help build muscle mass, boost strength, improve blood circulation and flexibility—all of which are known to boost energy and minimize pain symptoms.

Drink Water Regularly

Dehydration is an often overlooked cause of fatigue. Be sure to get your fill of fluids daily.

Eat Better

Your body requires nourishment. Add plenty of fruits and greens in your diet and get adequate protein and healthy fats. Avoid sugary and high salt foods and start your day with meals that include lots of lean protein and complex carbohydrates to serve as a source of energy.

Meditate

If anxiety or depression is causing your fatigue, try meditation to help reduce stress and calm your thoughts.

Support Your Joints

Wearing joint supports (such as elbow supports and knee supports) and using tools when necessary can help ease the stress on your joints as well as ease the pain associated with your illness, thus helping with fatigue.

Take Breaks When You Need It

It’s important to remain active, but listen to your body and rest when you need it. Rest allows your muscles to recover and refuel for more activity.

 

Do you experience fatigue because of your arthritis? We’d love to hear from you. Join the conversation on our Instagram or Facebook or leave a comment below.