Management of rheumatoid arthritis may include dietary and lifestyle changes, prescription or over the counter anti-inflammatory medications, disease modifying anti-rheumatic medications, alternative medicines and therapies or all of the above. Doctors look at a patient's symptoms and other factors when diagnosing rheumatoid arthritis.

Tests including X-rays and blood tests may be used when diagnosing rheumatoid arthritis. A blood test may reveal the presence of the rheumatoid factor antibody, but it is not present in all people who have the disease, and it may also be present in people who have different diseases.

Therefore, diagnosing rheumatoid arthritis requires doctors to look at other factors. Treatment plans for the management of rheumatoid arthritis may begin before all tests are finalized, particularly those treatments that address pain and inflammation.

Diagnosing rheumatoid arthritis involves looking at a patient's symptoms. For instance, morning joint stiffness may be a symptom of rheumatoid arthritis or osteoarthritis; X-rays may help doctors determine which form of arthritis is present.

Osteoarthritis is a wearing away of the protective cartilage and changes in the fluid between the joints. On an X-ray, it may look like the individual bones of the joints are touching or much closer than they normally would be.

Rheumatoid arthritis is an inflammation of the fluid that normally lubricates and protects the joints, so on an X-ray the individual bones of the joint may look farther apart than normal. Except for the inclusion of disease modifying anti-rheumatic medications, management of rheumatoid arthritis and osteoarthritis is typically similar.

After diagnosing rheumatoid arthritis, the progression of the disease must be taken into consideration. If the management of rheumatoid arthritis is not successful in the early stages, joint deformities can occur, leading to disabilities and sometimes requiring surgery.

In the early stages, the symptoms are similar to osteoarthritis, except that osteoarthritis sometimes affects only one joint or only the joints on one side of the body, while rheumatoid arthritis typically begins with inflammation in the small joints (hands and/or feet) on both sides of the body. It is this symmetry of pain and inflammation that is one determining factor when diagnosing rheumatoid arthritis.

Even after diagnosing rheumatoid arthritis, doctors' opinions vary on how best to achieve management of rheumatoid arthritis, prevent the disease from progressing and put the disease into remission.

Some doctors recommend a strict diet that excludes grains, milk, nuts, beef and eggs. These foods are common allergens and food allergies have been reported to play a negative role in inflammatory diseases.

It is also believed that rheumatoid arthritis may be caused by a malfunction of the immune system and food allergies are believed to play a role in auto-immune diseases, as well. In several studies, patients who followed this diet reported an alleviation of symptoms for as long as five years. A diet like this may be an effective part of a treatment plan for the management of rheumatoid arthritis.

While some doctors turn only to prescription medications after diagnosing rheumatoid arthritis, some consider herbals, botanicals, vitamins and mineral supplements as a part of the long term management of rheumatoid arthritis. Vitamin and mineral supplements sometimes recommended for management of rheumatoid arthritis include zinc, copper, selenium, omega-6 and omega-3 fatty acids.

Herbals and botanicals sometimes advised for the management of rheumatoid arthritis include ginger root, bromelain, feverfew, turmeric and mangosteen rind or puree (an exotic fruit native to Southeast Asia).

Studies have shown that the last one, the mangosteen, harbors anti-inflammatory properties and the rind of the mangosteen fruit has been shown to contain Cox-2 inhibitors, which have powerful pain relieving and anti-inflammatory effects. Many people in the Western world are now turning to substances like the mangosteen because they naturally contain Cox-2 inhibitors, and many people report experience pain alleviation.

Indeed, Dr. J Frederic Templeman, M.D. states: "In most types of arthritis the majority of mangosteen's benefits will come from its anti-inflammatory effects because it blocks the COX enzymes that are pro-inflammatory."

After diagnosing rheumatoid arthritis, doctors now realize that anti-inflammatory medications can have harmful effects on the digestive systems and may recommend additional testing after treatment begins.

For example, Dr. Templeman briefly addresses this issue by pointing out "....mangosteen doesn't cause the dangerous gastrointestinal side effects of prescribed or over-the-counter anti-inflammatory drugs."

The health supplements and botanicals like ginger root and mangosteen may actually protect the digestive tract from damage. Indeed, they are often recommended by herbalists and naturalists for the treatment of heartburn and acid reflux.

Other recommendations for long term management of rheumatoid arthritis may include a regular exercise program, with regular rest periods. Exercising in water is particularly easy on and beneficial for the joints. Changes around the house, like replacing small drawer handles with larger ones, replacing round door knobs with the lever type and placing commonly used items on lower shelves may make life a little easier.

After diagnosing rheumatoid arthritis, only your doctor and you can make decisions about what treatment plans to include in the management of rheumatoid arthritis symptoms. Acupuncture, bee therapy and many other non-conventional therapies do exist.

Investigate and explore the many options that are out there and after consulting with your doctor, you decide.

For me, the daily use of natural alternatives like mangosteen made more sense in improving my health, but other people may decide differently.