Arthritis: Types, Symptoms, Diet and Lifestyle Treatment

Arthritis affects more than 500 million people worldwide, making it one of the most common causes of pain and disability (1). Yet many people living with arthritis are never told about one of the most powerful tools available to them: lifestyle.

This page covers what you need to know about arthritis — what it is, how it affects your body, which types exist, and what the latest science says about diet, movement, sleep, and stress as treatment tools. You will also learn about the Plants for Joints study: a clinical trial conducted by our team that demonstrated significant improvements in arthritis symptoms through a plant-based lifestyle program.

Whether you have just been diagnosed or have been living with arthritis for years, this guide will give you evidence-based, practical insights to help you take control of your health. Jump to the section that matters most to you.

Author: Professor Dirkjan van Schaardenburg, rheumatologist
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What Is Arthritis?

Arthritis is a term for joint inflammation. It is not a single disease but an umbrella term covering more than 100 conditions that cause pain, swelling, and stiffness in the joints. Arthritis can affect people of all ages and is one of the leading causes of disability worldwide.

The word arthritis comes from the Greek words arthron (joint) and itis (inflammation). While inflammation is a natural immune response, in arthritis this process becomes chronic — causing ongoing damage to the joints, surrounding tissues, and in some cases, other organs.

Arthritis is often misunderstood as a single condition affecting only older adults. In reality, it encompasses a wide spectrum of diseases, from autoimmune conditions like rheumatoid arthritis to a bone and cartilage disorder like osteoarthritis, metabolic disorders like gout, and many others.

What makes arthritis particularly significant is that chronic inflammation, the underlying mechanism in many forms of arthritis, is also strongly linked to cardiovascular disease, type 2 diabetes, and other medical conditions. This means that managing arthritis well has benefits that extend far beyond the joints.

Types of Arthritis

There are more than 100 types of arthritis. The most common and well-studied are described below. Although each type has distinct characteristics, they share a common feature: inflammation that affects the quality of daily life.

Rheumatoid Arthritis (RA)

Rheumatoid arthritis is an autoimmune disease in which the immune system mistakenly attacks the lining of the joints (the synovium). This causes painful inflammation that, over time, can erode bone and cartilage.

RA typically affects the joints symmetrically — meaning if one knee is affected, the other usually is too. It commonly involves the hands, wrists, and feet, but can also affect the eyes, lungs, and heart. RA affects approximately 0.5% of the global population and is two to three times more common in women than in men (2).

Key symptoms: morning stiffness lasting more than 30 minutes, warm and swollen joints, and fatigue. RA is a systemic condition — it can affect the whole body.

What research shows: Previous plant-based diet (3,4) or Mediterranean diet studies (5,6) were effective in reducing rheumatoid arthritis disease activity. The Plants for Joints clinical trial demonstrated that a plant-based lifestyle program significantly reduced disease activity in people with rheumatoid arthritis — results comparable to what is typically achieved with drug trials (7).

Osteoarthritis (OA)

Osteoarthritis is the most common form of arthritis and the leading cause of disability worldwide (8). It occurs when the protective cartilage that cushions the ends of bones becomes thinner and less flexible over time. Contrary to popular belief, osteoarthritis is not simply ‘wear and tear’ — it involves active inflammatory processes within the joint.

OA most commonly affects the knees, hips, spine, and hands. It tends to develop gradually and is more prevalent in people over 50, those with a higher body weight, and those with a history of joint injury. Approximately 10% of the population in Western countries is affected.

Key symptoms: joint pain that worsens with activity, stiffness after rest, reduced range of motion, and a grating sensation in the joint.

What research shows: A calorie-restricted diet with added vegetables combined with exercise was more effective for osteoarthritis than either alone (9). The Plants for Joints study found that a plant-based lifestyle program led to a statistically significant and clinically relevant decrease in pain, stiffness, and improvement in physical function in people with osteoarthritis (10).

Gout

Gout is caused by a build-up of uric acid in the body, which forms crystals that deposit in and around joints — most commonly the big toe, ankles, and knees. This causes sudden, severe attacks of pain, redness, and swelling. Risk factors for gout include male sex, obesity, high uric acid blood level, decreased renal function and uric acid retaining medications, Gout is also strongly linked to diet, particularly high consumption of red meat, seafood, alcohol, and sugar-sweetened beverages.

What research shows: According to a systematic review, reduction of uric acid has been achieved with calorie-restricted, purine-restricted and Mediterranean diets (11). A plant-based diet is generally low in purines (the compounds that break down into uric acid) and has been associated with lower uric acid levels. Research from the Plants for Health team found that a whole-food plant-based diet reduced uric acid levels and participants reported fewer and less severe gout attacks (12).

→ Read more about gout and diet

Psoriatic Arthritis

Psoriatic arthritis affects 20-30% of people who have psoriasis, the skin condition characterised by red, scaly patches (13,14). It causes joint pain, stiffness, and swelling, and can affect any joint in the body. Like rheumatoid arthritis, it is an autoimmune condition with a strong inflammatory component.

What research shows: There is some (weak) evidence from observational studies that adherence to a Mediterranean or plant-based dietary pattern is associated with lower disease activity in psoriatic arthritis. Clinical trials have only shown lower disease activity associated with weight loss after a hypocaloric diet (15,16).

Several case reports describe patients who achieved remission after adopting a plant-based diet, but this is only considered as an indication, not as scientific evidence.

Other Types

Other significant forms of arthritis include:

Ankylosing Spondylitis — primarily affects the spine and sacroiliac joints, but also other joints such as hips and knees
Juvenile Idiopathic Arthritis — arthritis in children under 16
Crystal-induced arthritis – other types than gout
Reactive Arthritis — triggered by an infection elsewhere in the body
Lupus (Systemic Lupus Erythematosus) — an autoimmune disease affecting joints, skin, kidneys, and other organs

Arthritis Symptoms: What to Look For

The most common arthritis symptoms are: joint pain, stiffness (especially in the morning), swelling around the joints, reduced range of motion, warmth and redness around affected joints, and fatigue. Symptoms can range from mild to severe and may come and go in flares.

Symptoms vary significantly depending on the type of arthritis. However, most forms share a core set of joint-related complaints:

Symptom	Description	Most common in
Joint pain	Aching, burning, or sharp pain in and around the joint	All types
Stiffness	Difficulty moving a joint, especially after rest or in the morning	RA, OA, Psoriatic
Swelling	Fluid accumulation or capsule thickening causing visible puffiness around joints	RA, OA, Psoriatic
Warmth & redness	Joint feels warm and looks red due to inflammation	RA, OA
Reduced mobility	Difficulty bending, gripping, or walking	OA, RA
Fatigue	Persistent tiredness not relieved by rest	RA, Lupus, Psoriatic
Morning stiffness	Stiffness lasting more than 30 min after waking	RA (hallmark symptom)
Systemic symptoms	Fever, weight loss, organ involvement	RA, Lupus

If you experience persistent joint pain or swelling lasting more than a few weeks, it is important to consult a doctor. Early diagnosis and treatment — including lifestyle changes — can slow disease progression and significantly improve quality of life.

What Causes Arthritis?

Arthritis does not have a single cause. Most forms develop through a combination of genetic predisposition, immune system dysfunction, lifestyle factors, and environmental triggers. The good news is that several of these factors — particularly lifestyle — are within your control.

Genetic factors

Certain genes increase the risk of developing arthritis. For rheumatoid arthritis, the HLA-DRB1 gene is a well-established risk factor. For osteoarthritis, genes related to cartilage structure and inflammatory response play a role. However, having these genes does not mean you will develop arthritis — environmental factors including lifestyle determine whether the genetic risk is expressed.

Immune system dysregulation

In autoimmune forms of arthritis (such as RA, psoriatic arthritis, and lupus), the immune system mistakenly attacks the body’s own tissues. What triggers this malfunction is not fully understood, but chronic low-grade inflammation appears to play an underlying promoting role. One inciting mechanism may be that the immune system is activated by microorganisms that contain parts of proteins that are identical to parts of proteins in human tissue.

Chronic low-grade inflammation

Many forms of arthritis share one key underlying mechanism: chronic low-grade inflammation. This is a state in which the immune system is continuously mildly activated — not enough to cause a fever, but when present over several years may disrupt balancing mechanisms and cause disease.

Research shows that diet, physical activity, sleep quality, and stress levels all directly influence the body’s inflammatory state (17). This is why lifestyle plays such an important role in both the prevention and management of arthritis.

Lifestyle and environmental factors

Most important factors:

Diet: High intake of processed foods, red meat, sugar, alcoholic beverages and trans fats promotes inflammation; plant-rich diets reduce it
Body weight: Excess weight increases mechanical stress on joints and promotes systemic inflammation
Physical inactivity: Sedentary behaviour is associated with higher inflammatory markers
Stress: Prolonged high levels of stress increase the risk for rheumatoid arthritis and lupus
Smoking: A significant risk factor for rheumatoid arthritis
Industrial silica and cotton dust inhalation are risk factors for rheumatoid arthritis
Previous joint injury: Increases risk of osteoarthritis in the affected joint
Age and sex: Risk increases with age; RA is more common in women, gout in men

Can Diet Help Arthritis? What the Research Shows

Yes — diet has a measurable impact on arthritis. Several clinical trials show that a plant-based or anti-inflammatory diet can reduce joint pain, lower inflammatory markers in the blood, improve physical function, and in some cases reduce the need for medication. Diet alone cannot cure arthritis, but it is a powerful complementary treatment.

The connection between diet and arthritis works primarily through inflammation. What you eat directly affects the level of chronic low-grade inflammation in your body — the same inflammation that drives arthritis symptoms and disease progression.

The inflammation connection

Certain foods promote inflammation by activating inflammatory pathways, increasing oxidative stress, and altering the composition of microorganisms living in the gut, the “microbiome”. Other foods actively reduce inflammation by providing antioxidants, omega-3 fatty acids, fibre, and phytochemicals that modulate immune function.

This is not a new or fringe idea. The relationship between diet and systemic inflammation is well-established in the scientific literature and forms the basis of major dietary guidelines for chronic disease prevention.

What major studies have found

A systematic review of 24 studies found that plant-based diets significantly reduced C-reactive protein (CRP) — a key inflammatory marker — compared to control diets (18). Although this supports the idea that diet helps to dampen inflammation, the reduction is limited and the clinical relevance is uncertain.
A recent systematic review and metaanalysis of observational studies of healthy dietary patterns concluded that these healthy dietary patterns are protective against developing rheumatoid arthritis (19). The studies included anti-inflammatory diet, Mediterranean diet and Healthy Eating Index, which are all high in fruits, vegetables, legumes, whole grains, nuts, seeds and fatty fish and low in meat and dairy products.
Guidelines of the American and French rheumatology societies recommend the Mediterranean diet for arthritis, whereas the European Alliance of Rheumatology Associations (EULAR) does not (20-22).
The Plants for Joints clinical trial (our own research, which was published after the abovementioned guidelines) demonstrated that a whole-food plant-based lifestyle program significantly reduced disease activity in RA and reduced pain and stiffness in osteoarthritis — results comparable to medication trials (7,10).

The Plants for Joints study is particularly significant because it was a randomised controlled trial (RCT) — the gold standard in medical research. 77 people with RA and 64 with osteoarthritis participated. The lifestyle intervention group showed significantly better outcomes across multiple measures compared to the group receiving standard care alone.

→ Read the full details of the Plants for Joints study

The Anti-Inflammatory Diet for Arthritis

An anti-inflammatory diet is not a strict protocol — it is a dietary pattern that consistently favours foods that lower inflammation and limits foods that promote it. The plant-based dietary approach used in the Plants for Joints program is one of the most evidence-based anti-inflammatory diets available.

Core principles of the anti-inflammatory diet

Maximise whole plant foods: vegetables, fruits, legumes, whole grains, nuts, and seeds
Minimise ultra-processed foods: ready meals, packaged snacks, refined grains, and added sugars
Reduce or eliminate animal products, particularly red and processed meat. Fatty fish is often recommended because of its high omega-3 content, but also contains toxic heavy metals
Include omega-3 rich plant foods: flaxseed, walnuts, chia seeds, hemp seeds
Use extra virgin olive oil as the primary fat
Limit alcohol, particularly beer and spirits
Stay well hydrated with water and herbal teas

This pattern aligns closely with what the Plants for Health program teaches: a whole-food, plant-based (WFPB) approach that is practical, sustainable, and backed by clinical evidence.

Foods to Avoid with Arthritis

The foods most strongly linked to inflammation include: red and processed meat, ultra-processed foods, sugar and refined carbohydrates, trans fats, excessive alcohol, and foods high in omega-6 fatty acids. Avoiding or significantly reducing these foods can lower inflammation and reduce joint pain.

Food to avoid	Why it worsens arthritis	Better alternative
Red meat (beef, pork, lamb)	High in saturated fat and arachidonic acid — promotes inflammatory pathways	Legumes, lentils, tofu, tempeh
Processed meat (bacon, sausages)	Contains nitrites, saturated fat, high sodium — strongly pro-inflammatory	Plant-based protein sources
Ultra-processed foods	High in additives, trans fats, refined carbs — disrupt gut microbiome and promote inflammation	Whole, unprocessed plant foods
Sugar and refined carbs, including packaged fruit juice	High in additives, trans fats, refined carbs — disrupt gut microbiome and promote inflammation	Whole grains, whole fruits, sweet potato
Trans fats (margarine, fast food)	Directly increase inflammatory markers (TNF-alpha, IL-6)	Extra virgin olive oil, avocado
Alcohol (especially beer)	Increases uric acid (worsens gout), promotes systemic inflammation	Water, herbal/green/black tea, kombucha, coffee
Dairy products (for some)	Some people with RA report symptom improvement when reducing dairy	Plant-based milk alternatives
Excessive salt	Promotes water retention and inflammation	Plant-based milk alternatives
Dairy products	Some people with RA report symptom improvement when reducing dairy	Plant-based milk alternatives (preferably soy)

It is worth noting that not all foods affect all people equally. Some individuals with arthritis notice significant symptom improvement when eliminating specific foods (such as dairy or gluten), while others do not. Keeping a food diary can help you identify your personal trigger foods.

Foods That Help Arthritis

The foods most strongly linked to reduced arthritis inflammation include: leafy green vegetables, berries, fatty plant sources (walnuts, flaxseed), legumes, whole grains, olive oil, turmeric, ginger, and green tea. These foods provide antioxidants, omega-3 fatty acids, and polyphenols that directly counter inflammation.

Top anti-inflammatory foods for arthritis

Food	Active compounds	How it helps arthritis
Leafy greens (spinach, kale, chard)	Vitamin K, antioxidants, folate	Reduce oxidative stress
Berries (blueberries, strawberries, cherries)	Anthocyanins, vitamin C	Reduce CRP and joint inflammation
Walnuts	ALA omega-3, polyphenols	Lower inflammatory cytokines
Flaxseed (ground)	ALA omega-3, lignans	Reduce systemic inflammation
Legumes (beans, lentils, chickpeas)	Fibre, protein, antioxidants	Feed anti-inflammatory gut bacteria
FatigueWhole grains (oats, brown rice, quinoa)	Fibre, B vitamins	Reduce CRP levels
Extra virgin olive oil	Oleocanthal (acts like ibuprofen)	Directly inhibits inflammatory enzymes
Turmeric	Curcumin	Inhibits NF-kB inflammatory pathway
Ginger	Gingerols, shogaols	Reduce prostaglandins that cause joint pain
Green tea	EGCG catechins	Suppress inflammatory cytokines
Garlic and onions	Allicin, quercetin	Anti-inflammatory and antioxidant effects
Tofu and tempeh	Plant protein, isoflavones	Anti-inflammatory; replaces pro-inflammatory meat protein

A practical way to apply this: build each meal around a base of leafy greens or other vegetables, add a source of plant protein (legumes, tofu), include a portion of whole grains, and dress with olive oil and herbs such as turmeric and ginger. This is essentially the dietary pattern used in the Plants for Joints program.

Lifestyle Changes That Reduce Arthritis Symptoms

Diet is just one piece of the puzzle. While rigorous head-to-head comparisons of combined versus single lifestyle interventions remain scarce, it stands to reason that addressing nutrition, physical activity, sleep, and stress management together is more powerful than any single approach alone. This integrated perspective is the foundation of the Plants for Health program

1. Nutrition: An anti-inflammatory dietary pattern

As described above, a whole-food, plant-based diet is the most evidence-based dietary approach for reducing arthritis inflammation. The Plants for Joints study showed that participants following this dietary pattern experienced significant reductions in disease activity (RA) and pain and stiffness (OA) after just four months.

The key is not perfection but consistency. Small, sustained changes — such as replacing meat with legumes three evenings a week, adding berries to breakfast, and switching refined grains for whole grains — accumulate into significant anti-inflammatory effects over time.

2. Physical activity: Movement as medicine

It may seem counterintuitive to exercise with painful joints, but regular physical activity is one of the most effective treatments for arthritis. Exercise reduces inflammation, strengthens the muscles that support joints, improves mobility, and boosts mood and energy.

Low-impact aerobic exercise (walking, swimming, cycling) for 150 minutes per week
Resistance training to build muscle strength around affected joints
Flexibility and balance exercises (yoga, tai chi) to reduce stiffness and fall risk
Start gently and gradually increase — even 10 minutes of walking daily makes a difference

The key is to choose activities you enjoy and to move in a way that respects your current limitations while gently expanding them. As a rule of thumb, if an increase of pain after exercise does not subside within one day, you should exercise more gently.

3. Sleep: The underestimated recovery tool

Poor sleep and arthritis have a bidirectional relationship: arthritis pain disrupts sleep, and poor sleep worsens pain and inflammation. Chronic sleep deprivation increases levels of inflammatory cytokines including IL-6 and TNF-alpha — the same molecules that drive arthritis.

Aim for 7-9 hours of sleep per night
Maintain a consistent sleep schedule — go to bed and wake at the same time daily
Optimise your sleep environment: cool, dark, and quiet
Limit screen exposure in the hour before bed
Discuss pain management with your doctor if pain is preventing sleep

4. Stress management: Calming the immune system

Chronic psychological stress activates the hypothalamic-pituitary-adrenal (HPA) axis and increases cortisol levels, which over time promotes systemic inflammation. For people with autoimmune arthritis, stress can directly trigger flares.

Mindfulness meditation: even 10 minutes daily has measurable effects on inflammatory markers
Breathing exercises: slow, deep breathing activates the parasympathetic nervous system
Nature exposure: spending time outdoors reduces cortisol and promotes wellbeing
Social connection: meaningful relationships buffer the physiological impact of stress
Professional support: cognitive behavioural therapy (CBT) is evidence-based for chronic pain

The Plants for Joints Study: What We Found

The Plants for Joints study is a randomised controlled trial (RCT) — the gold standard in medical research — conducted by our team of doctors and researchers. It is one of the few clinical trials to rigorously test the effect of a comprehensive lifestyle program on arthritis outcomes.

Study design

141 participants: 77 with rheumatoid arthritis, 64 with osteoarthritis
Randomly assigned to the Plants for Joints lifestyle program or standard care (control group)
4-month programme: 10 group sessions covering plant-based nutrition, exercise, sleep, and stress management
Measurements taken at baseline, midway, and end of programme
Outcomes measured: disease activity, pain, stiffness, physical function, blood markers, body composition

Key results

Rheumatoid arthritis: disease activity decreased significantly in the lifestyle programme group compared to the control group. The effect size was comparable to what is typically achieved in pharmaceutical drug trials. Osteoarthritis: Statistically significant and clinically relevant decreases in pain and stiffness, and improvements in physical function compared to the control group. Both conditions: Improvements in body weight, waist circumference, cholesterol levels, blood sugar levels, and inflammatory markers.

These results demonstrate that lifestyle change is not a soft alternative to medical treatment — it is a clinically meaningful intervention that can produce outcomes equivalent to medication, without side effects.

The programme has since been published in peer-reviewed scientific journals and presented at international rheumatology conferences. The Plants for Health lifestyle programme is the direct translation of this research into an accessible, online programme.

The Plants for Health Lifestyle Programme for Arthritis

The Plants for Health Lifestyle Programme is the only online lifestyle programme for arthritis based on a published, peer-reviewed clinical trial. Developed by doctors, dietitians, and researchers — and designed to fit into your daily life.

If you are living with rheumatoid arthritis, osteoarthritis, gout, or another chronic inflammatory condition, the Plants for Health programme gives you the knowledge, tools, and support to make lasting lifestyle changes — step by step, at your own pace.

What the programme includes:

A personalised plant-based nutrition approach — practical, not restrictive
Movement guidance tailored to your condition and fitness level
Sleep optimisation tools
Stress reduction techniques with proven effects on inflammation
Scientific knowledge explained in accessible language
Support from a team of doctors, dietitians, and health coaches
Flexible, fully online — follow at your own pace

→ Discover the Plants for Health Lifestyle Programme

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Frequently Asked Questions About Arthritis

What is the difference between arthritis and rheumatoid arthritis?

Arthritis is a broad term covering more than 100 conditions that cause joint pain and inflammation. Rheumatoid arthritis (RA) is one specific type of arthritis — an autoimmune disease in which the immune system attacks the joint lining. The key difference is that osteoarthritis (the most common type) is primarily a joint condition affecting the thickness and quality of cartilage, while rheumatoid arthritis is an autoimmune disease that can affect the whole body.

Can arthritis be cured naturally?

There is currently no cure for most forms of arthritis. However, lifestyle changes — including a plant-based anti-inflammatory diet, regular exercise, quality sleep, and stress management — can significantly reduce symptoms, lower inflammatory markers, and in some cases reduce the need for medication. The Plants for Joints clinical trial showed results comparable to drug trials through lifestyle intervention alone.

What foods are bad for arthritis?

The foods most strongly linked to increased arthritis inflammation are: red and processed meat, ultra-processed foods, sugar and refined carbohydrates, trans fats, excessive alcohol, and foods high in omega-6 fatty acids such as sunflower and corn oil. Reducing or eliminating these foods can help lower systemic inflammation and reduce joint pain.

What is the best diet for arthritis?

The best-evidenced dietary pattern for arthritis is a whole-food, plant-based diet — rich in vegetables, fruits, legumes, whole grains, nuts, and seeds, and low in processed foods and animal products. This dietary pattern has been shown in multiple clinical studies, including the Plants for Joints RCT, to reduce inflammation, improve joint symptoms, and support overall health.

Does a plant-based diet help arthritis?

Yes. Multiple studies, including the Plants for Joints randomised controlled trial, have shown that a plant-based diet can significantly reduce arthritis symptoms. In the Plants for Joints study, participants following a whole-food plant-based lifestyle programme experienced significantly lower disease activity (RA) and significant reductions in pain and stiffness (OA) compared to those receiving standard care alone.

What vitamins help arthritis?

Several vitamins and nutrients have evidence supporting their role in arthritis management: Vitamin D (supports immune regulation; many arthritis patients are deficient), Vitamin K2 (important for bone health), Omega-3 fatty acids (reduce inflammatory cytokines), Vitamin C (antioxidant; supports collagen synthesis in joints), Magnesium (anti-inflammatory; supports muscle and joint function), and B12 (especially important on a plant-based diet). It is best to obtain these through a nutrient-rich diet where possible, supplementing only where there is a demonstrated deficiency (only B12 suppletion is unavoidable).

Can exercise make arthritis worse?

Appropriate exercise does not worsen arthritis — in fact, it is essential for a healthy joint and one of the most effective treatments for arthritis symptoms. The key is choosing low-impact activities (walking, swimming, cycling, yoga) that do not place excessive stress on affected joints. Starting gently and gradually increasing intensity is important. High-impact activities like running may need to be adapted for people with severe joint damage. Exercise reduces inflammation, strengthens muscles that support joints, and improves mobility and mood.

Is arthritis hereditary?

Genetic factors do influence arthritis risk — certain genes increase susceptibility, which vary between different types of arthritis. However, genetics is not destiny. Lifestyle factors including diet, physical activity, body weight, and smoking have a significant impact on whether genetic risk is expressed. This is why lifestyle intervention is considered a core component of arthritis prevention and management, regardless of family history.

Can arthritis go away on its own?

Most forms of arthritis are chronic conditions that do not disappear on their own. However, symptoms can go into remission — a state of significantly reduced or absent disease activity. Remission is most commonly achieved through a combination of medical treatment and lifestyle change. Some people with reactive arthritis (triggered by infection) or with subtypes of rheumatoid arthritis (especially those without RA-specific antibodies in the blood) do experience complete resolution over time.

What is the fastest way to reduce arthritis inflammation?

While there is no instant solution, the approaches with the fastest measurable impact on arthritis inflammation include: eliminating the most pro-inflammatory foods (processed meat, refined sugar, ultra-processed foods), adding omega-3 rich foods (walnuts, flaxseed, chia seeds), and beginning gentle daily movement. Fasting has shown effect as well. Anti-inflammatory medications can also reduce inflammation quickly, and are often used alongside lifestyle changes rather than instead of them. Discuss your options with your rheumatologist or GP.