DEAR DOCTOR K: I have rheumatoid arthritis. Medications have helped, but only up to a point. Can you discuss alternative therapies that might help to further relieve my discomfort?

DEAR READER: Rheumatoid arthritis (RA) is a long-term disease in which the body's immune system attacks healthy tissue lining the joints. This causes swelling, pain, redness and stiffness in joints throughout the body.

Drug treatments slow the effects of the disease, but alternative approaches can also help to reduce inflammation and relieve pain. I'll tell you what I know about the evidence for some of the more popular alternative therapies. Talk to your doctor before you try any of these.

- ACUPUNCTURE involves inserting tiny, sterile needles into the skin. It may relieve pain by releasing endorphins, the body's natural painkillers. The few studies of acupuncture for RA have had mixed results. If acupuncture is performed by experienced therapists who are careful to sterilize their needles, it may help, and it has little risk.

- MEDITATION. With mindfulness meditation, you are directed to focus your attention on the present moment. At least one study found that this type of meditation helped people with RA cope with pain.

- BIOFEEDBACK is a technique that helps you monitor and control your body's responses. Some evidence suggests that this may be helpful for pain relief in people with RA.

- RELAXATION TRAINING includes the technique of tensing certain muscles and then relaxing them. Relaxation training has been studied for RA, with mixed results.

- TAI CHI is a low-impact, slow-motion exercise that emphasizes breathing and mental focus. It involves moving continuously through a series of motions. Some small studies have not shown tai chi to improve joint pain, swelling or tenderness in people with RA. However, it did improve mood, quality of life and overall functioning.

- YOGA combines physical postures, breathing exercises and meditation. Some small studies have found that yoga improves physical function and helps relieve tender and swollen joints. People with RA should practice yoga cautiously to avoid placing too much stress on affected joints.

- FISH OIL. Omega-3 fatty acids, the primary fat found in cold-water fish (such as salmon, tuna, herring, sardines and mackerel), have anti-inflammatory properties. You can consume more omega-3 fatty acids by eating more fish or by taking fish oil supplements. Studies have found that fish oil supplements may help with tender joints and stiffness. They may also reduce the need for nonsteroidal anti-inflammatory drugs (NSAIDs).

However, fish oil supplements may increase the risk for bleeding, especially in people who take medications to prevent clotting. So if you are taking any such medications, check with your doctor before starting to take fish oil supplements.

With each of these alternative therapies some people did not have improved results. Unfortunately, your doctor has no way of knowing if you'll be one of the people who benefits. So if an approach that helps some people has little or no risk, it might be worth trying.

Dr. Komaroff is a physician and professor at Harvard Medical School. To send questions, go to AskDoctorK.com, or write: Ask Doctor K, 10 Shattuck St., Second Floor, Boston, MA 02115.