الفهرس 
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Abstract
Complementary and alternative medicine (CAM) consists of healthcare approaches currently not considered to be standard medical practice (Feldman et al., 2004).
Complementary and alternative medicine (CAM) includes a variety of diagnostic and therapeutic practices whose underlying theory or explanatory mechanisms do not conform to current medical thinking (Eskinazi, 1998).
Rheumatic diseases are chronic inflammatory diseases which are characterized by inflammation and loss of function of one or more connecting or supporting structures of the body. Swelling redness and/or heat and pain are symptoms of inflammation during rheumatic diseases. Rheumatic diseases especially affect joints, tendons, ligaments, bones, and muscles of the body. Internal organs are also involved in some rheumatic diseases. Pain, swelling, and stiffness are the common symptoms of rheumatic diseases. There are number of therapies to treat rheumatic diseases (Quandt et al., 2005).
People with RA may continue to have symptoms despite the use of conventional treatments, or they may have difficulties with side effects of beneficial treatments. Some add CAM to their treatment regimens in an effort to control pain and inflammation, improve physical function, or cope with the disease or side effects of treatment (Herman et al 2006).
In the treatment of rheumatic diseases, medication plays an important role. However, alternative therapies can also provide temporary pain relief and improve mobility in rheumatic diseases (Herman et al 2006).
In its various forms, CAM is enjoying a growing popularity among the public. Dissatisfaction with mainstream modern medicine particularly with regards to patient-physician relationship, concerns about the side effects of chemical drugs, and personal beliefs favouring a more holistic orientation to health care are often quoted as possible explanations (Coulter et al., 2004).
In recent years, patients with chronic rheumatic disorders are adopting complementary/alternative medicine (CAM) to help manage their chronic painful conditions. In previous reported arthritic studies, the prevalence of CAM was between the ranges of 33–90% (Klein et al., 2006).
CAM modalities include acupuncture, diets, herbal medicine, homoeopathy, massage and supplements(Trinh et al., 2007).
Acupuncture is defined as the stimulation of a certain point or points on the body, by the insertion of needles, to achieve a desirable effect. It is thought to prevent or modify the perception of pain or to alter physiologic functions, including pain control for the treatment of certain diseases or dysfunctions of the body ( Stux et al .,1995).
Acupuncture typically includes manual stimulation, electrical stimulation and heat stimulation of needles, Injection acupuncture, in which herbal extracts are injected into acupuncture points, are occasionally used as well. It is unclear which type of acupuncture produces the most beneficial effect (Ezzo et al., 2000)
Acupuncture helps in pain relieve and physical dysfunction to relieve muscle tightness. “Acupuncture and acupressure are effective for helping manage pain of osteoarthritis, but not for inflammatory arthritis like rheumatoid arthritis (White., ete al 2007)
Cupping is a method of relieving local congestion by applying partial vacuum that is created in a cup(s), either by heat or by suction. Cupping has been used for thousands of years. It was named after this practice as it refers to the surgical instrument that can scrape the skin to perform a style of cupping therapy. The practice of cupping therapy also dates back a long time in one of their leading medical journals, The Lancet. It was named after this practice as it refers to the surgical instrument that can scrape the skin to perform a style of cupping (Curtis, 2005).
Herbal medicine also called botanical medicine or phyto-medicine refers to using a plant’s seeds, berries, roots, leaves, bark, or flowers for medicinal purposes, they include Tripterygium wilfordii Hook, Plants contain gamma-Linolenic acid, Avocado/soybean unsaponifiables devil’s claw, Ginger, Articulin F, DuhuoJisheng Wan (DJW) , Glycine .
As defined by DSHEA, a dietary supplement is a product other than tobacco that is intended to supplement the diet and contains one of the following dietary ingredients: a vitamin, a mineral, an herb or other botanical, an amino acid Glucosamine,Chondroitin, Methylsulfonylmethane Omega 3-fatty acids Green tea and Vitamins.