• Dietary Supplements For Osteoarthritis

    Osteoarthritis imageOsteoarthritis (OA) is one of the most common forms of arthritis and can lead to chronic pain and disability.

    Joint Wear and Tear

    Degenerative joint disease, another term for OA, is a better description of the process of wear and tear that gradually softens and breaks down the joint cartilage that normally prevents bones from rubbing together. X-rays of osteoarthritic joints often show narrowing of the joint space and destructive changes in the adjacent bone.
    Patients with OA generally complain of joint pain and stiffness, particularly after physical activity. The hips, knees, ankles, and spine are susceptible to OA since they absorb the brunt of gravitational forces. The fingers and neck are also prone to OA.

    Cartilage Health

    Joint cartilage is made up of cells, called chondrocytes, embedded in a substance called the extracellular matrix. One of the primary components of this matrix is a material called proteoglycan. This material helps cartilage absorb the forces of friction.
    With normal aging, the proteoglycan content of the matrix decreases. This decrease can be accelerated by injury, excessive mechanical force, or joint deformity. This explains why certain occupations, like machine operators and athletes, become disabled from OA sooner than the rest of us. It also explains why obesity, which adds considerable stress to joints of the lower extremities, greatly increases the risk of OA, particularly in the knees.
    Even after OA begins to set in, there is evidence that regular exercise can delay or prevent the onset of pain and disability. Aerobic activity protects against obesity, while weight training enhances the strength and flexibility of the muscles, tendons, and ligaments around the joints, which improves joint stability and resilience. Keep in mind that acute injuries and repetitive strain increase the risk of OA. Therefore, exercise is only beneficial to joint health if it is done gradually and with proper preparation and equipment.

    Treating Osteoarthritis

    Standard treatments for symptomatic OA include:
    • Physical therapy to increase the strength and flexibility of affected joints
    • Prescription or nonprescription pain medicine (eg, nonsteroidal anti-inflammatory drugs)
    • Injections of more powerful anti-inflammatory steroid medicine into the joint
    • Joint replacement surgery
    Although often effective at relieving pain, these interventions do nothing to slow or reverse the deterioration of cartilage. Therefore, researchers have turned their attention to two natural constituents of human cartilage thought to preserve, or even enhance, cartilage integrity—glucosamine and chondroitin.

    Glucosamine and Chondroitin

    Glucosamine and chondroitin are thought to stimulate the production of proteoglycan and stop its breakdown. Glucosamine is derived from the exoskeletons of shrimp, lobster, and crabs. Chondroitin is manufactured from natural sources, such as shark and bovine cartilage.
    Numerous clinical studies have evaluated the effectiveness of these supplements in treating OA of the knee and hip. Some studies have shown glucosamine and/or chondroitin to be moderately more effective than a placebo, with no significant side effects. However, more recent studies have not shown these supplements to be effective. In fact, many of the studies that had positive results were funded by manufacturers of these products. Studies done by neutral researchers failed to find benefits.

    Other Supplements for OA

    Glucosamine and chondroitin are not the only natural products that have been tried as possible treatments for OA. Researchers have studied many other supplements, like:
    • S-adenosylmethionine (SAMe)–There is some evidence that SAMe may relieve the symptoms of arthritis and be as effective as anti-inflammatory medicine.
    • Avocado/soybean oil extracts–The results so far are promising for these extracts in treating OA.
    • Cetylated fatty acids—These naturally occurring fatty acids, which are available as an oral supplement and a cream, have also shown some promise.

    Your Next Move

    If you are interested in trying a natural approach to relieve OA, make an appointment with your doctor. This is an important step because, in some cases, supplements may interact with other medicines that you are taking or affect other conditions that you may have. Also, since these types of products are not regulated by the US Food and Drug Administration (FDA), it is difficult to know the purity of the supplement. Keep in mind, too, that researchers continue to study ways to help people find relief from joint pain and stiffness, so a new treatment may be discovered!

    RESOURCES

    Arthritis Foundation http://www.arthritis.org/

    National Center for Complementary and Alternative Medicine http://nccam.nih.gov/

    CANADIAN RESOURCES

    The Arthritis Society http://www.arthritis.ca/

    Seniors Canada On-line http://www.seniors.gc.ca/

    References

    10 ways you can protect your joints. Arthritis Foundation website. Available at: http://www.arthritis.org/protect-your-joints.php. Accessed June 5, 2012.

    Osteoarthritis. EBSCO Natural and Alternative Treatments website. Available at: http://www.ebscohost.com/healthLibrary/. Updated May 23, 2012. Accessed June 5, 2012.

    Osteoarthritis: what causes it? Arthritis Foundation website. Available at: http://www.arthritis.org/disease-center.php?disease%5Fid=32&df=causes/. Accessed June 5, 2012.

    What are the effects? Arthritis Foundation website. Available at: http://www.arthritis.org/disease-center.php?disease%5Fid=32&df=effects. Accessed June 5, 2012.

    What can you do about OA? Arthritis Foundation website. Available at: http://www.arthritis.org/what-can-you-do-about-osteoarthritis.php. Accessed June 5, 2012.

    10/15/2010 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php: Wandel S, Jüni P, Tendal B, et al. Effects of glucosamine, chondroitin, or placebo in patients with osteoarthritis of hip or knee: network meta-analysis. BMJ. 2010;341:c4675.

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