While there are many types of arthritis, osteoarthritis is the most common form and affects more than 25 million Americans. Osteoarthritis, or OA, is due to the loss of the cartilage cushion that lines the joints, leading to joint pain, reduced range of motion, and occasionally swelling and deformity.
OA is more common as we age, more prevalent in women compared with men after the age of 55, and more likely to occur in people who are obese or in those who have a lot of stress on their joints. It also has a predilection for certain joints, especially the hips, knees, spine and hands.
When OA occurs in the hands, it can be difficult to carry on one’s usual daily activities and hobbies. Standard medical treatments for OA include pain medication, physical therapy and application of ice or heat to the joints; in more advanced osteoarthritis, joint injections and surgery are recommended.
Researchers have looked at a number of alternative therapies to help prevent or treat arthritis, and glucosamine and chondroitin are two popular supplements that have been studied a fair bit for their role in this regard. Glucosamine and chondroitin are both found naturally in the body as a component of the cartilage in our joints; they seem to stimulate the growth of healthy cells in the joints, and they may also inhibit the breakdown of cartilage.
A Cochrane review of the literature in 2005 suggested that glucosamine sulfate was very effective at reducing pain and improving function in people with OA of the knees, but the evidence for chondroitin has been less robust.
However, some recent data from Switzerland suggests that chondroitin may indeed help people with osteoarthritis, especially OA of the hands. In this study, researchers looked at the impact of chondroitin in people with significant pain and functional impairment from OA of the hands.
The scientists randomized 162 people with X-ray-confirmed hand arthritis to receive either 800 milligrams of chondroitin sulfate or a placebo daily for six months. At the end of the study, those people getting the chondroitin had less pain, better hand function and less morning stiffness compared with the group getting the placebo. There was no significant difference in the use of acetaminophen between the two groups. No adverse effects were reported for the chondroitin in this study.
Should you choose to try chondroitin or glucosamine for your arthritis, there are several things to be cautious about. Many chondroitin preparations are obtained from the tracheas (windpipes) of cows, and contamination with other bovine tissue could theoretically increase the risk of prion (“mad cow”) disease.
The good news is that algae-derived chondroitin is now available on the market, so this is probably a safer bet. The standard dose is 800-1,200 milligrams per day. A more serious concern with chondroitin is that some data suggest it may increase the risk or progression of prostate cancer, so men with prostate cancer or a strong family history of prostate cancer should avoid chondroitin completely.
Some glucosamine products are made from the shells of lobster, crab and shrimp, so anyone who is allergic to shellfish should look for a vegetarian product instead. Another concern with glucosamine is that it can interact with some prescription medications including coumadin and certain chemotherapy drugs; if you are taking any of these meds, talk with your doctor before taking glucosamine. The standard dose of glucosamine sulfate is 1,500 milligrams per day.
In addition to glucosamine and chondroitin, multiple other interventions are useful for osteoarthritis. Adequate levels of vitamins A, C, D, E and K may all help to prevent progression of OA, and an anti-inflammatory diet is probably useful as well. Maintaining a normal weight as you get older also will help to protect your joints. And finally, there are a number of other alternative remedies that can be very helpful for OA, including SAMe, ashwagandha, avocado/soybean unsaponifiables, boswellia, bromelain, cat’s claw, curcumin (turmeric), devil’s claw, ginger and willow. We’ll cover these in a future column.
Drs. Kay Judge and Maxine Barish-Wreden are medical directors of Sutter Downtown Integrative Medicine program in Sacramento, Calif. Have a question related to alternativemedicine? Email firstname.lastname@example.org.