Osteoarthritis And Joint Degeneration
Osteoarthritis occurs when the cartilage on the ends of the joints wears down and the exposed bones rub together. This degenerative process causes excess friction in the joints, which leads to loss of motion, stiffness and joint pain. Osteoarthritis is more common among middle-aged and older individuals. Symptoms can range from mild to very severe pain in the back, neck, hands, hips, knees, and/or feet.
When degenerative osteoarthritis occurs in the back, it is usually referred to as facet joint osteoarthritis .
Glucosamine and chondroitin sulfate are believed to impact the cartilage degeneration process of osteoarthritis in the following ways:
What Is The Role Of Glucosamine And Chondroitin Sulfate In The Treatment Of Osteoarthritis
Glucosamine and chondroitin sulfate have been used in Europe for many years and continue to be popular with patients worldwide. In the United States, however, the glucosamine/chondroitin arthritis intervention trial reported, at best, limited benefit from glucosamine , chondroitin sulfate , or the combination of the 2 in patients with knee osteoarthritis.
In GAIT patients overall, glucosamine and chondroitin sulfate alone or in combination did not reduce pain effectively at 24 weeks, but in patients with moderate-to-severe pain at baseline, the rate of response was significantly higher with combined therapy than with placebo . At 2 years, no treatment achieved a clinically important difference in loss of joint-space width, though treatment effects on Kellgren-Lawrence grade 2 knees showed a trend toward improvement relative to the placebo group.
The AHRQ comparison found no clear difference between glucosamine or chondroitin and oral NSAIDs for relieving pain or improving function. However, the AHRQ observed that most trials showing therapeutic benefits from glucosamine used pharmaceutical-grade glucosamine that is not available in the United States, noting that the trial findings may therefore be inapplicable to currently available over-the-counter preparations.
Osteoarthritis Fact Sheet. Centers for Disease Control and Prevention. Available at . January 10, 2019 Accessed: February 7, 2020.
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More Study Needed But A Positive Beginning
I think this is an interesting study, which will hopefully lead to a new interventional option for patients who havent had satisfactory results from conventional therapy alone. We know placebo effect is high with glucosamine, yet we can account for this with novel questionnaires to address individual patient beliefs. I will be interested to see additional longer-term studies showing sustained benefit and safety while accounting for the placebo effect. This study shows it is safe, effective, and may be a good option for patients in addition to therapy. Or maybe we can eventually try glucosamine sulfate prior to NSAIDs or acetaminophen, which have reported side effects, says Dr. Botto-van Bemden.
Glucosamine And Chondroitin For Arthritis: Benefit Is Unlikely
Osteoarthritis , the most widespread type of arthritis, is a degenerative disease of the joints. Although sometimes capable of causing acute inflammation, it is most commonly a wear-and-tear disease involving degeneration of joint cartilage and formation of bony spurs within various joints. Trauma to the joints, repetitive occupational usage, and obesity are risk factors. Most people over 60 years of age have this affliction to some extent, with approximately 16 million sufferers requiring medical care. The main goal of treatment is to relieve pain.
Glucosamine and chondroitin have been widely promoted as a treatment for OA. Glucosamine, an amino sugar, is thought to promote the formation and repair of cartilage. Chondroitin, a carbohydrate, is a cartilage component that is thought to promote water retention and elasticity and to inhibit the enzymes that break down cartilage. Both compounds are manufactured by the body. Glucosamine supplements are derived from shellfish shells chondroitin supplements are generally made from cow cartilage.
The above-mentioned report was accompanied by an editorial which concluded:
In 2001, Consumer Reports evaluated 19 products and reported:
In 2001, Vital Nutrients recalled two products that had been found to contain aristolochic acid, a substance that can cause kidney toxicity and cancer .
The Bottom Line
Exercise May Help Knees More Than Glucosamine And Chondroitin
With osteoarthritis, knees become swollen and stiff, and cartilage can degenerate. Ted Kinsman/Science Sourcehide caption
If youre among the estimated 27 million Americans who suffer from osteoarthritis of the knee or hip, then perhaps youve tried the nutritional supplements glucosamine and chondroitin. Theyve been marketed for joint health for about 20 years, and sales are still brisk. But do they help?
Some horses might say yes. The supplements were first tried in horses, and theres some evidence that the supplements might improve joint function for them.
Glucosamine and chondroitin are also marketed to dog owners. But what about us humans? Unfortunately, researchers say that for us the results just dont match the glowing testimonials.
It would seem to make sense that glucosamine and chondroitin could help. Theyre both natural substances found in cartilage, that hard connective tissue that pads joints.
Glucosamine is an amino sugar that may help renew cartilage, and chondroitin sulfate is a complex carbohydrate that is thought to help cartilage retain water. Arthritis causes pain, swelling and stiffness in joints and damages cartilage over time. So the thought was maybe extra glucosamine and chondroitin could help maintain and even repair the damage.
The vast majority of patients reported no significant difference in pain relief between glucosamine, chondroitin, a combination of the two and placebo.
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Ra Treatment: Do Glucosamine And Chondroitin Really Work
If youre living with Rheumatoid Arthritis , you are no stranger to the pain associated with this condition. Stiffness, swelling, and tenderness in the joints. Back and muscle pain. Whole body fatigue, anemia, skin blemishes/redness, dry mouth, pins and needles sensations. Rheumatoid arthritis affects the whole body. And those that suffer from this chronic condition are seeking relief using a variety of compounds to limit or prevent inflammation.
< h3> Pain Relief via Supplements< /h3>
Glucosamine and Chondroitin Sulfate are compounds that work together to treat inflammation due to arthritis as found in RA and osteoarthritis. Glucosamine is key to cartilage formation and maintenance and is manufactured from shellfish. Chondroitin is also a key component to cartilage maintenance as its main function is to attract water to the cartilage to provide better shock absorption during physical activity.
Glucosamine and Chondroitin Sulfate have been found to have considerable success in the treatment of osteoarthritis in both humans and animals. Results from the American College of Rheumatologys medical studies indicate that both supplements have been found to reduce joint inflammation and swelling, with most evidence being present in the knee.
< h3> What Does the Research Say?< /h3>
< h3> The Case Against These Supplements?< /h3>
< h3> So Whats the Verdict?< /h3>
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Treating Osteoarthritis Of The Knee: Popular Supplements Dont Work
Osteoarthritis is the most common type of arthritis, affecting 1 in 10 Canadian adults . The knee is one of the most common and most symptomatically affected joints, causing knee pain in many people. They often try over-the-counter remedies to help the pain, and to avoid knee surgery. Amongst these treatments are the supplements glucosamine and chondroitin sulfate, which are very popular.
Because glucosamine and chondroitin are building blocks of cartilage, and because osteoarthritis is related to cartilage degradation, many believe that adding these building blocks to the diet of a person suffering from osteoarthritis will help rebuild cartilage and lessen pain. While on the surface this may seem logical, in reality these supplements do not provide effective pain relief. Heres why:
These popular supplements dont work.
Many studies have shown that glucosamine and chondroitin sulfate do not help to relieve pain from arthritic knees. People who take the supplements often report less pain or swelling of their joints. But people get similar results if they take a placeboa sugar pill with no active ingredients. Pain relieving drugs, such as acetaminophen and ibuprofen , help a lot more.
The supplements can be dangerous.
You arent always getting what you think.
To make matters worse, often the labels on the bottles are misleading. In 2013, Consumer Reports tested 16 joint pain supplements and found that seven had less chondroitin than the label listed.
Use drugs carefully.
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Topical Or Oral Nonsteroidal Anti
Dr. Newsum explains that topical over-the-counter anti-inflammatory medications in the form of gels or creams can be even more effective than similar medications taken by mouth.
Since the finger joints are right under the skin, topical anti-inflammatories can deliver the active ingredient quite well and even offer less side effects compared to oral anti-inflammatories.
Though, oral anti-inflammatories can be an effective treatment, too, if needed.
Your doctor can help you determine which is best for you, says Dr. Newsum.
Are There Side Effects From Glucosamine And Chondroitin Sulfate
The most common side effects of glucosamine and chondroitin sulfate are indigestion and nausea. Diarrhea, constipation, vomiting or heartburn may also occur. Significant adverse events have not been associated with long-term use of glucosamine and chondroitin sulfate. Be sure to talk to your doctor if you notice any unusual or new symptoms while taking glucosamine and/or chondroitin sulfate.
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Results Showed Glucosamine Sulfate To Improve Pain And Function
The research team didnt expect to see any changes until the six-month mark but were surprised to see results after just three months, reporting 18 percent difference in reduction of pain between the study and control group. The only side effects reported by the glucosamine sulfate group were some cases of mild and transient gastrointestinal upset.
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What Is Chondroitin And Glucosamine
Chondroitin is a naturally occurring substance formed of sugar chains. Chondroitin is believed to help the body maintain fluid and flexibility in the joints.
Glucosamine is sugar protein that helps your body build cartilage . Glucosamine is a naturally occurring substance found in bones, bone marrow, shellfish and fungus.
Chondroitin and glucosamine is a combination product that has been used in alternative medicine as a possibly effective aid in treating osteoarthritis pain.
It is not certain whether chondroitin and glucosamine is effective in treating any medical condition. Medicinal use of this product has not been approved by the FDA. Chondroitin and glucosamine should not be used in place of medication prescribed for you by your doctor.
Chondroitin and glucosamine is often sold as an herbal supplement. There are no regulated manufacturing standards in place for many herbal compounds and some marketed supplements have been found to be contaminated with toxic metals or other drugs. Herbal/health supplements should be purchased from a reliable source to minimize the risk of contamination.
Chondroitin and glucosamine may also be used for purposes not listed in this product guide.
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What Are The Possible Risks
- Shellfish allergy: most glucosamine supplements are made from shellfish, although some made from non-shellfish sources are now available.
- Bleeding: people taking the blood thinning medicine warfarin should talk to their doctor before starting, stopping or changing their dose of glucosamine or chondroitin. These supplements may interact with warfarin and make the blood less likely to clot or increase the risk of bleeding.
- Diabetes: glucosamine is a type of sugar so check with your doctor before taking glucosamine if you have diabetes.
- Pregnant or breastfeeding women: there have not been enough long-term studies to clearly say that glucosamine is safe for a developing baby. Pregnant women should talk to their doctor before taking glucosamine.
- Other side effects: upset stomach , headaches, and skin reactions.
Talk to your doctor or pharmacist about whether you should be trying these medications, whether they are safe for you and, if you decide to try them, make sure you get the right dose.
High-quality evidence shows little or no benefit from glucosamine or chondroitin for OA. If you want to try these supplements, talk to your doctor or pharmacist about whether they are safe for you.
Which Brand Of Arthritis Supplement Should I Use
There are many different brands of glucosamine and chondroitin, which are usually sold together as one arthritis supplement. Again, there is no government monitoring to ensure the purity of these products.
In order to assure that you get a consistent dose of the supplements, stick with a reputable manufacturer choose products sold by large and well-established companies. If you don’t recognize a brand name, ask about the company’s reputation, how long it has been in business, and how long the store has stocked the brand.
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Do Glucosamine Supplements Work For Arthritis
Glucosamine is a popular dietary supplement used to treat osteoarthritis.
Osteoarthritis is a degenerative disease caused by insufficient regeneration of cartilage in joints, most often in the knees and hips.
It gets worse over time and causes joint pain, difficulties walking and disability.
There is no known cure, but there are a few ways to potentially slow the process. Many people try to stave off osteoarthritis by taking glucosamine supplements.
But do they really work? This article takes a look at the evidence.
Dont Invest In Otc Supplements Before You Read This First
Theres something appealing about being able to help manage a chronic illness with so-called natural remedies like vitamins and minerals. That explains why theres no shortage of natural remedies marketed to people with rheumatoid arthritis and other forms of inflammatory arthritis.
There is a shortage, however, of solid scientific evidence to support whether or not you should take certain supplements. Will they actually help improve arthritis symptoms? Could they interact with other medications you take? Or might they potentially have negative side effects of their own?
Herbal supplements in particular concern me because theyre marketed using testimonials and not on any clinical data, says William Davis, MD, the chair of rheumatology at Oschner Health System in New Orleans and a fellow of the American College of Physicians and the American College of Rheumatology. As a physician, its my role to recommend treatments where theres a higher understanding of risks and benefits.
There are, however, certain vitamins and minerals that research shows can be an essential part of treatment for many patients with inflammatory arthritis. We asked Dr. Davis which ones you may need as part of your recommended treatment plan, as well as which natural remedies may show the most promise in helping with pain relief.
Glucosamine and chondroitin are two popular supplements said to help manage joint pain.
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Chondroitin And Glucosamine Side Effects
Get emergency medical help if you have signs of an allergic reaction: hives difficult breathing swelling of your face, lips, tongue, or throat.
Although not all side effects are known, chondroitin and glucosamine is thought to be possibly safe when taken for up to 2 years.
Stop using chondroitin and glucosamine and call your healthcare provider at once if you have:
irregular heartbeats or
Risk Factors For Hand And Finger Arthritis
According to Dr. Newsum, finger or hand arthritis can occur years after of an old injury, but most of the time, it affects people age 50 and older.
If you do, however, its important to get medical help to find your path toward relief.
Other factors that can increase your risk of arthritis in your hands and fingers include:
- Enlarged bumps at the fingers knuckles
Its also important to distinguish between the different types of hand or finger arthritis.
Dr. Newsum explains, Osteoarthritis affects the middle knuckles and knuckles near the nails and can appear as large bumps on the knuckle, which are bone spurs that are caused from bone rubbing on bone when the joint moves.
Rheumatoid arthritis, on the other hand, is an autoimmune disease that attacks tendons, ligaments, the joint lining and bones.
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Glucosamine And Chondroitin Together
Though the two can be taken separately, glucosamine and chondroitin are commonly taken as a single supplement. This combination has been more extensively studied.
A 2015 2-year double-blind, randomized study showed no differences in pain or joint space narrowing a sign of cartilage deterioration after taking either 1,500 mg/day of glucosamine sulfate, 800 mg/day of chondroitin sulfate, a combination of both, or a placebo .
Similar results were observed in a 2018 analysis, where combined glucosamine and chondroitin didnt significantly improve pain or stiffness. Meanwhile, chondroitin alone led to minor improvements in pain .
On the other hand, another 2018 analysis observed a significant improvement in pain scores when glucosamine and chondroitin were taken together, while no improvements were found when the supplements were taken separately .
Similarly, a 2015 sponsored study showed that combining 1,500 mg of glucosamine hydrochloride with 1,200 mg of chondroitin sulfate effectively reduced knee osteoarthritis pain, stiffness, and swelling compared with 200 mg of the osteoarthritis NSAID celecoxib (
However, keep in mind that glucosamine is commonly derived from chitin a compound found in shellfish. Therefore, those with a shellfish allergy should read the label carefully and opt for varieties made from cows or pigs .
And What About The Downsides
In general, glucosamine and chondroitin are thought to be safe. However, as with any medication, there are potential risks. In some clinical trials, people taking the glucosamine-chondroitin combination have reported
- heartburn or abdominal pain
- allergic reactions .
Another concern is drug interactions, which may be a problem with any combination of medications. For example, chondroitin may interact with blood thinners such as warfarin, so the combination could increase the risk of bleeding.
Check with your doctor or pharmacist before taking glucosamine and/or chondroitin. Many doctors warn patients that the FDA does not regulate supplements such as glucosamine and chondroitin, so they may not contain the amounts stated on the label, or there could be contaminants in them.
And, of course, there is cost to consider health insurance usually doesnt cover these supplements. .
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