Arthritis Supplements Don’t Work

Researchers are patting themselves on the back for finally proving that the popular arthritis supplements glucosamine and chondroitin don’t work. Too bad physicians don’t have much else that eases pain without causing serious side effects.
The latest analysis is from the British journal BMJ (online, Sept. 16, 2010). Investigators reviewed 10 studies that covered 3,800 subjects. They concluded, “Compared with placebo, glucosamine, chondroitin, and their combination do not reduce joint pain or have an impact on narrowing of joint space.”
This comes on the heels of a Norwegian study that investigated the benefits of glucosamine for lower back pain due to spinal osteoarthritis (Journal of the American Medical Association, July 7, 2010). Six months of glucosamine was no more helpful than placebo in that study either.
Many health professionals get a certain amount of pleasure from studies that show an alternative therapy is ineffective. They may feel vindicated when a pill that was not FDA-approved turns out to be no more helpful than an inactive placebo.
Even FDA-approved treatments for osteoarthritis are not above question, however. Doctors have prescribed nonsteroidal anti-inflammatory drugs (NSAIDs) for decades. The assumption is that they are effective for joint pain and relatively benign. The data on many of these drugs are not as convincing as many health professionals assume.
For one thing, there are surprisingly few long-term trials of NSAIDs. That’s a disappointment for drugs that may be taken for months or years. A meta-analysis of 23 studies involving more than 10,000 patients concluded, “NSAIDs can reduce short-term pain in osteoarthritis of the knee slightly better than placebo, but the current analysis does not support prolonged use of NSAIDs for this condition. As serious adverse effects are associated with oral NSAIDs, only limited use can be recommended” (BMJ, Dec. 4, 2004).
There is growing recognition that NSAIDs such as ibuprofen, naproxen and diclofenac carry substantial risk, including digestive distress such as heartburn, nausea or even life-threatening bleeding ulcers. Other NSAID complications may include elevated blood pressure, irregular heart rhythms, dizziness, fluid retention, ringing in the ears, kidney and liver damage.
A recent report from Denmark suggests that high doses of ibuprofen and diclofenac are associated with an increased risk of heart attacks and other cardiovascular problems (Expert Opinion on Drug Safety, online, June 23, 2010).
With such questionable benefits and serious side effects, it is not surprising that people are looking for alternatives. That’s why home remedies are so popular. They are generally affordable and far less risky. Readers of this column report that fruit juices such as cherry, grape, pineapple or pomegranate can be helpful. Spices like cayenne, turmeric and ginger may also give relief.
For those who like such approaches, we offer our book, Favorite Home Remedies, at www.peoplespharmacy.com. None are likely to be studied in double-blind trials, but they’re also unlikely to cause the kinds of complications associated with NSAIDs.