Osteoarthritis: A Primer

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Probably the most common age-related disease, osteoarthritis affects the joints of 16 million Americans, most over age 50. But pain and stiffness are not inevitable: Supplements may greatly relieve symptoms and slow the cartilage degeneration that’s at the root of this disorder.

What it is

With osteoarthritis, your joints gradually lose their cartilage — the smooth, gel-like, shock-absorbing material that prevents adjacent bones from touching. Most commonly affected are the fingers, knees, hips, neck, and spine. As cartilage loss continues, the friction of bone rubbing against bone can cause pain and joint instability.

What causes it

Osteoarthritis may be the result of decades of joint wear and tear, though genetic factors, excess weight, and impairments in the body’s ability to repair cartilage may also play a role. Some cases are linked to a specific cause, such as a previous injury to a joint; the overuse of a joint occupationally or athletically; or a congenital defect in joint structure.

How supplements can help

There is no sure cure for osteoarthritis, but glucosamine, a cartilage-building sugar compound, is one of the most helpful remedies for relieving arthritis pain. It appears to slow joint damage over time, though whether it can actually reverse the disease is unknown. To enhance its effectiveness, try glucosamine along with one other supplement listed in the chart. Allow at least a month to judge results; then, if necessary, substitute another supplement to use with glucosamine to see if it works better for you. These supplements can be used long term, as well as with conventional pain relievers, such as aspirin and acetaminophen.

Several large studies are assessing the impact of glucosamine when it’s combined with another cartilage-building compound, chondroitin (some experts believe this compound is poorly absorbed and of limited effectiveness). Other supplements that can be taken with glucosamine include niacinamide, which may be particularly effective in relieving knee pain; boswellia, a gummy tree resin that may inhibit inflammation and build cartilage; and sea cucumber, a Chinese remedy that may, through unknown mechanisms, reduce pain and stiffness and boost grip strength. One form of the amino acid methionine called SAM (S-adenosylmethionine) has anti-inflammatory effects similar to ibuprofen and has been shown to rebuild cartilage. Gelatin, containing the amino acids glycine and proline and other joint-building nutrients, may also be worth trying if other measures fail; little is known about its effectiveness.

Supplement Recommendations
(Note: Some dosages may be supplied by supplements you are already taking.)

Glucosamine

Dosage: 500 mg glucosamine sulfate 3 times a day.

Comments: Take with food to minimize digestive upset.

Chondroitin

Dosage: 400 mg chondroitin sulfate 3 times a day.

Comments: Often sold in combination with glucosamine.

Niacinamide

Dosage: 1,000 mg 3 times a day.

Comments: High doses can cause liver damage and other serious side effects; physician monitoring is necessary during treatment.

Cayenne cream

Dosage: Apply topical cream to affected joints several times a day.

Comments: Standardized to contain 0.025%-0.075% capsaicin.

Boswellia

Dosage: 1 pill 3 times a day.

Comments: Each pill standardized to have 150 mg boswellic acid.

Sea cucumber

Dosage: 1,000 mg a day.

Comments: Also known as b°che-de-mer.

SAM

Dosage: 400 mg twice a day for 2 weeks, then 200 mg twice a day as a maintenance dose.

Comments: May have mild gastrointestinal side effects. Should not be taken by people with manic-depressive illness.

Any of these therapies can be used along with topically applied cayenne cream for pain relief. The capsaicin in cayenne inhibits production of substance P, a chemical involved in sending pain messages to the brain. Initial applications, however, may cause a burning sensation.

What else you can do

• Engage in moderate low-impact exercise such as walking or swimming to strengthen muscles and improve overall joint condition.
• Apply heat or ice to joints for 20 minutes three times a day to help reduce pain.