Osteoarthritis is a common type of arthritis that causes the degeneration of various joints in the body. The disease may culminate in acute inflammation in some instances, but it is most commonly associated with wear and tear of joint cartilages as well as the formation of bony spurs in some joints. Its risk factors include repetitive occupational usage, joint trauma, and obesity. The illness is also prevalent among people over 60 years of age, with over 16 million individuals requiring medical care, whose main aim is pain relief (Sawitzke et al., 2010). Chondroitin, either on its own or in combination with glucosamine, has been widely promoted for the treatment of osteoarthritis. The former is a carbohydrate and a cartilage component that is believed to enhance elasticity and water retention, in addition to inhibiting the enzymes that cause cartilage breakdown. Glucosamine, on the other hand, is an amino sugar that improves the repair and formation of cartilage. When used to treat osteoarthritis, the combination of these two substances helps to reduce pain and the loss of function that is associated with the disease. However, numerous investigations concerning the efficacy of these supplementshas shown negligible or no effect in alleviating either joint damage or pain in patients as compared to those using a placebo.
The use of glucosamine and chondroitin sulphate nutritional supplements in treating osteoarthritis
Conventional medications have not yet shown any positive effects in slowing down or stopping the progression of osteoarthritis. Accordingly, the nutritional supplements, chondroitin sulphate and glucosamine, have emerged as an alternative treatment to some patients suffering from arthritis-related pain and joint degeneration. Chondroitin refers to one of the primary naturally occurring constituents of cartilage that enables it to retain water. Nevertheless, supplements can be produced artificially in laboratory settings or from the natural cartilages of various animals, including pigs, cows, and sharks (Wandel et al., 2010). The manufactured drugsare packed, marketed, and sold as chondroitin sulphate, which is accepted as a treatment for arthritis is several countries. In some regions, such as the United States, it is often combined with glucosamine supplements. Glucosamine is also a natural compound that occurs in healthy cartilages, especially in joint fluids, although it can also be manufactured in a lab or harvested from the shells of shellfish (Wandel et al., 2010). Glucosamine lab tests have shown the potential to reduce inflammation and increase cartilage regeneration.Browse Common Arthritis Supplements
According to Henrotin, Mathy, Sanchez, and Lambert (2010), chondroitin sulphate on its own may help to relieve pain in some patients suffering from hand and knee osteoarthritis, although the benefits are modest, usually between eight and ten percent improvement for up to three months. Indeed, the Natural Medicines Comprehensive Database (NMCD) classifies chondroitin sulphate as potentially useful for knee arthritis. Separate studies published in the Arthritis and Rheumatism journal found the supplement to moderately improve joint function and relieve pain in individuals with hand osteoarthritis, with improvements showing after three months of consistent treatment. However, chondroitin did not enhance grip strength or reduce the use of pain medication as compared to those using a placebo. Moreover, the lack of side effects qualifies chondroitin sulphate for use as an alternative to nonsteroidal anti-inflammatory drugs (NSAIDs) for patients in need of long-term care as well as those who cannot take the supplements for various reasons.
Studies have also found significant relief in a small subgroup of osteoarthritis patients with moderate to severe knee pain when chondroitin sulphate is combined with glucosamine. No effect was noted in a sample of patients with mild pain. Further, this combination was found to be no more effective at averting joint damage than a placebo. The results also showed that patients who experienced the least damage in their joints were either taking chondroitin or glucosamine alone. According to these findings, it is sufficing to connote that taking two supplements simultaneously may constrain their absorption, thereby lowering their efficacy. In the long term, both supplements, either individually or in combination, generated no greater benefits in relieving knee pain than placebo or colecoxib (Henrotin, Mobasheri, and Marty, 2012). Accordingly, the American College of Rheumatology does not recommend either glucosamine or chondroitin in the treatment of arthritis at its onset since the supplements may not be effective with all patients. However, the institution recommends continued use of both supplements by people who have experienced significant improvements.
Laboratory trials suggest that chondroitin has the potential to fight inflammation and constrain the production of enzymes that destroy cartilages. Other human studies have also found that the supplement can relieve the stiffness and pain caused by arthritis with negligible side effects than the typical arthritis medications. At the same time, some scholars and scientists have found no benefit in improving the welfare of patients. Although the precise cause of this scholarly conflict is yet to the determined, most experts point to the superior design and larger samples involved in adverse reports (Bottegoni, Muzzarelli, Giovannini, Busilacchi, and Gigante, 2014)). The National Institutes of Health’s (NIH) Glucosamine/Chondroitin Arthritis Intervention Trial (GAIT) is perhaps the major and best-designed exploration. GAIT has generated two sets of adverse findings on the effectiveness of both chondroitin and glucosamine, either alone or in combination. Numerous other studies have supported GAIT’s view that the supplements did not produce any significant variations in pain relief or structural benefit between placebo and treatment groups, and that their use should be discouraged.
Cochrane conducted a review of the literature published up to November 2013 that included 43 studies of 9110 patients. Most of the research concentrated on knee osteoarthritis ranging from one month to three years. Most of the investigations were funded by chondroitin manufacturers, which may imply the potential for conflict of interest. Nevertheless, this review found that chondroitin may relieve pain slightly in the short term and help in reducing knee pain by approximately 20 percent. Additionally, it was found to slow down the narrowing of joint spaces on X-rays of affected body parts, and also enhance patients’ quality of life as assessed by the Lequesne’s index, which is a combined measure of functionality, pain, and disability (Royati, Girolami, and Persiani, 2013). The supplement was also found to have minimal or no difference in serious adverse side effects as compared to other agents. However, the authors noted that most studies utilized unsound methodologies to evaluate the effects of chondroitin, while a substantial proportion lacked sufficient data. Investigations that used comparatively superior methods and adequate data revealed no improvement in either physical function or pain.
A vast body of research points to the lack of any significant side effects from the administration of both chondroitin and glucosamine. However, patients who have diabetes should take necessary precautions because the supplements can increase blood sugar. People on anticoagulants or blood-thinning medications are also advised to stay away from the drugs or consult their doctors before taking them. The supplements can also have blood-thinning effects in some patients. As such, individuals using anticoagulants should have regular blood checkups. Drugs with glucosamine and chondroitin combinations may cause allergic reactions to people with shellfish hypersensitivity. The supplements’ effects on developing babies or fetuses and growing children remain unknown (Sherman, Ojeda-Correal, and Mena, 2012) Accordingly, they are not recommended for pregnant women, nursing mothers, and those who could get pregnant. Bottegoni et al. (2014) also note some mild side effects of both chondroitin and glucosamine, including nausea, heartburn, constipation, diarrhea, and increased intestinal gas. These findings contradict those reported in most other studies, which calls for more comprehensive research.
Further, many individuals find it more useful to combine chondroitin sulphate and glucosamine nutritional supplements with other nonsurgical treatments under the guidance of a physician. Such interventions may include the use of pain medication with anti-inflammatory properties, such as COX-2 inhibitors, ibuprofen, naproxen, and other NSAIDs. Studies show that taking the supplements eliminates the need for pain relief or anti-inflammatory medicines in some patients, while others may continue to use the latter. Physical exercise may also be used to maintain flexibility and reduce joint and muscle stiffness even after pain relief. Experts also recommend water therapy, stationary exercise bikes, or elliptical machines to people with severe osteoarthritis pain. Other non-medical interventions, such as acupuncture, instrument-assisted soft tissue techniques, yoga, and muscle energy methods, among others, may also generate positive results in some patients (Henrotin et al., 2010). Weight loss in obese individuals may reduce stress in joints, thereby reducing pain and inflammation. Spine fusion surgery is recommended in severe cases or osteoarthritis, although this remedy is not optimal because the disease affects multiple vertebral levels.
chondroitin sulphate and glucosamine supplements do not offer the anticipated
pain relief for the majority of osteoarthritis patients. More importantly, their
associated risks and benefits have not been definitively proven. Comprehensive
long-term research is required to enhance the understanding of their impacts.
According to Sawitzke et al. (2010), the variations in the effectiveness of
chondroitin in treating osteoarthritis may be due to the differences in dosages
as well as the quality of supplements. Specifically, the chondroitin content
between various brands fluctuates significantly. The lack of government
oversight over the purity of these supplements may be the primary factor behind
the differences in the quality of brands. Accordingly, patients are advised to
stick to products sold by a reputable manufacturer and ensure consistent
Bottegoni, C., Muzzarelli, R.A., Giovannini, F., Busilacchi, A. and Gigante, A., 2014. Oral chondroprotection with nutraceuticals made of chondroitin sulphate plus glucosamine sulphate in osteoarthritis. Carbohydrate polymers, 109, pp.126-138.
Henrotin, Y., Mathy, M., Sanchez, C. and Lambert, C., 2010. Chondroitin sulfate in the treatment of osteoarthritis: from in vitro studies to clinical recommendations. Therapeutic advances in musculoskeletal disease, 2(6), pp.335-348.
Henrotin, Y., Mobasheri, A. and Marty, M., 2012. Is there any scientific evidence for the use of glucosamine in the management of human osteoarthritis?. Arthritis research & therapy, 14(1), p.201.
Rovati, L.C., Girolami, F. and Persiani, S., 2013. Crystalline glucosamine sulfate in the management of knee osteoarthritis: efficacy, safety, and pharmacokinetic properties. Therapeutic advances in musculoskeletal disease, 4(3), pp.167-180.
Sawitzke, A.D., Shi, H., Finco, M.F., Dunlop, D.D., Harris, C.L., Singer, N.G., Bradley, J.D., Silver, D., Jackson, C.G., Lane, N.E. and Oddis, C.V., 2010. Clinical efficacy and safety of glucosamine, chondroitin sulphate, their combination, celecoxib or placebo taken to treat osteoarthritis of the knee: 2-year results from GAIT. Annals of the rheumatic diseases, 69(8), pp.1459-1464.
Sherman, A.L., Ojeda‐Correal, G. and Mena, J., 2012. Use of glucosamine and chondroitin in persons with osteoarthritis. PM&R, 4, pp.S110-S116.
Wandel, S., Jüni, P., Tendal, B., Nüesch, E., Villiger, P.M., Welton, N.J., Reichenbach, S. and Trelle, S., 2010. Effects of glucosamine, chondroitin, or placebo in patients with osteoarthritis of hip or knee: network meta-analysis. Bmj, 341, p.c4675.
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