Alternative Approaches to Joint Pain Relief

Content provided by the Faculty of the Harvard Medical School
Excerpted from a Harvard Special Health Report

Over the years, people have turned to a wide variety of remedies to cope with the frustrating problem of joint pain. The choices are many, because joint pain has been around for many centuries and nearly every culture has developed medicines or therapies to treat it. Many of these remedies lack scientific support. But so long as they are not harmful, there is no reason not to use traditional or complementary therapies that seem to bring you relief. A few complementary therapies have some demonstrated effectiveness.

Acupuncture

This ancient Chinese technique uses slim needles to stimulate points along the body's "energy meridians" to correct disease-causing imbalances. In the language of Western medicine, acupuncture may work by releasing endorphins, natural morphine-like chemicals in the nervous system.

In 1997, a National Institutes of Health consensus panel concluded that acupuncture is an acceptable alternative or adjunct for treating many kinds of pain, including that from osteoarthritis. Since then, a number of studies have offered positive results specific to knees and hips. A 1999 study indicated that acupuncture may be useful for patellofemoral pain syndrome, and a small trial in 2001 looking at people with hip osteoarthritis showed that acupuncture helped them more than exercise did. A large 2004 study found that people with knee osteoarthritis who had acupuncture for six months reported less pain and better function than people who received sham acupuncture or participated in an arthritis education program. But a meta-analysis published in 2007 in Annals of Internal Medicine had conflicting results. While acupuncture for osteoarthritis of the knee led to significant improvements in pain and function compared with usual care or being on a waiting list for acupuncture, it did not provide a significant advantage over a sham procedure. This suggests that some of the benefits of acupuncture might be attributed to a placebo effect. If you decide to try acupuncture, find a certified acupuncturist.

For this nearly painless treatment, disposable, sterilized needles are pressed gently into the skin to relieve pain.

Supplements

The search for vitamins or other supplements to help relieve joint pain and restore cartilage has been a roller coaster ride of encouraging, then discouraging study results. The two supplements describe here have shown some promise but haven't been demonstrated to be consistently effective.

Glucosamine and chondroitin sulfate. Glucosamine is a substance normally found in both cartilage and synovial fluid, and chondroitin sulfate is one component of a protein that makes cartilage elastic. It isn't clear how supplements of these nutrients might work, but some evidence suggests it reduces pain in some people with osteoarthritis. For example, a large 2006 study published in The New England Journal of Medicine concluded that glucosamine and chondroitin did not reduce pain effectively over all, but that the supplements did benefit a subgroup of patients with moderate to severe pain. Two earlier three-year studies in Europe found that people with knee osteoarthritis taking glucosamine had significantly less pain and narrowing of their joint space than those taking a placebo.

Common side effects include intestinal gas and softened stools. Chondroitin sulfate structurally resembles the anticlotting drug heparin; if you're taking blood-thinning medication, tell your doctor and monitor your blood-clotting time. Patients with sulfa allergies should also avoid taking supplements containing chondroitin sulfate. Because glucosamine may worsen diabetes, watch blood sugar levels carefully. Glucosamine is manufactured from chitin found in the shells of crustaceans, so people with shellfish allergies may react to it.

Hyaluronic acid. This compound is found in many types of body tissue and is an important component of cartilage. Although supplements and injections containing hyaluronic acid are sometimes used for treating joint pain, solid scientific evidence for its use is lacking.

Reference: Arthritis section on Better Medicine


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