Arthritic knees benefit from chondroiton sulphate. Note: Normal knee shown above. (Photos.com)
The conventional medical management of osteoarthritis is centered on the use of analgesic (painkilling) drugs. Ultimately, though, joint condition may degenerate to the extent that joint replacement is deemed necessary.
Of course osteoarthritis can be addressed with more naturally oriented strategies, and one substance typically offered is chondroitin sulphate. Chondroitin is actually a component of cartilage, more specifically, a substance called glycoaminoglycans. Theoretically, taking chondroitin may help provide the cartilage with the building blocks required to maintain its structure and function.
In a recent study, the effects of chondroitin sulphate on osteoarthritis of the knee were assessed [1]. This study treated 622 individuals with either 800 mg of chondroitin sulphate once daily or placebo (inactive medication) over a two-year period. The researchers monitored pain as well as “joint-space width” (a measure of the amount of cartilage in the joint as determined by X-ray or some other type of imaging).
The results of this study showed lower pain scores in the individuals taking the chondroitin. Significant decreases in joint-space width (defined as a loss of 0.25 mm or more) were less common in the individuals taking chondroitin. The percentages of individuals seeing significant loss of joint space were 28 and 41 percent in individuals taking chondroitin and placebo respectively.
The pain and joint-space results were statistically significant. In other words, this study provides evidence that chondroitin can improve the condition of the joint as well as the symptoms of osteoarthritis.
The results of this study contrast sharply with those of a study published last year that found that treatment with chondroitin (400 mg, three times a day) for two years did not lead to a significant reduction in loss of joint space compared to placebo [2]. Neither glucosamine sulphate (500 mg, three times a day), nor a combination of these agents was effective for this purpose either.
On the plus side, though, there is some well-conducted research that has found glucosamine sulphate to be effective in the treatment of osteoarthritis [3]. Other evidence has found that glucosamine use is associated with roughly halving the risk of the progression of osteoarthritis of the knee [4].
Another study has found that previous glucosamine use is associated with a significantly reduced risk of requiring joint replacement [5]. Taken as a whole, I think the results on glucosamine and chondroitin suggest these agents have significant potential to help individuals with or at risk of osteoarthritis.
References:
1. Kahan A, et al. Long-term effects of chondroitins 4 and 6 sulfate on knee osteoarthritis: The study on osteoarthritis progression prevention, a two-year, randomized, double-blind, placebo-controlled trial. Arthritis & Rheumatism. 2009; 60(2): 524–533. [Epub ahead of print]
2. Sawitzke AD, et al. The effect of glucosamine and/or chondroitin sulfate on the progression of knee osteoarthritis: a report from the glucosamine/chondroitin arthritis intervention trial. Arthritis & Rheumatism. 2008; 58(10): 3183–91.
3. Noack W, et al. Glucosamine sulfate in osteoarthritis of the knee. Osteoarthritis and Cartilage. 1994; 2(1): 51–9.
4. Poolsup N, et al. Glucosamine long-term treatment and the progression of knee osteoarthritis: systematic review of randomized controlled trials. Annals of Pharmacotherapy. 2005; 39(6): 1080–7.
5. Bruyere O, et al. Total joint replacement after glucosamine sulphate treatment in knee osteoarthritis: results of a mean 8-year observation of patients from two previous 3-year, randomized, placebo-controlled trials. Osteoarthritis Cartilage. 2008; 16(2): 254–60.
Dr. John Briffa is a London-based physician and health writer with an interest in nutrition and natural medicine.
His Web site is drbriffa.com
