Dear Pharmacist,
I have osteoarthritis and take ibuprofen and hydrocodone. Glucosamine helps, but even after 6 months, I'm still stiff and riddled with pain. What else can I do?
--D.Y., Sarasota, Florida
Answer:You're not alone, 27 million Americans live with osteoarthritis (OA) and the affliction worsens over time. Left untreated, it can completely disable you, so luckily you are doing something. I like glucosamine. I prefer the glucosamine "sulfate" form over other forms, because it provides sulfur to the body... sulfur, not to be confused with sulfa, a drug that many people are allergic to.
OA always involves pro-inflammatory cytokines, you've heard me mention those before. Cytokines are pain-causing chemicals. But get used to the word cytokine, I use it frequently in my writings. Cytokines aren't bad until your body pumps them out in excess, and that's exactly what happens with OA, and it's exactly what you need to reduce. That controls pain and improves range of motion. Ibuprofen reduces the cytokines called prostaglandins and IL-1B. You want that. Glucosamine is a precursor for glycosaminoglycans and that is a component of joint cartilage. Consider these:
MSM- This is a sulfur-based compound that is actually a by-product of DMSO (DMSO is applied topically to joints, but it's intended for vet purposes, the FDA doesn't like humans using it even though many of you do). Anyway, MSM, an oral supplement is sold at health food stores and does wonders for joint pain.
Bromelain- This pineapple extract gets mixed reviews. One study found it to be as effective as diclofenac, a prescription anti-inflammatory. I personally like this and frequently recommend it.
Devil's Claw- Slightly more exotic, devil's claw is so named because of its hooked fruit. A 2011 study from Phytotherapy Research, concluded that the herb could block the release pro-inflammatory cytokines. In another study, Devil's claw performed as well as the prescription drug Vioxx (now off the market, however Celebrex which is safer does remain). The point is that Devil's claw is strong; it interacts with medicine, ask your doctor if it's right for you.
Boswellia- A resin from a tree. A 2013 study from the Journal of Head and Neck Pain studied the biological active ingredients in boswellia (pentacyclic triterpene acids) for their potent anti-inflammatory and analgesic properties. Boswellic acid is another major active ingredient. This is (in my mind) mother nature's ibuprofen.
This may sound obvious but take pressure off your joints. Extra weight does no favor to your painful knees and hip joints. You may have to start gently with yoga, or Tai Chi, but keep those joints moving. And finally, consider ramping up immunity, some forms of arthritis are due to infections, either fungal, viral or bacterial. Compounds in green tea reduce the cytokine called TNF alpha, often high in arthritic conditions. One cup of green (or matcha) tea could beat up germs and improve immunity. The L-theanine it contains is relaxing too. Drink it daily.
