Glucosamine and chondroitin are widely advertised as remedies for osteoarthritis. The benefits, however, are not clear.

A qualitative assessment of various trials were done by T.E. McAlindon et al. to evaluate the benefits of glucosamine and chondroitin products for osteoarthritis of the knee and/or hip.

The studies were randomised, double blind, placebo controlled of four weeks duration. Fifteen studies reached the criteria and were included in the analysis.

Conclusions: Trials of glucosamine and chondroitin products for osteoarthritis of the knee and hip showed moderate to higher effects but there were quality issues and possible bias suggesting that benefits were exaggerated.

They concluded, however, that some degree of benefits appear probable.

A trial by H.Muller-Fassbender et al. in 1994 compared glucosamine sulfate to ibuprofen in osteoarthritis of the knee. The result showed that glucosamine was as effective as ibuprofen but without the potential serious side effects.

Dr. Phil Hariram,

Arthritis Guide.

You can break this into symptoms, signs and impairment of function.

Pain develops around the osteoarthritic joint. The severity of pain and impairment depends largely on the individual. This can be influenced by expectation and state of mind. Anxiety and depression will influence pain perception. Level of satisfaction and success especially at work and home impacts on pain level and much as the personality profile.

A placebo surgery trial on osteoarthritic knee where no corrective surgery occurred produced significant improvement on pain level and functional impairment. Expectation was responsible for the improvement.

Crepitus (grating noise) is present in osteoarthritis. You can hear the noise as the joint is moved. Bony enlargement can occur and often the joint looks mis-shapened. Restricted movement is not uncommon. The joint may feel warm or swollen (effusion) following synovitis. Weakening of supporting muscles and wasting can follow.

Remember osteoarthritis is not only due to wear and tear. There may be other underlying problems associated wirth arthritis. Conditions such as fibromyalgia, gout and sepsis must be considered when having treatment for osteoarthritis.

If you suspect you have osteoarthritis, make sure you see your family doctor. Accurate assessment, diagnosis and investigation of potential associated illnesses will help both in the short and long term when having osteoarthritis treatment.

Dr. Phil Hariram.

Arthritis Guide.

Osteoarthritis is the commonest disease to affect joints. It is long thought to be the result of ageing and injury but it is not an inevitable consequence of growing old.

In osteoarthritis, there is focal cartilaginous loss and resultant bony reaction in the form of growth or sclerosis. X-ray remains the simple and most used test for diagnosis. An X-ray will show cartilage loss by reduction of joint space and resultant bone reaction will show as osteophytes or sclerosis. X-ray, however, may not show early or minimal osteoarthritis.

The level of symptoms does not have a direct relationship to the extent of osteoarthritis.

Osteoarthritis is strongly related to age and with the ageing population increasing, the burden on the health service is increasing.

It is uncommon in people under the age of 45 and at least half of 65s have X-ray evidence of osteoarthritis in at least on joint group but not necessarily any symptoms. Symptomatic osteoarthritis also increases with age.

In women there is higher incidence of X-ray evidence of severe osteoarthritis especially in the hand and knee. It is uncommon in blacks and Asians compared to white people. Polyarthritis of the hand is rare in black Africans and Malaysians. It is assumed there is a genetic cause.

Risk factors for developing osteoarthritis can be put into two categories.

General risk includes obesity and genetic factors.

Local risk includes mechanical problems such as meniscectomy and instability.

Genetics of osteoarthritis in not clear but there is a positive inheritance in osteoarthritis of the hand, hip and knee. Some factors such as obesity, occupation and use of joint can be areas where prevention is possible.

Dr. Phil Hariram.
Arthritis Treatment.