There are literally over 100 different types of arthritis. They are broadly categorised into degenerative and inflammatory. Degenerative arthritis is by far the most common and is known as the “wear and tear” arthritis.
Degenerative arthritis is also commonly referred to as osteoarthritis, degenerative joint disease (DJD), spondylosis and/or spondylitis.
Inflammatory arthritis includes examples such as:
- Rheumatoid arthritis
- Psoriatic arthritis
- Ankylosing spondylitis
Damage to joints in osteoarthritis (wear and tear) occurs due to:
- Repetitive, high, localised stress as a result of poor or uneven load distribution.
- Sustained immobilisation of a joint (this is very common and most people are unaware that one or two vertebrae of the spine are immobile as other vertebrae are actually working harder).
Damage accumulates more quickly than the body can repair it. Once injured, forces encountered in normal daily living will continue the process. Arthritis used to be thought of as a disease of old age but has more recently been found to begin its initially painless course when you’re still in your 30s, 20s or even younger.
Aside from having corrective chiropractic care with these changes is there anything else that one can do to help improve degenerative changes within joints? – Yes, there certainly is.
Moving arthritic joints is highly beneficial – assuming that it does not create excessive pain! If we don’t exercise them they can permanently freeze up.
- Water Workouts – the buoyancy of water can help you move stiff joints without gravity’s weight-bearing pressure.
- The Bicycle Exercise – lying in a reclined position and “riding a bike” can take burden off the sensitive hip and knee joints.
- Walking – if it doesn’t cause pain is a great way to keep joints from seizing up.
- Pilates, Yoga, Tai-Chi or Low-Impact aerobics – any exercise that doesn’t put excessive stress on the joints can help build up muscle and keep ligaments and tendons flexible enough to give the joints the support they need.
For some time it has been suggested that glucosamine and chondroitin sulphate (derived from shark cartilage) may be helpful in rebuilding cartilage in joints and effective in the treatment of pain arising from these joints.
Glucosamine Sulphate in Arthritis
Glucosamine sulphate is by far the most studied compound that has been shown to reduce osteoarthritis symptoms and to do so without side effects in human clinical trials. More specifically, it has been seen to be effective in the treatment of back pain related to osteoarthritis.1
Evidence that glucosamine sulphate is as effective as NSAIDs (non-steroidal anti-inflammatory drugs) on symptoms of knee osteoarthritis came in the form of a randomised, controlled study of 200 patients who had been hospitalised with osteoarthritis of the knee. Glucosamine demonstrated mild anti-inflammatory effects without serious reactions. The results for NSAIDs and glucosamine were similar, however as noted, glucosamine had far fewer side effects.2
In fact, the Cochrane Database System Review in 2001 identified 16 randomised controlled trials reporting on the efficacy and safety of glucosamine sulphate in the treatment of osteoarthritis. Two studies demonstrated that glucosamine was superior to NSAIDs in relieving symptoms and two studies indicated it was equivalent to NSAIDs. In all four studies, the safety of glucosamine sulphate was identified and reported.3
Chondroitin Sulphate in Arthritis
In a study reported in the Journal of Rheumatology, a population of arthritic patients were divided into two groups; the group receiving anti-inflammatory drugs had more immediate relief of pain, but the pain returned soon after stopping the drug. The group receiving chondroitin sulphate, on the other hand, experienced pain relief that took a little longer to manifest, but the relief lasted up to 3 months after discontinuation of treatment.4
In another study, chondroitin sulphate proved to be more effective on cellular events of inflammation than indomethacin and ibuprofen (non-steroidal anti-inflammatory drugs), without the dangerous side effects on stomach platelets, and kidney function that is seen with NSAID use.5
Chondroitin Sulphate Modifies the Degenerative Change on Osteoarthritis
Chondroitin sulphate plays a major role in maintaining the structural integrity of the cartilage. As cartilage continues to degrade through inflammatory events, chondroitin sulphate:
- Provides the substrate for repair.6
- Stimulates proteoglycan production by cartilage cells.
- Inhibits cartilage pain mediator production.
- Inhibits extracellular proteases involved in the metabolism of connective tissue.
- In bone, it accelerates bone mineralization and repair.7
Repair Mechanisms in Osteoarthritis
In comparison with the anti-inflammatory drug indomethacin, glucosamine sulphate had a much higher therapeutic margin. That is, while indomethacin was a more potent reducer of symptoms, its toxicity was 1000—4000 times greater than that of glucosamine sulfate.8
The longer term effects of both glucosamine sulphate and chondroitin sulphate may be attributable to their ability to restore some amount of joint integrity by stimulating compounds that are capable of providing substrate for the formation of a healthy joint matrix. A more recent three-year study reported in The Lancet demonstrated that the usual short term control of osteoarthritis can be extended with glucosamine sulphate supplementation.9
These positive findings for glucosamine sulphate and chondroitin sulphate demonstrate that supplementation with a high quality formulation could be a useful to support those individuals with both chronic inflammatory and degenerative joint conditions. In addition, it is a highly effective addition to the nutritional support of those individuals who wish to maintain healthy joints throughout their lifespan.
For more information about glucosamine and chondroitin just ask one of the chiropractors at Shirley Rd Chiropractic.
- Wiesel, S (2000) Nutraceuticals to sweep spine world. New study touts glucosamine for back pain. Backletter 15: 133, 140, 141.
- Muller-Fassbender H, Bach GL, Haase W, Rovati LC. Glucosamine sulphate compared to ibuprofen in osteoarthritis of the knee. Osteoarthritis Cartilage. 1994; 2(1): 61-69.
- Towheed TE, Anastassiades TP, Shea B, et al. Glucosamine therapy for treating osteoarthritis.
- Morreale P, Manapulo R, Galati M, et al. Comparison of the anti-inflammatory efficacy of chondroitin sulphate and diclofenac sodium in patients with knee osteoarthritis. J Rheumatol. 1996; 23(8): 1385-1391.
- Ronca F, Palmieri L, Panicucci P, Ronca G. Anti-inflammatory activity of chondroitin sulphate. Osteoarthritis Cartilage. 1998; 6Suppl A: 14-21.
- Watanabe H, Yamada Y, Kimata K. Roles of Aggrecan, a large chondroitin sulphate proteoglycan, in cartilage structure and function. J Biochem. (Tokyo). 1998; 124(4): 687-693.
- Bali JP, Cousse H, Neuzil E. Biochemical basis of the pharmacologic action of chondroitin sulphates on the osteoarticular system. Semin Arthritis Rheum. 2001; 31(1): 58-68.
- Setnikar I, Pacini MA, Revel L. Antiarthritic effects of glucosamine sulphate studied in animal models. Arzneimittelforschung. 1991. May; 41(5): 542-545.
- Reginster JY, Deroisy R, Rovati LC, et al. Long-term effects of glucosamine sulphate on osteoarthritis progression: a randomised, placebo-controlled clinical trial. Lancet. 2001. Jan 27; 357 (9252): 251-256.