MSM and glucosamine ease joint pain...

Combining the sulphur-containing nutrient MSM with well-known joint health supplement glucosamine appears to speed up the anti-inflammatory effect and further reduce pain in patients with osteoarthritis.

Glucosamine, derived largely from shrimp shells, is widely used by arthritis patients but it is less commonly found in combination with MSM, or methylsulfonylmethane.

In the new study, both glucosamine and MSM improved osteoarthritis symptoms in subjects but when taken together the effect was greater than either alone.

"Combination therapy showed better efficacy in reducing pain and swelling and in improving the functional ability of joints than the individual agents," report the researchers in the June 2004 issue of Clinical Drug Investigations [1].

Researchers from Nizam's Institute of Medical Sciences in Hyderabad, India randomised 118 people with mild to moderate osteoarthritis to receive either 500mg glucosamine, 500mg MSM, a combination of both or placebo capsules three times daily for 12 weeks.

Patients were evaluated at prior to the study and several times during treatment for efficacy and safety. After 12 weeks, the average pain score had fallen from 1.74 to 0.65 in those taking only glucosamine.

In MSM-only participants, it fell from 1.53 to 0.74. However, in the combination group, it fell from 1.7 to 0.36. The researchers also found that the combination treatment had a faster effect on pain and inflammation compared to glucosamine alone.

"The combination of MSM with glucosamine provides better and more rapid improvement in patients with osteoarthritis," write the researchers.

A team of Canadian researchers has concluded that glucosamine alone has no long-term beneficial effect [3].

Their study investigated whether the food supplement could prevent painful flare-ups in patients who had already been taking it for two years on average, with some signs of benefit.

The results showed that there was little difference with placebo: 42 per cent of placebo patients experienced flare-ups in the six-month follow-up, compared with 45 per cent in the glucosamine group.

In addition, subjects using glucosamine flared as quickly and as severely as those using a placebo.

The study, which used medicinal grade glucosamine, a purified derivative from shellfish, follows a series of conflicting results on the benefit of glucosamine for osteoarthritis.

Researchers in Liege, Belgium, designed a trial to examine the effect of glucosamine sulfate on long-term symptoms of knee osteoarthritis (OA) in postmenopausal women [4].

They analyzed the results of two separate trials that followed more than 300 postmenopausal women with knee OA for a period of three years in both trials.

Symptoms of women who took glucosamine improved, while symptoms in the placebo group worsened.

Less than 7 percent of the women in the glucosamine group showed a significant joint space narrowing, while more than 20 percent of the placebo group experienced significant narrowing.

A study conducted by researchers at the University of Western Australia tracked volunteers who experienced knee pain from cartilage damage or long-term wear and tear for 12 weeks.

Half the group took 2,000 milligrams of glucosamine daily, and the other half took a placebo. Almost 90 percent of the glucosamine group reported at least some amount of improvement after 12 weeks, compared to just 17 percent taking the placebo.

Most of the improvements for those taking glucosamine weren't noticed over the first eight weeks of treatment. Many subjects who reported no relief at all in the first two months eventually began improving.

Don't be discouraged if results are minimal at first. Even eight weeks may not be long enough to determine if glucosamine supplements will be effective for you.

One other way to reduce joint pain is simply to eat more fruit and vegetables.

A recent British study found that people who consumed more fruits and vegetables were less likely to suffer from rheumatoid arthritis, which is characterized by joint inflammation, destruction and deformity [2].

The study was based on data collected in a survey of 23,000 men and women in the UK. Participants recorded what they ate each week. People who ate the fewest fruits and vegetables were more likely to develop inflammation in the joints than those who consumed the most.

Because the study was a review of survey data, it did not test specifically for cause and effect of vitamin C and rheumatoid arthritis. However, there was a definite link between the two.

Vitamin C appeared to be the measured nutrient most responsible for this protective effect. Those with the lowest intake of vitamin C were three times more at risk than those with the highest intakes.

Vitamin C acts as a powerful antioxidant that "mops up" the free radicals that are produced during inflammation and joint damage. It also protects against infections that may trigger joint inflammation, and plays a vital role in the formation of collagen, which is necessary for joint health.

Reference
1. Usha, P.R., & Naidu, M.U.R. (2004). Randomised, double-blind, parallel, placebo-controlled study of oral glucosamine, methylsulfonylmethane and their combination in osteoarthritis. Clinical Drug Investigation, 24, 353-363
2. Pattison DJ, Silman AJ, Goodson NJ, Lunt M, Bunn D, Luben R, Welch A, Bingham S, Khaw KT, Day N, Symmons DP. (2004). Vitamin C and the risk of developing inflammatory polyarthritis: prospective nested case-control study. Annals of the Rheumatic Diseases. 2004 Jul;63(7):843-7
3. Cibere J, Kopec JA, Thorne A, Singer J, Canvin J, Robinson DB, Pope J, Hong P, Grant E, Esdaile JM. Randomized, double-blind, placebo-controlled glucosamine discontinuation trial in knee osteoarthritis. Arthritis Rheum. 2004 Oct 15;51(5):738-45
4. Bruyere O, Pavelka K, Rovati LC, Deroisy R, Olejarova M, Gatterova J, Giacovelli G, Reginster JY. Glucosamine sulfate reduces osteoarthritis progression in postmenopausal women with knee osteoarthritis: evidence from two 3-year studies. Menopause. 2004 Mar-Apr;11(2):138-43
5. Braham R, Dawson B, Goodman C. The effect of glucosamine supplementation on people experiencing regular knee pain. Br J Sports Med. 2003 Feb;37(1):45-9