Aching Joints

People are living longer, which means that there are more older people around.  Consequently the problems that older people suffer from are now affecting more and more people.  One of those problems is aching joints, and any product that brings relief from them is going to get a lot of takers.  But how good are the options that are out there?

Glucosamine

Glucosamine is one of the best known supplements for aching joints.  There are a couple of undeniable good points with it.  It is pretty cheap and it is very safe.  Glucosamine is found in the body anyway, and there don’t seem to be any adverse effects even from the very high doses that are recommended.

The question is, does it work?  The theory is a bit vague. Glucosamine is one of the things the body needs to make cartilage.  This doesn’t necessarily mean that if you dose yourself up with glucosamine you are going to make more cartilage than you would have done otherwise.  It is also far from clear that joint aches arise from a cartilage shortage anyway.  But science isn’t about theories, it’s about data.

Unfortunately the data is a bit vague too.  Studies have been done in people with arthritis which don’t show much advantage of glucosamine over just taking a a pill with no drug in it.  The modest benefits might be worth having though.  Comparing an active treatment to a placebo is important in working out whether or not an active actually has any activity because the placebo effect can be quite strong.  With something like joint pain you might be quite happy with any level of relief even if some of it is thanks to a psychological rather than a pharmaceutical effect.

A quick note about that placebo effect.   It still works even when you know it is a placebo.  But not all placebo effects are equal.  Branded drugs are more effective than generic ones at eliciting a placebo effect – so don’t buy the cheapest, buy the one with the most reassuring packaging.

Glucosamine gels and creams are also available.  I haven’t found any published data on how well they perform, but online reviews are positive and given that we don’t know how the supplements are working we can at least keep an open mind about applying them directly to the site of action.

Chondroitin

Chondroitin has also been proposed as a supplement for aching joints.  The evidence for its efficacy is even sketchier.  Glucosamine seems to have a loyal following of people who find it helps them.  Chondroitin hasn’t established the same level of enthusiasm.  I can’t really find any compelling reason to recommend it at the moment.

Celadrin

Another active that is being promoted for joints is Celadrin.  Unlike the other two, this is a branded ingredient.  More on that in a minute.

Celadrin is a particular blend of fatty acids that have been treated chemically to slightly modify their structure.  Quite why anyone thought this was a good idea I haven’t found out yet, and what led them to believe that it would be good for treating joints I can’t fathom.  But once again, science is about data.  And Celadrin has been subjected to some proper clinical trials.   There aren’t many of them, but they have been done to a reasonable protocol by credible researchers and published in reputable journals.

Celadrin has been tried both as a supplement and as a topical treatment in a cream.  In both cases patients were able to carry out tasks like walking across a room or flexing their knees more easily when they used Celadrin.  My feeling is that the topical treatment worked a bit better than the supplement – but data like this are hard to interpret even when you are doing the trial.  I could only work from the reports.

I don’t want to exaggerate- the effects were not huge.  But they were measurable and they seem to stand up scientifically.   I am still mystified as to how they might be working, but you can’t argue with results.  You can however argue with the quantity of results.  With only a few trials to draw on it is just possible that the manufacturers have stumbled on a lucky fluke.

I have pondered how it might be working.  I wonder if it makes the skin a bit more flexible and so reduces the stress on the joints below when they move.  If so, I can’t think of an experiment to test the idea that doesn’t involve deliberately torturing people with joint problems.  I have a strong thirst for knowledge, but I don’t think I will go that far.

The other big difference between Celadrin and glucosamine is that Celadrin is owned by a company that is doing its best to exploit it for profits.  I don’t say that to criticise.  That is what companies are supposed to do.  And in this case they have certainly come up with something that nobody else had thought of first.   But it does mean that they are limiting the supply and keeping the price up.   So while glucosamine is really cheap, Celadrin products are relatively expensive.  It will presumably come off patent at some point in the future, but for now if you want to give it a try you will have to put your hands in your pockets.

So my advice is that you might as well give glucosamine a try.  You might as well give chondroitin a miss.  Supplements or fine, but a gel or cream might be a better option.  If you have the cash to spare or you really want to find something to help with your problem, Celadrin might well have some benefits.

References

Glucosamine for osteoarthritis Towheed T, Maxwell L, Anastassiades TP, Shea B, Houpt J, Welch V, Hochberg MC, Wells GA Published Online: October 7, 2009

Drugs Aging. 2012 Sep;29(9):717-31. Nutraceuticals in the management of osteoarthritis : a critical review. Ragle RL1, Sawitzke AD.

The Journal of Rheumatology vol. 29 no. 8 1708-1712 Cetylated fatty acids improve knee function in patients with osteoarthritis. Robert Hesslink, Jr, David Armstrong, 3rd, M V Nagendran, Srinan Sreevatsan, and Raj Barathur

J Rheumatol 2004;31:767-74 Effect of a Cetylated Fatty Acid Topical Cream on Functional Mobility and Quality of Life of Patients with Osteoarthritis WILLIAM J. KRAEMER, NICHOLAS A. RATAMESS, JEFFREY M. ANDERSON, CARL M. MARESH, DAVID P. TIBERIO, MICHAEL E. JOYCE, BARRY N. MESSINGER, DUNCAN N. FRENCH, MATTHEW J. SHARMAN, MARTYN R. RUBIN, ANA L. GO?MEZ, JEFF S. VOLEK, and ROBERT L. HESSLINK