The truth about arthritis treatments

Source: Your Health: What Works, What Doesn’t

Arthritis pain is not only frustrating, but over time it can begin to interfere with your daily life. While the condition can’t be cured completely, there are treatments available that can bring relief. Best Health rounded up some of the tried-and-true methods in our guide to treatments that work, but what about the other options out there?

The following treatments have proven helpful for some arthritis sufferers. Talk to your doctor to determine if one might work for you.

Glucosamine and chondroitin

Despite huge initial promise’and major sales of the supplements around the world’this duo of natural remedies probably isn’t as useful for arthritis as we once hoped, either separately or together. When researchers evaluated 15 studies looking at its use for arthritis, all pointed to the same conclusion: Glucosamine is not effective. Then the largest, most thorough study ever conducted on the use of glucosamine and chondroitin, published in the New England Journal of Medicine, found that the combination wasn’t any more effective than a placebo for reducing mild to moderate knee pain.

The only exceptions were that people taking chondroitin alone responded better than those taking glucosamine alone and that the supplements seemed to have some measurable benefit for the subset of participants whose arthritis pain ranked higher than moderate. The general conclusion: For most people with arthritis, there is little benefit to the pills; for those with more severe pain, it can be considered as part of a broader treatment program.

Hyaluronic acid injections

In this treatment, hyaluronic acid is injected to replace a natural substance called hyaluronan that works like motor oil in the joint to let the cartilage surfaces of bones glide over each other smoothly. For some people, injections of this thick liquid can help reduce pain for a year or longer. And clinical studies show that the therapy is as effective in providing pain relief as nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin and ibuprofen. But these injections don’t work for everyone, must be given relatively frequently, and are expensive. For this reason, most doctors consider the injections (also called joint fluid therapy) only as a backup plan if other remedies don’t work.

Ginger

It’s great for certain types of nausea, but there is also evidence that this anti-inflammatory herb can help with the pain, swelling, and stiffness of osteoarthritis, particularly in the knee. In one study of 261 people with knee osteoarthritis, volunteers received either a sugar pill or ginger extract. The result: 63 percent of the ginger group experienced pain relief compared to 50 percent of the placebo group. Even better: Unlike some painkillers, ginger causes few if any stomach problems. Use fresh ginger liberally in your cooking, make tea by boiling several slices of fresh ginger, or for maximum benefit, take 500 to 1,000 milligrams of powdered ginger root daily.

Willow bark

White willow bark’the original source of salicin, the active ingredient in aspirin‘appears to provide some relief from arthritis pain, though it won’t work as well as traditional painkillers.

SAM-e

This somewhat controversial supplement has a fair amount of scientific support as a pain reliever for arthritis. SAM-e is short for S-adenosyl-methionine, a naturally occurring chemical in the body that has many functions. In test-tube and animal research, it protects cells that produce cartilage and stimulates them to produce joint-lubricating chemicals. Sold as a drug in some countries and as an over-the-counter supplement in others, it has proven as effective as some COX-2 inhibitors for relieving arthritis pain, but it takes longer to act. An analysis of 14 SAM-e studies showed it is also effective for improving mobility in people with osteoarthritis. However, high doses of SAM-e can cause several side effects, and it interacts with many medications. Use it only after talking with your doctor.

Osteotomy

This form of surgery repositions or reshapes the bones in the knee to shift weight away from the damaged arthritic area. A review of numerous studies found that while it does improve knee function and reduce pain in people with arthritis of the knee, there’s no evidence yet as to whether it’s more effective than conservative approaches such as exercise and pain medication.

Remember that not all arthritis treatments are created equal. Here are a few treatments you’d be better to avoid.

Arthroscopic surgery

In this type of surgery, the surgeon makes tiny incisions in the knee, then uses small tools to either clean out debris and remove or sand down rough, torn pieces of cartilage (arthroscopic debridement) or flush out debris and calcium phosphate crystals (arthroscopic lavage). But in a major study in which 180 people were treated with either one of the two procedures or a fake arthroscopic procedure, researchers found that the surgeries not only didn’t work but were potentially harmful. The researchers followed patients for two years after the surgery and found that those who had the fake surgery actually climbed stairs and walked slightly faster than those who got the real thing.

Topical pain relievers

There is little evidence that aspirin-containing creams like Aspercreme are effective for treating arthritis pain. A review of nine studies found that while the creams tend to work fairly well for one-time aches and pains (such as soreness from raking leaves), they’re not very good at relieving the chronic pain of arthritis.

Vitamin E

Some natural healing practitioners theorize that vitamin E and other antioxidants reduce inflammation and ease arthritis pain. Vitamin E has been evaluated in five high-quality clinical trials. Although two concluded the vitamin worked better than a placebo for reducing pain, and one found it worked as well as an NSAID, the two largest and longest trials found no difference between the vitamin and a placebo in terms of reducing pain from osteoarthritis of the knee. Also, recent studies show that taking daily supplements of vitamin E at a dose of 400 milligrams or more can be dangerous.