Ask the Pharmacist

Q: With the nice weather I have been trying to get more active but have found the pain and stiffness in my knees and back are really limiting me. I’d rather not take continuous maximum doses of Tylenol or Advil; is there anything else I can try?

A: The joint pain and stiffness that is a result of osteoarthritis can be a real dampener on one’s ability to exercise. This is a shame since increased exercise is considered one of the most effective ways of treating this condition.

For those looking to avoid the usual pharmaceutical options, a “natural” product that has been around for decades is generating new headlines regarding its effectiveness.

Chondroitin Sulfate first rose to prominence in the early 2000s shortly after glucosamine’s initial rise in popularity. Chondroitin is a gylcosaminoglycan that is found naturally occurring within our bodies. It is sold in most pharmacies and health food stores and is sold by all the major players in the “naturals” market such as Jamieson, Swiss and Webber.

The powder that is found within the various capsules and pills is produced either synthetically or from more natural sources such as bovine or shark cartilage. For years, there has been a great deal of debate as to whether chondroitin was actually effective for arthritis or whether any benefits felt were more of a placebo effect than anything else.

A new study conducted in 604 people located within five different European countries, seems to provide new evidence that not only does chondroitin work for some people, but that it may eventually work as well as the prescription anti-inflammatory Celebrex (celocoxib).

In this study, the patients were given either Celebrex, chondroitin or a placebo and their knee pain and stiffness were assessed over the next six months. The researchers found that while all three groups showed initial improvement (yes, even the placebo group), by the third month onward, the Celebrex and chondroitin seemed to be making a significantly greater impact in reducing the arthritic symptoms. In fact, statistically by the sixth month of the study, there seemed to be little to choose between the Celebrex and the chondroitin when it came to effectiveness (however, Celebrex did provide relief at an earlier date than did chondroitin).

Given that anti-inflammatories like Celebrex carry some degree of risk due to side effects and can possibly harm our cardiovascular and kidney systems, finding a relatively safe and just as effective natural alternative could be a real benefit to many.

Chondroitin is generally well-tolerated and its use has been followed in patients for up to six years at a time. Most generally do not experience adverse effects; however, some may deal with a certain degree of diarrhea or constipation, indigestion, nausea, headache and swelling in the lower legs or eyelids.

This is far from the first study on chondroitin, and previous ones have shown wildly-conflicting results with some indicating that chondroitin is, indeed, an excellent option and others seemingly showing that it is no more effective than a placebo.

There are many reasons why the same product could show such divergent results, including differences between the studies in the dosing used, the populations studied, and the actual product itself (not all natural versions are completely the same).

There is also evidence that chondroitin does more than just treat the symptoms of osteoarthritis. Most long-term clinical trials of at least two years duration show that chondroitin can actually slow the progression of knee or hip arthritis by attenuating joint space-narrowing or cartilage degradation.

The usual dose of chondroitin is 800-2,000 milligrams (mg) daily and it may be taken as a single dose or divided up into as many as three smaller ones. There is also some evidence that chondroitin might be effective in treating plaque psoriasis, interstitial cystitis, GERD (heartburn) and preventing a heart attack.

It can be purchased either on its own or in combination with glucosamine in various strengths.

Summing up, chondroitin looks to be an option worth at least trialling over a two- to three-month period if your arthritis is at the point that it is beginning to affect the quality of your life.

For more information about this or any other health-related questions, contact the pharmacists at Gordon Pharmasave, Your Health and Wellness Destination. Also check the website at www.gordon-pharmasave.com/ and the Facebook page at www.facebook.com/GordonPharmasave/?fref=ts