Pain is something we all experience from time to time.
Most aches and pains are a minor nuisance, rather than a serious
problem, but six million people in the UK suffer from chronic and
persistent pain on a daily basis.
Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen
are widely prescribed to treat acute and chronic pain. Although
they are effective analgesics, they are associated with a number of
adverse events, including kidney damage, exacerbation of asthma and
gastric ulceration. Recently, the use of NSAIDs was found to
increase the chance of developing heart failure in older people;
one recent study showed that taking an NSAID increased the risk of
a first hospital admission for heart failure by 30%. For those with
previous heart failure, taking such a drug increased the chance of
admission to hospital almost nine-fold.1 NSAIDs have
also been associated with the appearance of psychiatric symptoms,
including changes in mood and thought processes and exacerbation of
pre-existing psychiatric problems.2 A number of NSAIDs
have also been withdrawn due to increased risk of heart attack and
stroke. Overall, it is estimated that around 25 million
prescriptions are issued for them in the UK each year, resulting in
12,000 admissions to hospital to treat serious side effects, and
there are as many as 2,600 deaths.3
Many people therefore prefer to try a natural alternative -
especially for treating arthritis. Whereas NSAIDs can only damp
down inflammation and pain, food supplements such as glucosamine
plus chondroitin have the potential to halt the degenerative
effects of osteoarthritis. The following supplements can help to
reduce joint or back pain.
Glucosamine stimulates the formation of
proteoglycans (protein molecules), important for strengthening
cartilage so it can resist compressive forces; it is also thought
to have an anti-inflammatory action. A pivotal trial published in
The Lancet showed that taking glucosamine supplements (1,500mg once
daily) produced significant improvements in pain and disability,
with no significant loss of joint space seen over the three-year
trial period. In contrast, those taking a placebo developed
worsening symptoms with increased narrowing of the knee joint
space.4 A systematic review of 20 randomised controlled
trials found that, in people with osteoarthritis, glucosamine was
28% more effective at relieving pain than placebo, with a 21%
improvement in joint function.5 This review included
four trials in which glucosamine was shown to be superior to an
NSAID in two of the trials and at least as effective in the others,
with a considerably lower risk of side effects.
Chondroitin also stimulates proteoglycan
synthesis and promotes cartilage formation. It is often combined
with glucosamine for their naturally synergistic actions. A
clinical trial in which people with osteoarthritis of the knee took
chondroitin for three months, on two occasions throughout the year,
showed significant improvement in pain and joint function compared
with those on a placebo.6 This suggests that chondroitin
has a disease-modifying action against osteoarthritis of the knee.
In a recent trial, the effects of glucosamine and chondroitin were
compared with that of the NSAID, Celecoxib. For people with
moderate to severe knee pain, the combination of 1,500mg
glucosamine plus 1,200mg chondroitin per day was more effective at
producing a 20% decrease in knee pain over the 24-week study than
Celecoxib.7
Other natural painkillers
MSM methyl-sulphonylmethane has an
antiinflammatory action that reduces the formation of free radicals
by white blood cells.8 MSM can reduce joint pain in
people with osteoarthritis by 80% within six weeks, compared with
an average improvement of 20% in those on placebo.9 MSM
can be taken with glucosamine and, in one study, the combination of
500mg glucosamine plus 500mg MSM three times per day was found to
significantly improve joint function and to reduce pain and
swelling more than either agent alone. The combination also
produced a more rapid reduction in symptoms.10
Bromelain, a proteolytic enzyme derived from
pineapple, has an antiinflammatory action, reducing the migration
of white blood cells into areas of inflammation and damping down
the release of inflammatory chemicals.11 It has been
shown to significantly reduce acute knee pain and stiffness, and to
improve general well-being in a dose-dependent manner.12
Helps to reduce pain and swelling associated with arthritis,
sprains and soft tissue injury - reduces knee pain and inflammation
associated with rheumatoid arthritis and improves mobility of
osteoarthritis.
Devil’s Claw is a natural herbal
painkiller for lowerback pain and inflamed joints. Two clinical
trials found strong evidence that it was better than a placebo for
improving back pain and another study found it was at least as
effective as the now-withdrawn NSAID, rofecoxib.13
Green-lipped mussel extracts have an
antiinflammatory action. A recent trial showed that they
significantly improved the signs and symptoms of osteoarthritis by
80% within two months.14
Turmeric contains curcumin, a powerful
anti-inflammatory agent15 which helps to ease stiff
joints. Unlike NSAIDS, turmeric protects the stomach from peptic
ulceration.16
Ginger has significant analgesic effects
against joint pain and has been shown to suppress inflammation by
blocking the release of inflammatory chemicals within synovial
fluid, cartilage and white blood cells.17
So if you have joint or back pain and are wary about taking a
nonsteroidal anti-inflammatory drug, a number of food supplements
have antiinflammatory, pain-killing actions. In addition to being
as effective as some prescribed analgesics, these food supplements
are less likely to cause serious adverse side effects.
1 Huerta C et al. 2006. Nonsteroidal
anti-inflammatory drugs and risk of first hospital admission for
heart failure in the general population. Heart May 22
(Epub)
2 Onder G et al. 2004. NSAID-related psychiatric
adverse events: who is at risk? Drugs. 64(23):2619-27.
3http://www.jr2.ox.ac.uk/bandolier/booth/painpag/nsae/nsae.html
4 Reginster JY et al. 2001. Long-term effects of
glucosamine sulphate on osteoarthritis progression: a randomised,
placebo-controlled clinical trial. Lancet 357(9252):251-6
5 Towheed TE et al. 2005 Glucosamine therapy for
treating osteoarthritis. Cochrane Database Syst Rev.
(2):CD002946.
6 Uebelhart D et al. 2004. Intermittent treatment of
knee osteoarthritis with oral chondroitin sulfate: a one-year,
randomized, double-blind, multicenter study versus placebo.
Osteoarthritis Cartilage. 12(4):269-76.
7 Clegg DO et al. 2006 Glucosamine, chondroitin
sulfate, and the two in combination for painful knee
osteoarthritis. N Engl J Med 23;354(8):795-808
8 Beilke MA et al. 1987. Effects of dimethyl
sulfoxide on the oxidative function of human neutrophils. J Lab
Clin Med 110:91-96.
9 Jacob SW, Appleton J. MSM: The Definitive Guide. A
Comprehensive Review of the Science and Therapeutics of
Methylsulfonylmethane. Topanga, CA: Freedom Press;
2003:107-121.
10 Usha PR, Naidu MUR. 2004. Randomised,
double-blind, parallel, placebo-controlled study of oral
glucosamine, methylsulfonylmethane and their combination in
osteoarthritis. Clinical Drug Investigation.24:353-363
11 Hale LP et al. 2002. Bromelain treatment alters
leukocyte expression of cell surface molecules involved in cellular
adhesion and activation. Clin Immunol. 104(2):183-90
12 Walker AF et al. 2002. Bromelain reduces mild
acute knee pain and improves well=being in a dose-dependent fashion
in an open study of otherwise healthy adults. Phytomedicine
9(8):68106
13 Gagnier JJ et al. 2006 Herbal medicine for low
back pain. Cochrane Database Syst Rev (2):CH004504
14 Cho SH et al. 2003. Clinical efficacy and safety
of Lyprinol, a patented extract from New Zealand green-lipped
mussel (Perna Canaliculus) in patients with osteoarthritis of the
hip and knee: a multicenter 2-month clinical trial. Allerg Immunol
(Paris) 35(6):212-6
15 Lantz RC et al. 2005. The effect of turmeric
extracts on inflammatory mediator production. Phytomedicine.
12(6-7):445-52.
16 Prucksunand C 2001. Phase II clinical trial on
effect of the long turmeric (Curcuma longa Linn) on healing of
peptic ulcer. Southeast Asian J Trop Med Public Health.
32(1):208-15.
17 Phan PV et al. 2005. Ginger extract components
suppress induction of chemokine expression in human synoviocytes. J
Altern Complement Med 11(1):149-54
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