I see a lot of different health issues in practice, and these can broadly be divided into what you might call "primary" and "secondary" concerns. I see primary concerns as the sort of things that cause individuals to make appointments to see me. Common examples include fatigue, irritable bowel syndrome, asthma, and eczema.
On the other hand, secondary concerns tend not to be volunteered, and may only come out while I'm doing a review of all health issues. One common secondary issue relates to the joints. For example, I may see individuals who have a tendency to pain and stiffness in one or more joints, generally as a result of wear and tear, also known as osteoarthritis. Many of these individuals have sustained sporting injuries, after which they may find the joint never was "quite right."
Of all the joints to be affected in this way, I find the knee to be the most common. Not only is this one of the major weight-bearing joints in the body, but also it is prone to injury during the twisting and turning and abnormal forces induced by, say, skiing, rugby, football, squash, or tennis.
Appropriate physical therapy (e.g. physiotherapy, osteopathy, biomechanical assessment, and management) has its part to play in such cases. However, from a nutritional perspective, a mainstay of the management I advise is the agent glucosamine sulphate. This substance is a basic building block in cartilage and other soft tissues such as ligament and tendon.
While not all research is utterly consistent, there is evidence that supplementation with glucosamine sulphate can be effective in the relief of osteoarthritis, including that affecting the knee [1–4]. In practice, I find glucosamine to be generally very effective in improving the function of the knee joint and reducing discomfort. It can be a critical factor in allowing individuals to retain active, productive lives.
I was therefore interested to read a recent study that looked at the relationship between supplementation with glucosamine sulphate and risk of requiring a subsequent knee replacement [5].
Knee replacement surgery is usually the final option for individuals suffering from osteoarthritis of the knee who have been unable to find appropriate relief using other means. In theory at least, glucosamine sulphate may enhance the health of the joint, including its cartilage, and this may lead to being spared surgery.
In this study, 275 individuals were followed through time. For the purposes of the analysis, individuals were divided into two groups: those who in previous studies had taken glucosamine sulphate for at least one year and up to three years, and those who in previous studies had taken a placebo.
The participants in this study were followed for an average of five years following the time that they discontinued the medication or placebo.
The results of this study found:
Those who had previously taken glucosamine were 57 percent less likely to have knee replacement compared to those who had taken a placebo. Those who had previously taken glucosamine used less medication and health resources generally compared to those who had taken a placebo.
This study supports the use of glucosamine sulphate for the treatment of wear and tear and osteoarthritis of the knee. In particular, this agent seems to help keep people off the operating table.
References:
1. Pupate JM, et al. Double blind clinical evaluation of oral glucosamine sulphate in the basic treatment of osteoarthrosis. Current Medical Research Opinion 1980; 2:110–114
2. Covanta A, et al. Therapeutic activity of oral glucosamine sulphate in osteoarthritis: a placebo-controlled double-blind investigation Clinical Therapeutics 1980; 3(4): 266–272
3. Noack W, et al. Glucosamine sulphate in osteoarthritis of the knee. Osteoarthritis and Cartilage 1994; 2:51–59
4. Muller-Fabbender H, et al. Glucosamine sulphate compared to ibuprofen in osteoarthritis of the knee Osteoarthritis and Cartilage 1994; 2:61–69
5. Bruyere O, et al. Total joint replacement after glucosamine sulphate treatment in knee osteoarthritis: results of a mean 8-year observation of patients from two previous 3-year, randomized, placebo-controlled trials. Osteoarthritis and Cartilage, 2008; 16(2): 254–60.
Dr. John Briffa is a London-based doctor and author with an interest in nutrition and natural medicine.
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