DR. HOOK- Ouch! Pills don't pop joint pain

Pain is something that's awful, prevalent, and hard to describe to someone else. Some people experience pain, others share the pain (and yet still others just cause pain).  

   I was shopping at the local ABC store. (Mary Poppins sang, "A spoon full of sugar helps the medicine go down," but did not include "A small amount of alcohol is good for most people's cardiovascular system as well.") It was completely quiet in the store until a woman came in who acted like she was a model on Project Runway– senior citizen version. In short, she was no Heidi Klum.  

   "Do I get a senior discount?" she snapped. The customer service man tried to explain to her, and explain to her, and explain to her again that there are no discounts. The tiny lady replied, "Well, last time I bought a case of vodka, I got a discount." (A case of vodka? Where does she live– Club Med?)  

She kept complaining and complaining, and then had the customer service man carry out the heavy box of booze to her illegally parked car along the fire lane. She made a U-turn– and stopped all traffic until she could slowly back up, go forward, back up again, and then zoom off. There are starving people without homes in this world, and all she could do was spread pain in every direction. Is there a cure for pain?

   Glucosamine chondroitin is a pretty well known over-the-counter supplement for osteoarthritis (OA). Twenty million Americans have OA, and it's becoming more prevalent. In OA, the cartilage of the joint breaks down so there's no longer a cushion between the bones.  

Glucosamine and chondroitin are both supposed to decrease the rate of cartilage breakdown and help the joint repair itself, as well as reduce pain. However, studies have been poorly conducted, and results have been conflicting. Scientific research, statistics, and politics can be kind of like LA smog: hazy.

   The February 23 edition of the New England Journal of Medicine published "Glucosamine, Chondroitin Sulfate, and the Two in Combination for Painful Knee Osteoarthritis." Despite the name, it was a pretty good study.  People 40 years or older who had knee OA were randomized into five groups– including a placebo group.  

   I was really hoping to see miraculous results because there's no cure for OA, and treatment for the joint pain is like buying a timeshare– it usually does live up to the sales pitch. However, I didn't stand up on my chair and sing "Let the Sunshine In" from Hair. 

After 24 weeks of treatment, Glucosamine/Chondroitin was not shown to be effective in pain relief.

   The study had one big limitation: it looked only at people with OA of the knee, not other joints like backs, hands, and necks. So with all the conflicting studies out there, it doesn't look good. If someone got up on a podium and said to buy stock in Glucosamine Chondroitin, I would wonder if he was related to Ken Lay or Jeff Skilling.

I estimate that about 25 percent of my patients on Glucosamine Chondroitin say it helps their OA pain. Who knows? Maybe it really does slow down OA progression. It has not been shown to be harmful– unless a person has a shellfish allergy. But it's another pill to swallow, and it costs money.

   I hope one day there will be a cure for OA or a completely safe medication to effectively stop the pain. But for now, OA is like that lady in the liquor store who demands service and gives nothing back except grief.

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