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Easing Arthritic Pain

How a supplement often used on animals is helping humans, too.

WebMD Feature

April 10, 2000 (San Francisco) -- For more than 10 years, 72-year-old San Franciscan Ellen Arbenz was dogged by pain every time she climbed a set of stairs. Sometimes just walking across a room made her joints cry out. And though she'd always loved gardening, she had gradually come to enjoy it less and less. Kneeling to yank a weed, pushing a trowel into the dirt, or merely reaching to clip a flower had become too painful.

Arbenz's troubles are all too common: an estimated 20 million Americans suffer from osteoarthritis. Like many others with this ailment, Arbenz has long taken the standard therapy: non-steroidal anti-inflammatory drugs, or NSAIDs. The pills made her joints less achy, but they also upset her stomach.

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A year or so ago, she heard of a dietary supplement called glucosamine. Indeed, if you know a lot of people with arthritis, as Arbenz does, it's hard not to hear about this substance. Again and again, fellow sufferers told her that glucosamine -- sometimes taken along with another supplement called chondroitin -- helped them. A book on these pills, The Arthritis Cure, by Jason Theodosakis, MD, was selling like hotcakes.

Six months ago, Arbenz tried glucosamine herself. "I've had very good results," she says. "I no longer take the anti-inflammatories, and the pain is still improving."

Arbenz's rebound would come as no surprise to veterinarians, many of whom have long used glucosamine and chondroitin to treat creaky horses and dogs. "We see it all the time," says Andrew Sams, DVM, a veterinary surgeon at the Madera Pet Hospital in Corte Madera, Calif. "I've had many pet owners start using these supplements for themselves after their dog began to show improvements." But after years of such anecdotal successes with only small-scale foreign studies to back them up, there's been little medical evidence of their effectiveness.

That may be about to change. The National Institutes of Health (NIH) recently allocated $6.6 million for the biggest study ever on these supplements. This eagerly awaited nine-center trial, slated to begin this summer, will assign more than 1,000 osteoarthritis patients to receive either glucosamine alone, chondroitin alone, the two substances together, or a placebo. Monthly evaluations will look at patients' levels of pain and how well they're able to manage everyday chores. Researchers will also compare X-rays of joints taken at the beginning and end of the study to look for structural changes over the four-month period.

"While this study design won't answer how the supplements work," says Daniel O. Clegg, MD, professor of medicine at the University of Utah and the NIH study coordinator, "it will be able to say with some real authority whether or not they work." This kind of clarity is needed. A review in the March 15 Journal of the American Medical Association criticized many of the past studies for possible bias and exaggeration. Even so, author Timothy McAlindon, DM, concludes that the supplements appear helpful.

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