n Glucosamine. Despite lingering doubts, many experts now believe that glucosamine (a dietary supplement) can reduce osteoarthritis pain. The best evidence comes from studies involving the knee. In a large trial published in 2001, X-rays indicated that glucosamine may help protect or restore arthritic knees. That finding has been disputed, but a research review published in 2000 found that glucosamine does relieve pain and improve flexibility in affected knees or hips. Glucosamine lacks aspirin’s gastrointestinal side effects, but animal studies suggest it can interfere with insulin, causing blood sugar to rise. The clinical significance of that finding is unknown. People with shellfish allergy or iodine hypersensitivity should avoid glucosamine.
Chondroitin. Chondroitin sulfate, another possible remedy for joint pain, is often combined with glucosamine. Several studies have found it helpful in people with osteoarthritis, but rigorous evidence is still lacking. Like glucosamine, chondroitin could theoretically cause elevations in blood sugar. Experts also worry that it could promote excessive bleeding, especially if taken with blood-thinning agents such as warfarin (Coumadin) or heparin.
SAMe. Doctors have studied Sadenosylmethionine, or SAMe, for more than 20 years as a treatment for depression, liver disease and osteoarthritis. The arthritis research has focused mainly on knee problems, along with some chronic hip and spine symptoms. A new federally funded review of the scientific evidence concludes that SAMe may be as effective as NSAIDs for reducing osteoarthritis pain. Side effects such as restlessness, anxiety, insomnia and mania occasionally occur, and may be more common in people with bipolar disorder. SAMe may also cause stomach upset and nausea, particularly at higher doses.
Herbs and acupuncture. The agents used to treat arthritis pain range from boswellia and curcumin (turmeric) to evening-primrose oil, ginger, guggul, horse-chestnut-seed extract, shark cartilage and stinging nettle. Unfortunately, the scientific evidence is too sparse to support firm conclusions about any of them. Acupuncture is being studied for its effects on pain in the knees, hips and spine, but its benefits are not well established. For most sufferers, finding safe, effective relief is still a process of trial and error.
