Nutritional Help For Aging Joints

Osteoarthritis: A Major Public Health Problem

Osteoarthritis affects more than 20 million Americans. This painful condition is most often seen in older individuals: more than 80% of people older than 75 have clinical osteoarthritis, and more than 80% of those over the age of 50 have measurable evidence of the condition. With increasing life expectancy, the number of people living long enough to suffer degenerative joint disease continues to grow. It can also occur in younger people, usually following injury or repetitive stress. Dancers and athletes, for example, often develop osteoarthritis at an early age following injuries and the constant wear and tear on their joints.

What Happens to Joints in Osteoarthritis?

Our joints are lined by a fluid-filled sac which acts as a lubricant, enabling the joint surfaces to move in a smooth, friction-free way. Shock absorption and cushioning for the joint is provided by cartilage and ligaments. Cartilage is made up of a collagen framework filled with proteoglycans--compounds that attract fluid and give cartilage its elasticity, strength, and resiliency.

Arthritis can attack all of these structures, causing them to break down and become inflamed. As cartilage is damaged, it becomes thinner and the manufacture of collagen and proteoglycans declines. When production of proteoglycans slows, it reduces the water-holding capacity of cartilage and makes it more susceptible to damage during normal joint motion. Over the past decade, several nutrients and botanicals have been clinically shown to help build cartilage and ease the pain of osteoarthritis.

Glucosamine Helps Maintain Cartilage

Glucosamine is a key building block for proteoglycans and other molecules that make up cartilage and lubricating joint fluid. In 2000, a review of clinical trials that examined supplemental glucosamine's effects on pain and symptoms of osteoarthritis concluded that glucosamine is both safe and effective. More recently, the results of several new studies suggest that glucosamine can slow joint degeneration. In one three year trial, 1500 mg of glucosamine sulfate was found to improve the ability to do everyday tasks like bending and going down stairs (1).

The researchers also measured the space within the joint. They found that the space narrowed in those taking placebos, indicating progressive joint degeneration. Impressively, there was no significant loss of joint space in the glucosamine group. Results from another, three year trial conducted by a different team of investigators also found symptoms improvement and no loss of joint space (2).

Boswellia serrata: Calming Inflammation

Also called Indian frankincense, boswellia is the gum resin from the bark of a tree that grows abundantly in the hills of India. Known for its anti-inflammatory effects, this resin has historically been used in traditional Indian medicine to support joint health. Laboratory studies suggest it may also help block the release of an enzyme that breaks down cartilage. One well-conducted clinical trial has shown that patients taking 1,000 mg of supplemental boswellia daily experienced easier movement, less swelling, and a better ability to bend their knees, compared to the period during which they were given a placebo (3).

Vitamin C Supports Joint Health

Vitamin C is needed to form collagen that gives strength not only to joints, but to skin, ligaments, bones, and blood vessels. In addition, a new study suggests that vitamin C may also help fight joint and muscle pain. This pilot study examined the effect of vitamin C on complex regional pain syndrome (CRPS)- a pain syndrome that develops in about 30% of people who fracture their wrists. Only 8% of patients given vitamin C developed CRPS compared to 22% who did not take the supplement (4). CRPS involves inflammation. Since the inflammatory process is sparked by free radicals, antioxidant vitamin C may help counter these effects. A larger study is underway to confirm the potential of vitamin C to help control this debilitating problem.

References

1. Reginster JY, et al. Long-term effects of glucosamine sulphate on osteoarthritis progression: a randomized, placebo-controlled clinical trial. Lancet 357:251-6, 2001.
2. Pavelka K et, al. Glucosamine sulfate use and delay of progression of knee osteoarthritis: a three year, randomized, placebo-controlled, double-blind study. Arch Intern Med. 162:2113-23, 2002.
3. Kimmatkar N, et al. Efficacy and tolerability of Boswellia serrata extract in treatment of osteoarthritis of the knee-A randomized, double-blind, placebo-controlled trial. Phytomedicine 10:3-7, 2003.
4. McBride A, et al. News release from Bristol Royal Infirmary's university department of orthopedics, Arthritis Research Campaign, October, 2003.