The treatment of osteoarthritis, for example the common osteoarthritis of the knee, Orthopaedic surgeons, apart from suggesting rest, ice therapy, supportive and elevation, would like to prescribe a course of anti-inflammatory drugs to control inflammation, pain and swelling. In choosing which NSAID to prescribe, doctors may have some personal preference and should also consider the possible associated side effects such as nausea, gastrointestinal irritation and ulceration. Some patients with possible allergy or hypersensitivity reaction, he may need to adjust the prescription accordingly.
As the early stage of the joint degeneration starts with the intra-articular cartilage, thinning and wear and tear, it is quite natural to think of supplementing its constituents as a form of treatment. Cartilage supplement or its constituent, different preparations of glucosamine and chondroitin have been promoted as effective in the treatment and prevention of osteoarthritis.
As we have understood, degenerative osteoarthritis is the result of excessive use, wear and tear beyond the physiological load of the joint. It is not due to inadequacy or inability of the joint to produce normal cartilage and articular or synovial fluid. One cannot expect supplementing with cartilage or its constituents will help to slow down or reverse the degenerative process. Neither will these supplements help to control the inflammation in osteoarthritis. Although there were reports that some glucosamine preparations had been found to be able to stabilize some inflammatory cells and helped to alleviate the inflammation and pain, further study is necessary to prove their efficacy in pain control. Moreover, orally taken glucosamines and chondroitin will be digested and may not be reconstituted as cartilage or synovial fluid in the degenerated joint.
Preparation of glucosamine and chondoitin are manufactured from shrimps, crabs or other shelled animals. Some of them are derived from shark fish or cartilage from birds, trachea from pigs and cows. The raw materials are very diverse and difficult to standardize their prescriptions. Patients with hypersensitivities to shell or iodine products should avoid taking such preparations.
Dr. MAK, Kan-hing