Related topics: •  Arthritis Center

Alternative remedies for arthritis are nothing new. Folklore is full of potions and poultices that supposedly relieve joint pain, and the advent of modern medicine hasn't dampened the public's interest. If anything, arthritis patients are more adventuresome than ever before.

According to reports in the journal Rheumatic Disease Clinics of North America, today's arthritis patients have been known to rub whiskey and actual snake oil into their joints. Some swear that drinking sour cherry juice relieves inflammation, and magnets and copper bracelets have become popular accessories for the same reason. Nutritional supplements for arthritis are a billion-dollar business. Finally, many chiropractors, homeopaths, and acupuncturists owe a large percentage of their livelihoods to joint pain.

It's no surprise that so many arthritis sufferers are willing to venture beyond the bounds of mainstream medicine, says John H. Klippel, MD, president of the Arthritis Foundation. With few exceptions, patients with arthritis are never completely cured by standard medicine. "Traditional treatments can relieve pain, but people still suffer," he says. In addition, today's patients aren't always willing to just sit back and take doctor's orders. "Many patients will try anything to take charge of their health."

When this proactive attitude is backed up with caution and common sense, good things can sometimes happen, Klippel says. In some cases, he says, today's alternative medicine may someday be tomorrow's mainstream. Many rheumatologists (doctors who specialize in arthritis and other joint diseases) are very open to the idea of alternative medicine, he says. If any remedy can prove its worth in controlled clinical trials, doctors will quickly embrace it.

Unfortunately, most alternative remedies have rarely, if ever, been put to the scientific test. A few studies have shown some benefit from these treatments, but the results aren't consistent. While some patients swear by the results, doctors are still waiting for the hard data. There are, however, a number of studies on at least two alternative treatments that show great promise: acupuncture and glucosamine/chondroitin.

A landmark 2004 study funded by the National Center for Complementary and Alternative Medicine (NCCAM), part of the National Institutes of Health, found that acupuncture provides pain relief and improves function in patients with osteoarthritis of the knee. Other studies have also found it helpful in relieving pain. As a result, it is increasingly being used as part of arthritis treatment and may even be covered by health insurance.

Glucosamin and chondroitin have also begun to enter the mainstream. According to Klippel, preliminary studies have suggested that the supplements can relieve osteoarthritis, presumably by restoring cartilage. The supplements may even be able to slow down the advance of the disease, a claim that no current medication can make. (There's no reason to think that the supplements would be effective against any other form of arthritis, including rheumatoid arthritis, he says.)

Interest in glucosamine and chondroitin is so great that the National Institutes of Health conducted a large-scale study of the supplements for treating osteoarthritis of the knee. More than 1,500 osteoarthritis sufferers at 16 rheumatology centers across the United States participated in the study over a 24-week period. Scientists gave research subjects five different treatment options including glucosamine only, chondroitin only, and a combination of both. Although there were no significant differences between treatments overall, researchers found that for those with moderate to severe pain, glucosamine combined with chondroitin reduced patient suffering by at least 20 percent. However, a follow-up study published in 2008 found that the supplement did no better than a placebo in slowing the loss of cartilage. Since the placebo group did better than expected, however, researchers cautioned that the results are difficult to interpret and further research is needed.

Glucosamine and chondroitin are sold in grocery stores everywhere, but picking up a bottle isn't the same as grabbing a bag of potato chips. Klippel urges patients to treat the supplements like serious medicine. That means reading the instructions and following the directions to the letter.

Above all, patients should talk to their doctors before trying glucosamine, chondroitin, or any other alternative remedies, Klippel says. For one thing, doctors can offer valuable advice. More importantly, they need to know about anything and everything that might affect a patient's condition. If a patient suddenly gets better after trying a new treatment, the doctor should know where the credit belongs. Likewise, if something goes wrong, physicians should know about any potential causes.

Many people assume that "natural" products like glucosamine and chondroitin must be safe, but that assumption could backfire. According to the Arthritis Foundation, glucosamine and chondroitin carry risks. For example, chondroitin may interfere with blood-thinning medications, and glucosamine could potentially raise blood sugar in people with diabetes. The Arthritis Foundation says that children, pregnant women, or women who might become pregnant shouldn't take the supplements because there are no long-term studies of the effects on those populations.

Patients shopping for glucosamine or chondroitin need to be aware of another potential pitfall. Since nutritional supplements are not as stringently monitored as drugs, the pills in the bottle may not have any of the ingredients listed on the label. For this reason, the Arthritis Foundation recommends buying supplements only from large, reputable companies. Be aware, however, that the federal government doesn't regulate any supplements for safety and effectiveness before they are put on the market.

Alternative therapies should never take the place of standard medical care, Klippel says. People with joint pain need to know exactly what kind of arthritis they have and what their future holds. Working together with their doctors, they may find alternative treatments that really work.

-- Chris Woolston, M.S., is a health and medical writer with a master's degree in biology. He is a contributing editor at Consumer Health Interactive, and was the staff writer at Hippocrates, a magazine for physicians. He has also covered science issues for Time Inc. Health, WebMD, and the Chronicle of Higher Education.

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Last updated August 11, 2009
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