A New Treatment for Degenerative Arthritis

Degenerative arthritis, or osteoarthritis, is the most common form of arthritis that people get. Symptoms range in severity from none to rapidly progressive and disabling, in some cases eventually culminating in joint failure.

The symptoms of osteoarthritis are joint pain, stiffness, and restriction in range of motion. Symptoms usually occur in only a few joints in middle age. The pain is typically worse with joint use and improved by rest. Pain is generally worse in the late afternoon and early evening but can also be worse in the morning soon after waking up. There may also be night pain in severe osteoarthritis, which can interfere with sleep. Giving way or buckling is a common symptom in knee osteoarthritis. Osteoarthritis usually doesn’t appear until after age 45. Osteoarthritis causes significant interference with daily activities in many patients. 

The challenge with osteoarthritis is treatment. Tylenol is typically unhelpful. Non-steroidal anti-inflammatory drugs like Advil and Aleve can be helpful, but have side effect risks (e.g., gastrointestinal bleeding) that increase with dose and continued use.

Interest in using chondroitin sulfate, a compound used for many years to treat arthritis in dogs, has waned because studies in humans have shown it to be no better than placebo. A recent study, however, challenged this notion by asking the following question: might the purity of the chondroitin influence its effectiveness? In the U.S. the only kind of chondroitin that’s been studied has been nutraceutical-grade, which exhibits striking variations in composition, purity, and preparation. Pharmaceutical-grade chondroitin, on the other hand, doesn’t exhibit such variation and is typically greater than 95% pure.

The study in question compared 800 mg of pharmaceutical-grade chondroitin sulfate to Celebrex (an anti-inflammatory pain reliever) and placebo. Six hundred and three patients were randomized to one of these three arms. Results showed that all three groups had improvement in pain at one month, three months, and six months (remember, the placebo effect is especially pronounced when it comes to treating pain), but by 6 months most patients taking either Celebrex or pharmaceutical-grade chondroitin saw a 10% greater reduction in their pain when compared to placebo (which represented a greater than 50% total reduction in their pain).

The advantage of using pharmaceutical-grade chondroitin is its safety profile: it causes no appreciable side effects at all. Whether combining pharmaceutical-grade chondroitin with Celebrex would provide additional pain relief when compared to using either alone wasn’t assessed in this study. But having an effective treatment that’s essentially entirely safe represents a real breakthrough in the treatment of this unfortunately all-too-common disease.

Pharmaceutical-grade chondroitin can be obtained from compounding pharmacies in the U.S. and require a prescription from your doctor.

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  • Alex,

    Thanks for this newsletter’s informative explanation about degenerative arthritis. As you know, I’ve had pain challenges from this physical deterioration, particularly in my right knee, for quite a while now. For the present, I’m trying to deal with it by taking spaced apart Celebrex tabs to reduce the daily cost. I’m okay with it for now, but I recognize the pain, stiffness, and weakness are worsening. Sometime in the future, when I don’t know, we’ll have to re-assess my condition.

    Thanks, Alex.

    Tom Reiter