Osteoarthritis (OA) is a condition in which the protective cartilage surrounding joints breaks down and leads to pain, and though it's more prevalent in the hip and knee, hand OA is also common. Treatment options for hand OA are limited and often not very effective in the long term. Therefore, alternative treatments have been sought, and glucosamine and chondroitin sulfate (CS) are two non-prescription dietary supplements that have recently gained popularity in the U.S. Both supplements have been used in Europe for decades as prescriptions, but in the U.S. they are usually available over-the-counter, meaning they are not regulated by the Food and Drug Administration (FDA). Due to this, and inconsistent results from research studies, it is not yet known how effective glucosamine and CS are for hand OA. A recent article attempted to clarify this.
Most research studies have focused on knee and hip OA rather than hand OA. Two recent randomized-controlled trials (RCTs), considered the gold standard for clinical trials, found that glucosamine and CS led to significant improvements in function and reductions in pain for patients with knee OA. Another RCT showed that hand OA patients who took CS had significantly less pain, improved functional scores and less morning stiffness compared to placebo (a fake drug patients were told was CS). Though some other studies have still presented conflicting results, these few powerful RCTs provide some solid evidence to support glucosamine and CS.
In addition to the supportive studies on the effectiveness of these supplements, there have also been numerous RCTs that have shown the safety of glucosamine and CS to be similar to that of placebo. Patients treated for up to three years have tolerated long-term use, and in general, both supplements are regarded as having excellent safety profiles, especially when compared to other popular pain medications. More research is needed to further confirm these findings, but based on the supportive RCTs and overall safety of use, glucosamine and CS should be considered a reasonable treatment option to be taken in addition to other interventions like physical therapy to manage hand OA.
-As reported in the August '13 issue of the Journal of Hand Surgery
