By Dr. Mercola
You've probably heard that glucosamine and chondroitin can help relieve symptoms of joint pain.
However, the results from recent studies evaluating these supplements have been mixed, and many do not appear to be getting any significant relief from either glucosamine or chondroitin.
NPR1 recently highlighted The Glucosamine/chondroitin Arthritis Intervention Trial (GAIT), which found that, for most joint-pain patients, the supplements didn’t relieve pain any better than a placebo, nor did they impact joint structure in any way that would delay the progression of the disease.2
Still, some physicians support the use of glucosamine and chondroitin simply because the placebo effect actually results in the pain feeling better – and this allows the person to stay active and lose weight. Exercise is the real joint-pain solution that many are seeking…
Regular Exercise May Be One of the Most Effective Treatments Available for Knee Pain
A recent JAMA study revealed that among overweight and obese adults with knee osteoarthritis, following an intensive diet and exercise program led to less pain and better function, along with better physical health-related qualify of life scores.3 As NPR reported:4
“There's abundant evidence that losing weight and regular exercise are the most effective treatments available for osteoarthritis pain, [rheumatologist Dr. Patience] White adds. 'It's quite striking,' she says."
If you lose only five pounds, you're talking about the equivalent of 20 pounds [less stress] across those knees, so you can imagine it would make quite a difference."
Pretty much any type of exercise seems to reduce pain and increase flexibility, according to [rheumatologist Dr. David] Felson. 'There have been a variety of different exercise studies which have tried everything from water aerobics to walking to muscle strengthening, and they all seem to work.'”
Arthritis rates are more than twice as high in obese people as those who are normal weight, because the extra weight puts more pressure on your joints, as well as increases inflammation in your body. This not only leads to osteoarthritis, it can also make joint pain from any cause exponentially worse.
Exercise, along with a healthy diet, can help you to jumpstart weight loss if you're overweight, and this can lead to tremendous improvements in your joint pain. Exercise can also improve bone density and joint function, which can help prevent and alleviate osteoarthritis as you age.
Unfortunately, many with joint pain are missing out on these potential benefits. Research from Northwestern University Feinberg School of Medicine found that over 40 percent of men and 56 percent of women with knee osteoarthritis were inactive, which means they did not engage in even one 10-minute period of moderate-to-vigorous activity all week.5
If You Have Knee, or Other, Joint Pain, Exercise Is a Must to Prevent Loss of Function
The notion that exercise is detrimental to your joints is a serious misconception; as there is no evidence to support this belief. It's simply a myth that you can 'wear down' your knees just from average levels of exercise and/or normal activity. Instead, the evidence points to exercise having a positive impact on joint tissues, whether you need to lose weight or not.
For instance, exercise can help by reducing your joint pain and making it easier for you to perform daily tasks. This is important, as the pain of osteoarthritis has a tendency to lead to decreased activity, which in turn promotes muscle weakness, joint contractures and loss of range of motion. This, in turn, can lead to more pain and loss of function, and even less activity. Exercise can help you to break free from this devastating cycle.
Precautions and Tips for Exercising with Joint Pain
There are some factors to consider, particularly if your pain worsens with movement, as you do not want to strain a significantly unstable joint. Pain during movement is one of the most common and debilitating symptoms of osteoarthritis, and typically this is the result of your bones starting to come into contact with each other as cartilage and synovial fluid is reduced.
If you find that you're in pain for longer than one hour after your exercise session, you should slow down or choose another form of exercise. Assistive devices are also helpful to decrease the pressure on affected joints during your workout. You may also want to work with a physical therapist or qualified personal trainer who can develop a safe range of activities for you. Your program should include a range of activities, just as I recommend for any exerciser. Weight training, high-intensity cardio, stretching and core work can all be integrated into your routine.
My most highly recommended form of exercise is high-intensity interval training (HIIT), like Peak Fitness, and this program can be used by virtually everyone. However, if you've already developed osteoarthritis in your knee, you'll want to incorporate exercises that strengthen the quadriceps muscle at the front of your thigh. And, rather than running or other high-impact exercises, you may be better off with non-weight-bearing exercises like swimming and bicycling. Strengthening and stretching the areas around, above, and below your knee is key to lessening or eliminating most knee pain, in particular. Non-weight bearing leg and knee strengthening exercises that can help include:
- Sitting on the edge of a table or bed and slowly bending and straightening your leg
- Lying face down on the floor and slowly bending your leg, bringing your knee toward your gluteus
- Lying on your back, one leg bent and the other leg extended, then slowly raising your extended leg toward the ceiling.
Complete these exercises with a minimum of eight repetitions, at a slow and controlled pace. Stretching is also recommended, as tightness above and/or below your kneecap can increase your pain and decrease range of motion. My favorite type of stretching is active isolated stretching (AIS), which could be very beneficial if you have joint pain.
If You Have Knee Pain, Check Your Vitamin D and Consider MSM
Exercise aside, cartilage loss in your knees, which is one of the hallmarks of osteoarthritis, is associated with low levels of vitamin D. So if you're struggling with joint pain due to osteoarthritis, get your vitamin D levels tested, then optimize them using appropriate sun exposure or a safe tanning bed. If neither of these options are available, supplementation with oral vitamin D3 along with vitamin K2 can be considered.
Sulfur also plays a vital role in the structure and biological activity of both proteins and enzymes. If you don't have sufficient amounts of sulfur in your body, this deficiency can cascade into a number of health problems, including impacting your joints and connective tissues.
Ideally, you’d be best off getting your sulfur needs filled from the foods you eat. However, this can be a bit of a challenge these days. There’s been a transition away from many traditional foods that have been the big sources of sulfur, like collagen or keratin, which we just don’t eat much nowadays. You may be able to get enough if you cook down bones from organically raised animals into bone broth and drink the broth regularly (or use for soups and stews). The connective tissues are sulfur-rich, and when you slow-cook the bones, you dissolve these nutrients out of the bone and into the water.
Dr. Stephanie Seneff, a senior scientist at MIT, also recommends soaking your body in magnesium sulfate (Epsom salt) baths to compensate and counteract sulfur deficiency. She uses about 1/4 cup in a tub of water, twice a week. It's particularly useful if you have joint problems or arthritis. Methylsulfonylmethane, commonly known by its acronym, MSM, is another alternative that may be helpful. MSM is an organic form of sulfur and a potent antioxidant, naturally found in many plants, and is available in supplement form.
Six More Natural Options for Joint Pain Relief
Remember, a regular exercise program is crucial if you have knee or other joint pain. If you’re not sure how to begin, make an appointment with a personal trainer or a physical therapist who can show you how to exercise effectively and safely. Just be sure you keep moving. As Harvard Health Publications reported:6
“ … the right set of exercises can be a long-lasting way to tame ankle, knee, hip, or shoulder pain. Practiced regularly, joint pain relief workouts might permit you to postpone — or even avoid — surgery on a problem joint that has been worsening for years by strengthening key supportive muscles and restoring flexibility. Over time, you may find limitations you’ve learned to work around will begin to ease. Tasks and opportunities for fun that have been weeded out of your repertoire by necessity may come back into reach, too.”
That said, in addition to exercise, the following pain-relieving supplements may also be effective, and they make particularly good alternatives to potentially dangerous anti-inflammatory drugs like non-steroidal anti-inflammatories (NSAIDs) and analgesics, like Tylenol:
- Astaxanthin: An anti-inflammatory antioxidant that affects a wide range of inflammation mediators, but in a gentler, less concentrated manner and without the negative side effects associated with steroidal and non-steroidal anti-inflammatory drugs. And it works for a high percentage of people. In one study, more than 80 percent of arthritis sufferers improved with astaxanthin.7
- Eggshell membrane: The eggshell membrane is the unique protective barrier between the egg white and the mineralized eggshell. The membrane contains elastin, a protein that supports cartilage health, and collagen, a fibrous protein that supports cartilage and connective tissue strength and elasticity.
It also contains transforming growth factor-b, a protein that supports tissue rejuvenation, along with other amino acids and structural components that support the stability and flexibility of your joints by providing them with the building blocks needed to build cartilage.
- Hyaluronic acid (HA): Hyaluronic acid is a key component of your cartilage, responsible for moving nutrients into your cells and moving waste out. One of its most important biological functions is the retention of water… second only to providing nutrients and removing waste from cells that lack a direct blood supply, such as cartilage cells.
Unfortunately, the process of normal aging reduces the amount of HA synthesized by your body. Oral hyaluronic acid supplementation may effectively help most people cushion their joints after just two to four months.
- Boswellia: Also known as boswellin or "Indian frankincense," this Indian herb is one treatment I've found to be particularly useful against arthritic inflammation and associated pain. With sustained use, boswellia may help maintain steady blood flow to your joints, supporting your joint tissues' ability to boost flexibility and strength.
- Turmeric / curcumin: A study in the Journal of Alternative and Complementary Medicine found that taking turmeric extracts each day for six weeks was just as effective as ibuprofen for relieving knee osteoarthritis pain.8 This is most likely related to the anti-inflammatory effects of curcumin -- the powerful pigment that gives the turmeric spice its yellow-orange color.
- Animal-based omega-3 fats: These are excellent for joint pain because omega-3s are well known to help reduce inflammation. Look for a high-quality, animal-based source such as krill oil.