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What Can I Do For My Joint Pain?

This is a common question I hear almost every day. Osteoarthritis, also known as degenerative joint disease, is very common in people especially over the age of 30.

The joints that are most commonly affected include the ones that take the most weight bearing and abuse such as the following:

• big toe

• knee

• hip joint

• spine

People who have sustained sports injuries are at greater risk of degeneration of the joint. Common every day activities do produce some wear and tear on the joints particularly if the body weight is increased. Even a 5 pound weight gain transmits five times which would equal 25 extra pounds of pressure to the lower body joints, so maintaining a normal body weight is very important.

Stretching and strengthening exercises are very important as they stabilize the joints. Since the tendons, joints and cartilage do not have any direct blood vessels, movement In the form of activity, specifically aerobic exercise that gets the heart rate up is important for diffusing both oxygen and nutrients into the joints.

Supplements and Medications To Help Joint Pain

1. Vitamin D

The number one supplement I recommend for joint health and overall musculoskeletal health is vitamin D3. Vitamin D is not a vitamin, but it is a pro steroid hormone. Humans can make vitamin D if they are exposed to the right ultraviolet light. However, most of my patients over age 50 are low in vitamin D (on blood testing with a 25-hydroxy vitamin D test). If you have joint pain consider starting 1,000 to 2,000 units of vitamin D per day and/or have your physician check your level.

2. Estrogen

Estrogen is important for musculoskeletal health, including joint health. There are estrogen receptors and cartilage and tendons. Postmenopausal women with low estrogen state may complain of joint pain and stiffness as their primary menopausal symptoms.

Low estrogen states can exacerbate tendinitis. Estrogen therapy is generally not given specifically for joint pain unless the woman is suffering from additional menopausal symptoms. There’s also evidence that women who undergo total joint replacements who are on post-menopausal estrogen do better than those not on hormone therapy. Talk to your women's health physician to see if estrogen is right for you.

3. Glucosamine and Chondroitin Sulfate

Glucosamine and chondroitin sulfate are one of the most common combination supplements that I recommend to women with joint pain, especially knee pain. Glucosamine has shown some protective benefit for knee arthritis in up to 70% of persons in divided doses of 1,000 to 1,500 mg per day.

The first time, I recommended the supplement several years ago I had a woman exclaimed, “That is what my veterinarian has me give my dog!” Dogs like other mammals do suffer from degenerative joint disease with aging.

Some studies have shown no benefit with glucosamine while others have shown reductions in joint pain - particularly the glucosamine sulfate salt. Various studies have shown the benefit of both glucosamine and chondrointin sulfate showing less pain and swelling and joint space narrowing, in doses of 800 to 1200 mg per day.

4. MSM

Methylsulfonlymethane (MSM) in doses of up to 6 g per day orally have been shown to reduce pain, improve function and reduce some stiffness. Long term studies aren’t available.

5. Turmeric

Turmeric is a spice containing curcumin, and taking 500 mg orally up to twice daily has been shown to have some anti-inflammatory, anti-oxidant, anti-cancer and perhaps anti-atherosclerotic effects. A side effect of turmeric can be increasing bleeding time, so patients on blood thinners and Coumadin need to be aware as well as some people who have G.I. distress.

6. Omega 3

Omega 3 fatty acids in doses of 2 to 4 g has been shown to reduce pain.

7. Ginger

Ginger is an herb that has anti-inflammatory, anti-cancer and anti-atherosclerotic effects and can be ingested, 3 g per day. Ginger is also used to treat nausea.

8. SAMe

S-adenosyl-L-methionine (SAMe) is a compound found naturally in the body.

A supplement form of SAMe has been used to help the liver, reduce joint pain and even elevate the mood.

Doses start at 400 up to 1200 mg per day and this supplement can be pricey.