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A Bitter Pill for Arthritis

There is some question over the benefits of some anti-arthritic medications.  While there is much subjective evidence to the effectiveness of many medications, there are many questions about their long term benefits and if they really do work?

A recent study into the effectiveness of paracetamol in treating arthritis suggests that it is of only limited value. The main treatment prescribed is non-steroid anti-inflammatory drugs (NSAIDS). NSAIDs in the long term, show greater mortality (death rate) than patients not taking them. They cause fluid retention, increase blood pressure and increased kidney damage. So what are the alternatives?

Some of the alternative medicines have been used widely with mixed success. Some studies endorse the use of Glucosamine (which has been clouded by spurious commercial claims of different salts being better than others), other studies run counter to these claims. The world authority on sorting out such claims and counter claims is the unbiased Cochrane Collaboration. A cochrane review does detailed research into all the published research studies based on how accurate, the degree of bias and real evidence used by the studies. It is the double blind studies are the most accurate where both the patient and the researcher don't know which patients are taking the drug or a dummy drug until the results are analyzed. The cochrane review tool could not find any evidence of the effectiveness of Glucosamine. It appears it is mainly the placebo effect at work. However you cannot totally disregard the placebo effect, as the psychosomatic effect can generally give 60% of the population relief. The placebo effect generally lasts up to 6 weeks, proving that mind over matter does work. Some prescribed drugs have such a low effectiveness, less than 2% improvement, that it is the placebo effect that has the greatest effect.
Surprisingly, there is some evidence for the effectiveness of Fish Oil in the treatment of arthritis. There was no evidence for it to have any benefit for minor damage, but for major damage it appears to slightly improve collagen rebuilding in major weight bearing joints. It also appears to have beneficial effect for the heart. Krill oil is more expensive and less effective than fish oil.
Other natural remedies such as coumarin, shark cartilage, copper bracelets, snake venom, horse manure with garlic and ginger are generally without empirical support.

So if all these treatments do not work or are harmful, what does work?
Did anyone suggest light exercise to you? After the initial discomfort, evidence suggests that exercise is just as effective as taking NSAIDs without the discomfort of stomach upsets and other side effects. Exercise strengthens the muscles that support the joints and takes some of the strain from the joints.
Another certain remedy, which is often overlooked, is to loose weight. The not so common, “Common Sense” will tell you that by reducing your weight you will reduce the wear and tear on your weight bearing joints. It also removes some of the fatty tissue near the joints and increases mobility.
Evidence for prescribed medicines or complimentary medicines is inconclusive (both are being over promoted by the big multi-national “pharmaceutical” and “vitamin-pharma” companies). We would all like a quick fix for chronic problems, the evidence is clear, exercise and weight loss are the best treatment, but for some that is a bitter pill to swallow.