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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The nutritional supplements glucosamine and chondroitine sulphate are widely used in the treatment of osteoarthritis. In published studies, glucosamine used in a dosage of 1.5 gram daily is, after a period of 2 to 4 weeks, just as effective as low doses of NSAIDs in alleviating pain. Chondroitine sulphate has been less well investigated. There are indications that it affects the symptoms of osteoarthritis, even though this effect only occurs after a longer period of time. The side effects for both substances are minor. A disease-modifying effect (defined as delay of radiological progression of osteoarthritis) has not been proven.
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PMID:[Glucosamine and chondroitin sulfate as a possible treatment for osteoarthritis]. 1238 65

Americans spend more on natural remedies for osteoarthritis than for any other medical condition. In treating osteoarthritis, glucosamine and chondroitin sulfate, two of the molecular building blocks found in articular cartilage, are the most commonly used alternative supplements. In randomized trials of variable quality, these compounds show efficacy in reducing symptoms, but neither has been shown to arrest progression of the disease or regenerate damaged cartilage. Although few clinical trials on S-adenosylmethionine exist, preliminary evidence indicates that it relieves pain to a degree similar to that of nonsteroidal anti-inflammatory drugs but with fewer side effects. Clinical trials of dimethyl sulfoxide offer conflicting results. Neither ginger nor cetyl myristoleate has proven clinical usefulness.
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PMID:Alternative therapies for traditional disease states: osteoarthritis. 1462 May 92

Several entities have been carefully investigated for the symptomatic and structural management of osteoarthritis (OA). The most compelling evidence of a potential for inhibiting the structural progression of OA has been obtained with glucosamine sulfate, while some preliminary results also suggest that other compounds could be used in the same indication. At any rate, several medications have clearly demonstrated a symptomatic action, mainly in OA of the lower limbs, including pain relief and improvement of functional disability. An important issue is that all conclusive studies with such chemical entities resulted from the use of prescription medicines and not over-the-counter or nutriceutical supplements.
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PMID:New perspectives in the management of osteoarthritis. structure modification: facts or fantasy? 1292 46

Glucosamine (2-amino-2-deoxy-d-glucose) and glucosamine-containing products have been reported to have efficacy in the treatment of various musculoskeletal disorders. Glucosamine's efficacy, including reduction of pain, is attributed to disease-modifying properties, specifically to cartilage-rebuilding associated with modulation of interleukin-1-induced activation of chondrocytes and to inhibition of proinflammatory effects of the nuclear factor-kappaB pathway. However, glucosamine has not been shown to have direct analgesic activity. We report here that commercial glucosamine (90.4% glucosamine sulfate + 9.6% excipients) administered as the sole agent (up to 500 mg/kg p.o.) was inactive in the mouse abdominal irritant test but that certain combinations of glucosamine with nonopioid analgesics at the oral doses and ratios tested resulted in a synergistic (ibuprofen and ketoprofen), additive (diclofenac, indomethacin, naproxen, and piroxicam), or subadditive (aspirin and acetaminophen) antinociceptive interaction. In the specific case of ibuprofen, the racemate (standard ibuprofen) produced dose-related antinociception with ED50 = 26.1 +/- 3.4 mg/kg. Combinations containing racemic ibuprofen and glucosamine in greater than 1:1 ratio (glucosamine/ibuprofen) were synergistic in the test (e.g., ED50 = 11.0 +/- 2.1 for the 9:1 ratio; p < 0.01, analysis of variance). Combinations containing glucosamine and ibuprofen (2:1 and 9:1) yielded plasma levels of ibuprofen that were no different from administration of ibuprofen alone. The possibility that combinations containing certain fixed ratios of glucosamine and certain nonsteroidal anti-inflammatory drugs (NSAIDs) might enhance pain relief in patients with pain or might achieve acceptable levels of pain relief with lower doses of NSAIDs (reduced adverse effects) is presently being pursued in clinical trials.
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PMID:Antinociceptive synergy, additivity, and subadditivity with combinations of oral glucosamine plus nonopioid analgesics in mice. 1296 52

The Knee injury and Osteoarthritis Outcome Score (KOOS) was developed as an extension of the WOMAC Osteoarthritis Index with the purpose of evaluating short-term and long-term symptoms and function in subjects with knee injury and osteoarthritis. The KOOS holds five separately scored subscales: Pain, other Symptoms, Function in daily living (ADL), Function in Sport and Recreation (Sport/Rec), and knee-related Quality of Life (QOL). The KOOS has been validated for several orthopaedic interventions such as anterior cruciate ligament reconstruction, meniscectomy and total knee replacement. In addition the instrument has been used to evaluate physical therapy, nutritional supplementation and glucosamine supplementation. The effect size is generally largest for the subscale QOL followed by the subscale Pain. The KOOS is a valid, reliable and responsive self-administered instrument that can be used for short-term and long-term follow-up of several types of knee injury including osteoarthritis. The measure is relatively new and further use of the instrument will add knowledge and suggest areas that need to be further explored and improved.
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PMID:The Knee injury and Osteoarthritis Outcome Score (KOOS): from joint injury to osteoarthritis. 1461 58

Glucosamine products have been used extensively for the management of pain in osteoarthritis. This paper reviews the most recent clinical and experimental studies regarding its efficacy and safety. Although clinical trials include methodologic flaws and publication bias, glucosamine is likely an effective therapy for the symptomatic management of osteoarthritis. In turn, definite proof for chondromodulating effect requires well-conducted clinical trials. In North America, glucosamine is an over-the-counter dietary supplement and preparations made by different manufacturers may vary. There is also a need to standardize this therapy and allow practitioners to give patients suitable advice. An ongoing long-term clinical trial in the US will possibly permit to investigate the clinical relevance of these results and give appropriate recommendations.
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PMID:The use of glucosamine therapy in osteoarthritis. 1471 1

Glucosamine products have been used extensively for the management of pain in osteoarthritis. This paper reviews the most recent clinical and experimental studies regarding its efficacy and safety. Although clinical trials include methodologic flaws and publication bias, glucosamine is likely an effective therapy for the symptomatic management of osteoarthritis. In turn, definite proof for chondromodulating effect requires well-conducted clinical trials. In North America, glucosamine is an over-the-counter dietary supplement and preparations made by different manufacturers may vary. There is also a need to standardize this therapy and allow practitioners to give patients suitable advice. An ongoing long-term clinical trial in the US will possibly permit to investigate the clinical relevance of these results and give appropriate recommendations.
Curr Pain Headache Rep 2004 Dec
PMID:The use of glucosamine therapy in osteoarthritis. 1550 66

Until recently, treatment of osteoarthritis targeted the pain and the disability of the involved joints. It consisted in a mix of analgesics, anti-inflammatory drugs, steroid infiltrations and physical therapies. Usefulness of slow but long acting substances is increasing not only by their action on the symptoms but also because they positively influence the evolution of the disease. Some of them seem to induce a structural effect on the cartilage confirmed by a slow down of the joint space narrowing on successive radiographs of the knees. Presently, only basic matricial precursors such as chondroitin sulfate, glucosamine sulfate and hyaluronic acid are available in the clinic. They act by reducing cartilage destruction and enhancing chondrocyte anabolism. These preliminary results should be confirmed by further studies based on magnetic resonance imaging and surrogate markers of the cartilage matrix. Recent developments in the understanding of the physiopathology of osteoarthritis, including the key role of some cytokines, should allow new therapic ways, individually or in combination.
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PMID:[Slow-acting anti-rheumatic agents: recent developments]. 1555 52

Glucosamine and chondroitin are alternative solutions to previous pharmaceutical options for the treatment of osteoarthritis. This article describes the mechanisms of action, pharmacokinetics, recent findings, and upcoming studies of these two natural remedies. The majority of studies on the mechanisms behind glucosamine and chondroitin have been performed in vitro or on animal models; however, the results have shown favorable effects on the balance between cartilage matrix synthesis and degradation. The pharmacokinetics of the three main forms of glucosamine were compared, and glucosamine hydrochloride displayed the greatest compound purity, despite the compounds having equal oral absorption rates of 90%. Chondroitin sulfate has been the principal clinical formulation with a slightly lower oral absorption of 70%. Clinical trials were evaluated based on two categories-radiographic changes and symptom improvement of pain and function. Although adverse effects of these two remedies were minor, the quality and labeled quantity of these relatively unregulated products must be considered. More randomized controlled studies on humans in vivo need to evaluate the efficacy, long-term effects, and quality of these compounds.
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PMID:Recent advances in glucosamine and chondroitin supplementation. 1555 85

The use of nonsteroidal antiinflammatory medications (NSAIDs) and nutraceuticals, such as glucosamine and chondroitin, is common among athletes at all ages and levels of participation. The use of these drugs has significant effects on pain and swelling associated with injury; however, this use does have significant risks to the gastrointestinal, hepatic, and renal organ systems. In the athlete with degenerative changes in the joints, the use of these medications can become chronic and lead to an increased risk of adverse effects. The purpose of this article is to examine the incidence of injury in sports, the prevalence of osteoarthritis in athletes, and the use of common over-the-counter medications and supplements. In addition, the mechanism of action, adverse side effects, and behavioral patterns for use of these medications will be analyzed.
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PMID:The use of NSAIDs and nutritional supplements in athletes with osteoarthritis: prevalence, benefits, and consequences. 1563 78


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