Invasive procedures and expensive prescriptions for treatment of osteoarthritis of the knees may be going the way of tonsillectomies.
New research, including some surprising study results published this week, suggest that knee replacements and drugs like Celebrex may not be necessary to successfully treat the degenerative joint condition.
Painful knees are a fact of life for many people as they enter middle age and beyond — especially for weekend warriors who pounded the pavement and other athletes and dancers, amateur or professional.
Here's the good news:
High quality (pharmaceutical grade) chondroitin sulfate is as good as a widely prescribed non-steroidal anti-inflammatory drug (celecoxib) for the treatment of painful knee osteoarthritis, according to a British study published in the Annals of Rheumatic Diseases.
"It reduces pain, improves function, and is safe. Its effectiveness and safety prompt the researchers to call for it to be used for long term treatment."
Knee arthritis is typically treated with painkillers, specifically non-steroidal anti-inflammatory drugs (NSAIDs), and acetaminophen (Tylenol). But there are serious side effects associated with taking high doses of these drugs over the long term.
Researchers carried out a clinical trial in which 604 patients from five European countries with symptomatic knee osteoarthritis were randomly assigned to one of three daily treatments and monitored for six months. They concluded that a daily dose of 800 mg of pharmaceutical-grade chondroitin sulfate is better than a placebo and as good as Celebrex in reducing pain and improving joint function in symptomatic knee osteoarthritis.
It is a formulation that should be considered first for the treatment of the condition, they emphasized.
A fibre-rich diet is linked to a lowered risk of painful knee osteoarthritis, finds the first study of its kind, published online in the Annals of the Rheumatic Diseases.
The findings, which draw on two different long term studies, are broadly in line with the other reported health benefits of a fibre-rich diet: reductions in blood pressure, weight, and systemic inflammation, and improved blood glucose control.
The researchers used data from two U.S. studies to find out if dietary fibre might have any bearing on the risks of x-ray evidence of knee osteoarthritis and worsening knee pain.
The Osteoarthritis Initiative study found that, compared with the lowest intake of fibre (bottom 25 per cent of participants), the highest intake (top 25 per cent) was associated with a 30 per cent lower risk of worsening knee pain. In the Framingham study, there was a 61 per cent lower risk of worsening knee pain. However, there was no association with x-ray evidence of knee osteoarthritis.
"Knee replacement surgery for patients with osteoarthritis, as currently used, provides minimal improvements in quality of life," the British Medical Journal reported recently. Researchers concluded that improvements in quality of life were higher after surgery on patients with more severe symptoms and lower physical function before surgery.
Previous U.S. research determined that one-third of all knee replacements were unnecessary.
Boomers feeling the pain of degenerating knees should consider high-grade chondroitin, adding more fibre to their diets, exercises — walking, swimming, elliptical training, biking — that don't stress the knees, and perhaps wearing knee braces to ease the load on the joints.
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