SCI nurse, you recomended a med for sore shoulders a while back....

[Tweetybird]

A while back (I cannot find the thread), as you recomended a medication for sore shoulders. My doctor wanted me on Celebrex so it will be less likely to cause stomoch problems. My problem is, MassHealth will not approve it as they do not think it is a reasonable reason, so I was denied. You had recomended something else. I cannot stand the pain in my shoulders as I am trying to increase my activity and independence. What was it so I can ask the doctor?

[LaoziSailor]

Tweety,

Do a search on "Glucosamine" and you'll find a lot of posts. It's not q "quick" fix but when I sprained my shoulder I took it for about a month and things got fixed up.

Cheers!

[fuentejps]

YUP WHAT SAILOR SAID................get gluco/chond w/ msm......i like joint fuel
http://www.bodybuilding.com/store/tl/joint.html

or gnc brand

[2jazzyjeff]

i have arthritis, tendonitis, and bersitis in both shoulders... esp. in my right 'cause i broke my scapula, collar bone and a rib in my crash. i take OTC Naproxen... it works for me, but you may need something stronger. good luck..

[Wise Young]

A while back (I cannot find the thread), as you recomended a medication for sore shoulders. My doctor wanted me on Celebrex so it will be less likely to cause stomoch problems. My problem is, MassHealth will not approve it as they do not think it is a reasonable reason, so I was denied. You had recomended something else. I cannot stand the pain in my shoulders as I am trying to increase my activity and independence. What was it so I can ask the doctor?

Tweety,

You may be thinking of glucosamine and chondroitin. Several large clinical trials indicate that regular supplementation with glucosamine and chondroitin will retard progression of joint breakdown from a number of causes (Source). On the other hand, a recently completed NIH clinical trial suggest that the treatment is not effective for people with mild arthritis (Source). In my opinion, however, none of the clinical trials rigorously control exercise and use of the joints, which are as important or more important variables contributing to joint breakdown than the glucosamine/chondroitin supplement.

A recent study in rabbits suggest that vitamin B1 derivative enhances cartilage healing (Kobayashi, et al. 2005). Veterinarians have found that the combination of glucosamine and chondrotin is more effective that either alone, and that higher doses are more effective (Dechant, et al., 2005; Neil, et al., 2005) in horses and other animals. Torelli, et al. (2005) showed that chondroitin sulfate alone did not reduce osteoarthritis resulting from immobilization of rabbits, suggesting that exercise or use of the joint is essential for the treatment to have a beneficial effect.

You should not take glucosamine if you are allergic to shellfish since this is the primary source, or if you are taking anti-coagulants (such as heparin). Chondroitin usually is derived from bovine cartilage. Please note that over a third of consumer products claiming to provide certain doses of glucosamine and chondroitin do not have the claimed amounts, particularly chondroitin which is more expensive. A University of Maryland study suggested that 26 of 32 products tested did not have the 90% of chondroitin claimed, 17 of the 32 products had less than 40% of the chondroitin claimed (Source). The quality of the chondroitin in particular appears to be important (Owens, et al., 2004).

The literature suggests that liquid formulations are better than the capsules or tablets. The recommended dosage of glucosamine is 1500 mg per day (Source). The dose of chondroitin is not known and some people don't think that it is necessary but some clinics recommend 800-1200 mg per day (Source). Many commercial supplements also include MSM (Methyl sulphonyl methane) which adds sulfur to the chondroitin sulfate and may make it more effective, typically at the dose of 1000-3000 mg per day.


Wise.

References cited

1. Kobayashi T, Notoya K, Nakamura A and Akimoto K (2005). Fursultiamine, a vitamin B1 derivative, enhances chondroprotective effects of glucosamine hydrochloride and chondroitin sulfate in rabbit experimental osteoarthritis. Inflamm Res 54: 249-55. OBJECT AND DESIGN: The therapeutic effect of glucosamine hydrochloride (GH) and chondroitin sulfate (CS) in combination with fursultiamine, a vitamin B1 derivative, on the development of cartilage lesions was investigated in an animal model of osteoarthritis (OA). METHODS: The OA model was created by partial medial meniscectomy of the right knee joint (day 0). The rabbits were placed into three experimental groups: operated (OA) rabbits that received placebo treatment, OA rabbits that received GH (1000 mg/kg) + CS (800 mg/kg), and OA rabbits that received GH + CS + fursultiamine (100 mg/kg). Each treatment was initiated on day 3 and continued for 8 weeks. Macroscopic and histologic analyses were performed on the cartilage. The level of MMP-1 in OA cartilage chondrocytes was evaluated by immunohistochemistry. RESULTS: Only the group receiving combined treatment with GH + CS + fursultiamine showed a significant reduction in the severity of macroscopic and histologic lesions on tibial plateau, which is the weight bearing cartilage surface of the tibia, compared with placebo-treated OA rabbits. This treatment group also revealed a small, but significant, decrease in the body weight gain of the rabbits. In cartilage from placebo-treated OA rabbits, a significantly higher percentage of chondrocytes in superficial layer stained positive for MMP-1 compared with unoperated control. Rabbits treated with the GH + CS + fursultiamine revealed a significant reduction in the level of MMP-1. CONCLUSION: These results suggest that the chondroprotective effect of GH + CS is enhanced by the addition of fursultiamine in experimental OA. This effect was associated with a reduction in the level of MMP-1, which are known to play an important role in the pathophysiology of OA lesions. Pharmacology Research Laboratories I, Pharmaceutical Research Division, Takeda Pharmaceutical Company Limited, 17-85, Jusohonmachi 2-chome, Yodogawa-ku, Osaka, 532-8686, Japan. http://www.ncbi.nlm.nih.gov/entrez/q..._uids=15973508
   
2. Dechant JE, Baxter GM, Frisbie DD, Trotter GW and McIlwraith CW (2005). Effects of glucosamine hydrochloride and chondroitin sulphate, alone and in combination, on normal and interleukin-1 conditioned equine articular cartilage explant metabolism. Equine Vet J 37: 227-31. REASONS FOR PERFORMING STUDY: Clinical trials in human and veterinary literature have documented the benefits of oral nutraceutical joint supplements containing glucosamine (GU) and chondroitin sulphate (CS) to treat mild to moderate osteoarthritis, but the effects of these components have not yet been conclusively determined. OBJECTIVES: To assess varying dosages of GU and CS on normal and interleukin-1alpha (IL-1) conditioned equine cartilage explants and rationalise the use of these products. HYPOTHESIS: Treatment would not be detrimental to cartilage metabolism and higher dosages and the combination of GU and CS would be more beneficial than lower dosages and. GU or CS alone. METHODS: Articular cartilage explants collected from the femoral trochlea and condyles were cultured in normal and IL-1 conditioned media. Treatment groups included 0, 12.5, 25,125 and 250 microg/ml concentrations of GU alone, CS alone, or GU+CS in combination. Glycosaminoglycan (GAG) synthesis and total GAG content in the explants and media were analysed. RESULTS: There were no detrimental effects of GU, CS or GU+CS on cartilage metabolism. High dosages of GU+CS reduced total GAG release into the media (degradation). CONCLUSIONS: Our results suggests that GU+CS may prevent cartilage GAG degradation. POTENTIAL RELEVANCE: The combination of GU and CS may be more effective in preventing or treating osteoarthritis in horses than either product alone. Equine Orthopaedic Research Laboratory, Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado 80523, USA. http://www.ncbi.nlm.nih.gov/entrez/q..._uids=15892231
   
3. Neil KM, Caron JP and Orth MW (2005). The role of glucosamine and chondroitin sulfate in treatment for and prevention of osteoarthritis in animals. J Am Vet Med Assoc 226: 1079-88. Department of Large Animal Clinical Science, College of Veterinary Medicine, Michigan State University, East Lansing, Ml 48824-1314, USA. http://www.ncbi.nlm.nih.gov/entrez/q..._uids=15825732
   
4. Chou MM, Vergnolle N, McDougall JJ, Wallace JL, Marty S, Teskey V and Buret AG (2005). Effects of chondroitin and glucosamine sulfate in a dietary bar formulation on inflammation, interleukin-1beta, matrix metalloprotease-9, and cartilage damage in arthritis. Exp Biol Med (Maywood) 230: 255-62. This study examined the effects of chondroitin sulfate (CS) alone and CS plus glucosamine sulfate (GS) in a dietary bar formulation on inflammatory parameters of adjuvant-induced arthritis and on the synthesis of interleukin-1beta (IL-1beta) and matrix metalloprotease-9 (MMP-9). Following 25 days pretreatment with dietary bars containing either CS alone, CS plus GS, or neither CS nor GS, rats were either sham injected or injected with Freund's complete adjuvant into the tail vein. Rats were fed their respective bars for another 17 days after inoculation. Parameters of disease examined included clinical score (combination of joint temperature, edema, hyperalgesia, and standing and walking limb function), incidence of disease, levels of IL-1beta in the serum and paw joints, levels of MMP-9 in the paw joints, paw joint histology, and joint cartilage thickness. Treatment with CS plus GS, but not CS alone, significantly reduced clinical scores, incidences of disease, joint temperatures, and joint and serum IL-1beta levels. Treatment with CS alone and CS plus GS inhibited the production of edema and prevented raised levels of joint MMP-9 associated with arthritis. Similarly, CS alone and CS plus GS treatment also prevented the development of cartilage damage associated with arthritis. Combination CS plus GS treatment in a dietary bar formulation ameliorates clinical, inflammatory, and histologic parameters of adjuvant-induced arthritis. The benefits of CS and GS in combination are more pronounced than those of CS alone. The reduction of arthritic disease by CS plus GS is associated with a reduction of IL-1beta and MMP-9 synthesis. Department of Biological Sciences, University of Calgary, 2500 University Drive, Calgary, Alberta, Canada, T2N 1N4. http://www.ncbi.nlm.nih.gov/entrez/q..._uids=15792947
   
5. Torelli SR, Rahal SC, Volpi RS, Sequeira JL and Grassioto IQ (2005). Histopathological evaluation of treatment with chondroitin sulphate for osteoarthritis induced by continuous immobilization in rabbits. J Vet Med A Physiol Pathol Clin Med 52: 45-51. The aim of this study was to evaluate histologically the action of chondroitin sulphate in osteoarthritis experimentally induced by continuous immobilization. Fourteen young female Norfolk rabbits aged 2.5-3 months at the beginning of the experiment were divided into two equitable groups submitted to immobilization of the right knee for a period of 12 weeks. The treated group received 1.0 ml/animal/s.c. of 12% chondroitin sulphate, once a week for 12 weeks, and the untreated group did not receive any treatment. Two additional animals were not submitted to knee immobilization (sham group). Microscopical examination of knee preparations stained with haematoxylin-eosin and Masson trichrome showed lesions of both joints in treated and untreated groups, with no significant difference between the scores obtained for the right and left knees. Examination of preparations stained with picrosirius red showed collagen fibre alignment and misalignment in the right and left knees of the animals of all groups, but statistic analysis could not be performed. It was not possible to differentiate the proteoglycan concentration between limbs or groups (treated and untreated) by safranin O or toluidine blue staining. It was possible to conclude that the chondroitin sulphate was not able to reduce the histological changes induced by this osteoarthritis experimental model. Graduated Program in Veterinary Medicine, UNESP Botucatu, Caixa Postal 560, Rubiao Junior, s/n, CEP: 18618-000, Botucatu (SP), Brazil. http://www.ncbi.nlm.nih.gov/entrez/q..._uids=15703011
   
6. Owens S, Wagner P and Vangsness CT, Jr. (2004). Recent advances in glucosamine and chondroitin supplementation. J Knee Surg 17: 185-93. 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. Department of Orthopedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, Calif, USA. http://www.ncbi.nlm.nih.gov/entrez/q..._uids=15553585

[metronycguy]

tweety bird fight the bastards, learn the system with your insurance, your doc may have to try another cheaper older anti inflammatorry , your doctor should know how to work around it, plenty of anti inflamattorys out there, daypro,mobic, mobic,

[fuentejps]

wise , should we take more than the normal 1500/1200, if we workout heavily. i know bodybuilders megadose it.

[carl]

The literature suggests that liquid formulations are better than the capsules or tablets.

Wise,
Do you know where one can get the liquid formulations? I've never seen them anywhere. I believe that the NIH study used CosaminDS from Nutramax which is supposed to be more easily absorbed. My dog's vet is also a proponent of CosaminDS over the others (dogs and cats use Nutramax Cosequin - he uses CosaminDS). The best deals for CosaminDS seem to be on ebay. Since these are "alternative medicines" most insurance will not reimburse for it - CosaminDS from ebay is about 50 cents a day.
Carl

[metronycguy]

costco has a liquid version that has a instant rebate now. not sure of the quality
http://www.costco.com/Browse/Product.aspx?Prodid=10027237&whse=BC&topnav=&brows e=&s=1

[fuentejps]

joint fuel comes in liquid form as well. www.dpsnutrition.com