January 2nd, 2007 by Dr. Val Jones in News
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Many people use glucosamine and chondroitin sulfate as a natural therapy to treat their arthritis pain. This seems like a reasonable thing to do since glucosamine is a critical building block for cartilage, and chondroitin can help keep joints properly hydrated. And as we know, osteoarthritis is caused by joint wear and tear and decreased cartilage health.
Unfortunately, the research results have been fairly underwhelming.
Here is how one author* summarized the latest research:
“It seems prudent to tell our patients with symptomatic osteoarthritis of the knee that neither glucosamine hydrochloride nor chondroitin sulfate alone has been shown to be more efficacious than placebo for the treatment of knee pain. If patients choose to take dietary supplements to control their symptoms, they should be advised to take glucosamine sulfate rather than glucosamine hydrochloride and, for those with severe pain, that taking chondroitin sulfate with glucosamine sulfate may have an additive effect. Three months of treatment is a sufficient period for the evaluation of efficacy; if there is no clinically significant decrease in symptoms by this time, the supplements should be discontinued. Furthermore, there is no evidence that these agents prevent osteoarthritis in healthy persons or in persons with knee pain but normal radiographs.”
So I guess the bottom line is that these supplements are no magic cure for knee pain – they aren’t known to be harmful (except to the wallet) but they aren’t sure to be helpful either.
*Hochberg, Marc C.
Nutritional Supplements for Knee Osteoarthritis — Still No Resolution
N Engl J Med 2006 354: 858-860
Val Jones is a licensed practitioner of Rehabilitation Medicine and Senior Medical Director of Revolution Health’s portal. No information in this blog is intended to diagnose or treat any condition. The opinions expressed here are Val’s and do not necessarily reflect those of Revolution Health.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
December 30th, 2006 by Dr. Val Jones in True Stories
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Good medical diagnosis and treatment often requires some detective work. One of my patients came to see me for foot pain recently. She described what sounded like a pretty typical case of plantar fasciitis – pain in the heel of her foot, worst with the first few steps in the morning, improving throughout the day. I recommended stretches, physical therapy, night splints, ibuprofen… but to my surprise nothing was really helping.
One wintery day she came back on a return visit and I happened to notice her footwear – boots with a very thin, flexible sole. Slowly I began to think of her tromping over ice, sand, gravel, and snow in these boots… I asked her if she could feel the ground under her feet.
“Yes, I can feel everything – I don’t like to walk around in the snow and ice because it kind of hurts to step on all the lumps and bumps. But I can’t just stay indoors all day, I have errands to run!”
I explained to my patient that I had a hunch that the rocks were bruising her plantar fascia, causing it to be inflamed and painful. I asked her to buy herself some thick soled boots – the kind where she couldn’t feel the lumps and bumps under her feet.
About a week later my patient called to tell me that her foot pain was much better. The new boots seemed to be doing the trick… “I never knew why my plantar fasciitis got worse in the winter times, doc. I thought it was the cold that made things worse.”
Well, I had learned a lot too… sometimes the best treatment option is not on the standard protocol list. The power of observation is one of a physician’s most important weapons.
This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
December 28th, 2006 by Dr. Val Jones in Health Tips
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The plantar fascia is basically a thin, broad “rubber band” on the bottom of your foot. It holds your foot bones together and gives you a little spring in your step. But when that rubber band gets stiff, every step can be painful, especially the first few steps in the morning. So what would you do with a stiff rubber band that needs to fit around a deck of cards? You’d stretch it gently until it could fit around them, right? Well, as it turns out, that’s the best course of action for plantar fasciitis. There are many different ways to stretch the fascia (like rolling a tennis ball under the bottom of your foot) but my favorite method is: the night splint.
What’s a night splint? They’re little booties that keep your feet at a 90 degree angle when you’re lying down. This gentle stretching works while you sleep, so it couldn’t be easier. Night splints are available online or at most surgical supply stores, and cost upwards of $30. Try them for several nights in a row, and see if it makes a difference in the pain you’ve been feeling when you take your first steps of the day. Keep it up for a week or two, and you may have cured yourself.
Have you tried night splints? Still having pain? Find out what else might work in the next blog entry!This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
