Many physical therapists and even our own clients know the standard supplement for arthritis for years has been glucosamine. But what if you combined other supplements together: could you get a bigger impact and would it be safe? A new study is out that looks at combining supplements and their effects on physical therapy specific measures like pain, ROM, and function in those with knee arthritis.
The recent article published by Mineretti et al in the open access journal called Cureus. This article was a small randomized trial looking at a chondro-protective supplements, which means the compound protects the cartilage of a joint. There were 51 subjects in all with three different groups:
The first group was a control: so they basically took a sugar pill';
The second group took a combined drug or supplement rather it's called Syalox. And in that was 300 mg of hyaluronic acid combined with 100 mg of boswellia;
The last group received a combination of glucosamine chondroitin sulfate and curcumin.
Hyaluronic acid has been injected into joints for a long time. It has been touted to help rebuild cartigelage on imaging but does not translate to improvements in range of motion or function. Many of our PT clients in Naples come to us after their orthopedic surgeons have given them Synvisc or Orthovisc. So, this study is interesting in that they gave the hyaluronic acid orally. The other compound, Boswellia, in the syalox supplement is a know anti-inflammatory herb. Known as Indian nightshade, I have been recommending this supplement to my clients in Ponte Vedra and Saint Augustine to help alleviate several forms of arthritis and pain. Overall, the supplement is very safe and acts on a different pathway than tradtional anti-inflammatories (uses a Lipoxygenase pathway, which does not impact the stomach lining like Motrin and Advil).
The other supplement used the traditional glucosamine but it also had curcumin in it. Curcumin has helped many of our Naples and Ponte Vedra PT clients with arthrtis by reducing inflammation in a very similar way to an Advil without nearly as many side effects. Curcumin comes naturally from the root turmeric, the yellowish/red spice often found in Indian foods.
Anyhow, the three outcome measures they were primarily focused on one was pain at rest and pain with movement. The second outcome was range of motion, and the third was the WOMAC, which is basically a functional measure of the knee during standing, walking, stiffness, and pain during tasks.
Well, obviously, the control group saw no changes…if anything they got worse with pain, which is why we tell our PT clients that motion is lotion and exercise is key. On the other hand, the two treatment groups did see a benefit with pain. Now again, this is statistical benefit. So let's get down to absolute differences and actual minimal clinical important differences. The numeric pain scale change was a one. So I would say that's pretty minimal, not nothing really to write home about, but the range of motion scores in the two treatment groups were significantly improved by 25 degrees! So that would be not only statistical that would also be clinically significant, as in the subjects could get off the toilet, climb stairs, or kneel easier. The functional score, the WOMAC, also improved 6 to 7 points in both treatment groups. So overall, patients moved a little better, had more motion, and slightly less pain — with very few adverse event.
In the end, the study shows hope for combining common supplements for our clients with arthritis in Naples, Ponte Vedra, and Saint Augustine. Combining such supplements with a physical therapy plan of care, including dry needling, would maximize ROM, strength, and function even further. If you or a loved one is struggling with arthritis, give us a call and we can get you started on our arthritis treatment protocol today! 904.568.1156
Keywords: knee OA, arthritis, PT, physical therapy, dietary supplements, Naples, boswellia, Ponte Vedra, curcumin, Nocatee, Jacksonville Beach, Bonita Springs