The Use of Glucosamine, Devil’s Claw (Harpagophytum
procumbens), and Acupuncture as Complementary and
Alternative Treatments for Osteoarthritis

This section is compiled by Frank M. Painter, D.C.
Send all comments or additions to:     Frankp@chiro.org

FROM:   Alternative Medicine Review 2011 (Sep); 16 (3): 228–238 ~ FULL TEXT

Marcus Sanders, BS and Oliver Grundmann, PhD

College of Pharmacy,
University of Florida,
PO Box 100485,
Gainesville, FL 32610
grundman@cop.ufl.edu

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Osteoarthritis is one of the most common chronic in!ammatory conditions seen in the general population. Current pharmacological treatments focus on reduction of pain and increased mobility to improve overall quality of life. However, the relief afforded by current standard care is often insuficient and can be associated with significant side effects. Many patients, therefore, seek the option of non-standard therapies, such as nutritional and herbal supplements, acupuncture, and exercise regimens. Glucosamine, Harpagophytum procumbens, and acupuncture are among the most commonly used complementary and alternative medicine approaches utilized by patients suffering from osteoarthritis. Their clinical relevance, safety, and potential mechanisms of action are discussed in this review.

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From the FULL TEXT Article

OARSI Non-pharmacological Treatment Recommendations

All patients with hip and knee OA should be given information access and education about treatment objectives and the importance of changes in lifestyle, exercise, pacing of activities, weight reduction, and other measures to unload the damaged joint(s). The initial focus should be on selfhelp and patient-driven treatments rather than on passive therapies delivered by health professionals. Subsequently emphasis should be placed on encouraging adherence to the regimen of non-pharmacological therapy.

The clinical status of patients with hip or knee OA can be improved if patients are contacted regularly by phone.

Patients with symptomatic hip and knee OA may bene"t from referral to a physical therapist for evaluation and instruction in appropriate exercises to reduce pain and improve functional capacity. This evaluation may result in provision of assistive devices such as canes and walkers, as appropriate. Patients with hip and knee OA should be encouraged to undertake continuous regular aerobic, muscle strengthening, and range of motion exercises. For patients with symptomatic hip OA, exercises in water can be e#ective.

Overweight patients with hip and knee OA should be encouraged to lose weight and maintain the weight loss.

Walking aids can reduce pain in patients with hip and knee OA. Patients should be given instruction in the optimal use of a cane or crutch in the contralateral hand. Frames or wheeled walkers are often preferable for those with bilateral disease.

In patients with knee OA and mild/moderate varus or valgus instability, a knee brace can reduce pain, improve stability, and diminish the risk of falling.

Every patient with hip or knee OA should receive advice concerning appropriate footwear. In patients with knee OA, insoles can reduce pain and improve ambulation. Lateral wedged insoles can be of symptomatic bene"t for some patients with medial tibio-femoral compartment OA.

Some thermal modalities may be effective for relieving symptoms in hip and knee OA.

Transcutaneous electrical nerve stimulation (TENS) can help with short-term pain control in some patients with hip or knee OA.

Acupuncture may be of symptomatic benefit in patients with knee OA.

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