Chiropractic Use of Glucosamine Sulfate
in the Treatment of Osteoarthritis

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

FROM:   J Manip Physiol Ther 1997 (Jul);   20 (6):   400–414

Gottlieb MS

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Objective:   To evaluate the rationale behind the most commonly used treatments of osteoarthritis, including non-steroidal anti-inflammatory drugs (NSAIDs), and to assess more effective conservative treatment options.

Summary of Background Data:   This review includes a description of the pathophysiology and prevalence of osteoarthritis, joint physiology and NSAID treatment of osteoarthritis, as well as side effects on joints, the gastrointestinal tract, kidneys and liver. Several studies of conservative treatment consisting of use of glucosamine sulfate supplementation (which is a naturally occurring substance in the human body), exercise and the use of chiropractic treatment for maintaining joint function and preventing further destruction are reviewed.

Data Sources:   A computerized search of Medline using the key indexing terms osteoarthritis, degenerative joint disease, nonsteroidal anti-inflammatory drugs, glucosamine sulfate, chiropractic, and manipulation.

Results:   Numerous studies were obtained under each subheading and reviewed by category. Human and animal-model studies are described.

Conclusion:   The rationales for using NSAIDs in the treatment of osteoarthritis is controversial and openly contested. Given the detrimental effects of NSAIDs on joints and other organs, their use should be discouraged and their classification as a first choice conservative treatment should be abolished. A truly effective and conservative approach to the treatment of osteoarthritis should include chiropractic manipulation, essential nutrient supplementation, exogenous administration of glucosamine sulfate and rehabilitative stretches and exercises to maintain joint function. Because there is no correlation between pain levels and the extent of degeneration detected by radiographic or physical examination, conservative treatment should be initiated and sustained based on functional, objective findings and not strictly on how the patient feels. The us of NSAIDs should be limited to the treatment of gross inflammation, and analgesics should only be used in the short-term when absolutely necessary for pain palliation. The present conservative approach could lead not only a better quality of life, but to the saving of health care dollars by reducing the iatrogenic morbidity and mortality associated with NSAID use.

Key Indexing Terms:   Chiropractic; Fibromyalgia; Fibrositis; Physical Therapy; Randomized Controlled Trial.

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