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Glucosamine, Chondroitin supplements for Joint Pain in Downtown Winnipeg

If you work in Downtown Winnipeg, you experience the ‘hardness’ of your daily commute. It is a ‘concrete jungle’, and the impact on your feet, knees, hips and back can be felt on a daily basis.

We all know someone who takes ‘vitamins’, or some kind of ‘supplement’ with the latest health benefit.

I get asked almost everyday about ‘glucosamine supplements’ for arthritis, joint pain, etc. Those ‘horse pills almost choked me’ exclaimed one patient, ‘how much do I need to take to even notice a difference in my knee pain?’, ‘where can I get those pills that supposedly help my joints?…are common questions in Downtown Winnipeg.

In a 2010 British Medical Journal, one of the most reputable of all scientific journals; an article published this conclusion:

“Compared with placebo, glucosamine, chondroitin, and their combination do not reduce joint pain or have an impact on narrowing of joint space. Health authorities and health insurers should not cover the costs of these preparations, and new prescriptions to patients who have not received treatment should be discouraged.”

So is it fair to conclude that it’s not worth taking glucosamine, and/or chondroitin supplements?

Maybe.

May I present the evidence to people to let them make an informed decision. I have seen patients describe dramatic reductions in pain after taking G&C. If the supplement helps your symptoms it may be worth continuing it, especially if stopping taking it causes an increase in pain. I’ve also seen many report no change and complain about the ongoing cost. 1 or 2 have reported occasional side effects, although these supplements are generally considered fairly safe to take.

Other studies have shown more promising results, with Bruyere et al. (2008) concluding G&C may reduce the need for total joint replacement. It’s worth noting however, that in terms of quality of evidence, a systematic review of multiple research papers is usually considered better evidence than an isolated study. A recent analysis by Lee et al 2010 did show that G&C may slow progression of osteoarthritis (as measured by X-ray change) although it required taking it daily over 2-3 years.

But Sawitzke et al. 2010 found “no clinically important difference in pain or function” when compared to placebo. The Cochrane Review (2009) – Glucosamine Therapy for Treating Osteoarthritis had somewhat mixed results but concluded it may reduce pain and improve function.

Prices of G&C vary a great deal. Most clients speak of Costco having ‘bulk’ prices, while Walmart still has the edge on discount pricing for ‘reasonable amounts’. But physicians I have questioned here in Winnipeg, some at our best sportsmedicine centres, still recommend greater than 1600 mgs per day, over greater than an initial 6 week period to judge the supps usage.

Personally, I have recommended our local Winnipeg stores, like Guerrilla Jacks and Sunrise Health; as there is still nothing like more opinions and education about your health.

So the question you need to ask yourself is, am I willing to spend that much on a treatment that might help or may make no difference to my pain or the progression of arthritis?

Words of caution: If you are planning to take supplements to treat arthritis or other conditions discuss this with your GP or Pharmacist.

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Sitting in Winnipeg; an Ergonomic approach to your Physiotherapy needs

Many people ask; ‘what do you treat most often Downtown?’, to that I reply; “mostly neck and back injuries, just from sitting all day at a workstation”.

Here’s where my 27 years of experience as a physiotherapist, who provides specific assessment, feedback, education and instruction in Occupational Ergonomics, or how we interact with our ‘work tasks’, benefits my patients of the grain, finance and legal hub of Winnipeg.

As a physiotherapist, I must assess your workstation and task challenges in order to understand your biomechanics that caused an injury or pain. I only use evidence based guidelines published, and reviewed annually (CSA link http://t.co/Su0MxsFy). Beware of those ‘weekend course’ assessors, quite frankly you will get what you pay for.

You, and your company can reduce repetitive strain complaints in your workplace with an ergonomic assessment at your specific, work site. I will assess problem areas and make recommendations for change to workstations, task organization and management, and your specific, body mechanics with a focus on employee participation, responsibility and behaviour change.

A worksite visit to understand your business and jobs will only provide a baseline for understanding the demands on workers. It will provide us with an ability to recommend modifications for ergonomic improvements and safe body mechanics training.

By providing immediate feedback; employees are able to participate and install immediate, habitual changes at work, home and play, that assist in improving compliance with safe work procedures, and biomechanics that prevent injury.

The main risk factors for musculoskeletal injury can be categorized under one of the following four broad headings: force, posture, repetition and duration of task. In the office or call centre environment these risk factors could be interpreted as;

  • force – is an exertion performed to overcome the weight, resistance, or inertia of the body or a work object (i.e. forceful hand movements while keying or mousing),
  • posture – awkward postures deviate from neutral or comfortable positions. (i.e. twisted neck, raised shoulder, extended wrist, etc..),
  • repetition – refers to tasks or series of motions that are performed over and again by the same muscle groups with little variation (i.e. continuous mousing or keying)
  • duration – the time which something continues (i.e. sustained neck extension to view monitor or abducted shoulder while mousing)

check back again for more on this continuing series regarding your ‘sitting in Winnipeg’…