Chondroitin May Improve Hand Function for Osteoarthritis Patients

A new study suggests that chondroitin sulfate may reduce hand stiffness and pain for individuals with osteoarthritis.

Chondroitin, which was first extracted and purified in the 1960s, may be manufactured synthetically or from natural sources, including shark and beef cartilage or bovine trachea. In general, expert opinion supports the use of chondroitin along with its common partner agent, glucosamine, for improving symptoms and stopping the degenerative process of osteoarthritis. Although recent clinical trials supporting its use have been of superior methodological quality, some of the older trials have serious methodological flaws, possibly resulting in an overestimation of its potential benefit.

In a new study, 162 patients with radiographic hand osteoarthritis were randomly assigned to 800 milligrams of chondroitin sulfate or placebo once daily for six months. Before inclusion, patients were identified as having spontaneous hand pain of at least 40 millimeters on a 0-100 millimeter visual analogue scale and functional impairment of at least a 6 on the 0-30 functional index for hand osteoarthritis scale.

The researchers found that hand pain decreased significantly and hand function improved significantly for individuals treated with chondroitin sulfate when compared to those in the placebo group. Individuals treated with chondroitin also felt a significant improvement in morning stiffness. Furthermore, chondroitin patients were significantly more favorable of overall treatment effectiveness than those treated with placebo.

The authors concluded that chondroitin sulfate may reduce pain and improve functioning for individuals with hand osteoarthritis. Although promising, additional research is necessary.

For more information about integrative treatments with evidence of benefit for osteoarthritis, including acupuncture, glucosamine and willow bark, please visit Natural Standard's Comparative Effectiveness Database

For more information about chondroitin, please visit Natural Standard's Foods, Herbs & Supplements Database.

Comments

[Empire Bakuba]

Interesting article, I'm curious about the use of Chondroitin in sports athletes as possible preventative medicine. Its relative safe and I'm assuming their isn't any toxicities from long term use.

[NK]

Another studied use of chondroitin is in patients with coronary artery disease (CAD). As many of these patients are on anticoagulants and/or antiplatelets something to know is chondroitin is related to heparin. If used in combination with these anticoagulants/antiplatelets, it may increase the patient’s chance of bleeding. Gastrointestinal bleeding, being one of the bleeds of concern, is a major complication that can lead to serious complications.

[NK]

Since chondroitin is often combined with glucosamine, it would have been nice to see a third arm. This would have evaluated the efficacy of chondroitin alone vs chondroitin and glucosamine. This would be important to see if there is any additional benefit when glucosamine is also supplemented. In future studies, researchers could also evaluate chondroitin at different doses to see if there would be any statistically or clinically significant difference.

[CLZ]

BB, though I do not have OA, I can speak about my personal experience with chondroitin and the weight bearing joints. Last year I was training for a marathon. When I increased my millage past 6 miles, I started noticing a pain in my knees and had to stop training. Under the advice of a Physical Therapist, I began taking chondroitin and glucosamine to strengthen my knees. After about a month of taking the supplements, my knee pain was gone, and I was able to increase my millage in time for the marathon. I was able to save the $150 entrance fee and more importantly my pride.

[ss]

I recently read a study regarding the use of glucosamine and chondroitin in rheumatoid arthritis of the hands. If I recall the subjective measures showed improvement by the participants. This could be a beneficial alternative for people who suffer from both OA and RA - I look forward to further studies.

[BR]

BB and SG, this is great information to have...thanks for sharing! Often, when reading through studies it is easy to skim over outcome measures that you're not familiar with, but knowing the differences and which is better for measuring within and between participants will help us all to better understand and evaluate studies in the future!

[PR]

I was curious about muscle cramps and what measures can be taken to prevent or treat it. According to Natural Standard monograph, chondroitin and glucosamine have strong scientific evidence for osteoarthritis, which contributes to joint pain and muscle weakness. Although not proven scientifically, chondroitin and glucosamine probably help with muscle cramps by improving mobility and reducing pain. Also, it will be nice to see promising studies on topical chondroiton ant its use in osteoarthritis and musculoskeletal conditions.

[EB]

Whenever I think of chondroitin, I usually associate it with osteoarthritis. According to the NS website, chondroitin is rated an Evidence Grade B for urinary incontinence. This would be a good thing to keep in mind for our patients with this problem since there are no Evidence Grade A therapies as of yet.

[EB]

Whenever I think of chondroitin, I usually associate it with osteoarthritis. According to the NS website, chondroitin is rated an Evidence Grade B for urinary incontinence. This would be a good thing to keep in mind for our patients with this problem since there is are Evidence Grade A therapies as of yet.

[EB]

Whenever I think of chondroitin, I usually associate it with osteoarthritis. According to the NS website, chondroitin is rated an Evidence Grade B for urinary incontinence. This would be a good thing to keep in mind for our patients with this problem since there is no Evidence Grade A therapies as of yet.

[SG]

BB, thanks for your research! While VAS is increasingly used, it still seems quite subjective. But I suppose it’s an improvement over rating pain on a 1-10 scale. I also read that VAS scales are more valuable when looking at pain within individuals, but when it comes to comparing pain across a group of individuals at one time point, they are of less value. It’s an important limitation to keep in mind when looking at these clinical trials.

[BB]

SG in response to your question--I wasn't 100% sure but after doing a quick search online I found that a visual analogue scale (VAS), which is used for outcomes that are subjective/cannot be directly measured easily (such as pain), is most valuable when examining change (in a particular outcome) within the participants.
That being said, it does seem as if researchers use a VAS as an attempt to quantify subjective data and make pain a more "objective" outcome.

[SS]

I have heard conflicting reports (pro and con) concerning chondroitin over the past 10 years....this seems promising and it would be interesting if a study was done regarding weight bearing joints - knees and hips to see if the results would be similar. There is always hope!

[IL]

Excellent news. This simply adds to the various studies out there that show that chondroitin may be helpful for osteoarthritis patients.
SG, there are many studies that already show chondroitin's use for osteoarthritis of the knees. This study adds on to those findings by selectively testing hand function for osteoarthritis patients.

[RJW]

Very good question SG. The millimeter scale is much like the numeric 1-10 scale. In it a patient is shown a 10cm line segment and told to indicate where their pain is along that continuum. So it's a rating of 1-100mm that is determined visually rather than numerically. Some researchers believe that this gives a more accurate and meaningful assessment of pain.

[EB]

Reading that chondroitin comes from all different types of natural sources, I was curious what else it can be made from other than shark cartilage and bovine trachea. According to the Natural Standard website, chondroitin can be made out of other types of shellfish. Make sure to ask your patients about allergies when counseling them on this product!

[MA]

This is great news for patients with hand osteoarthritis, especially those who prefer not to take prescription medication! It’s a great natural alternative to improve daily functioning and pain, especially in those patients where the pain and inflammation is not yet too debilitating. The NS monograph mentions that long-term studies (beyond three years) looking at both efficacy and toxicity have not yet been assessed. I am interested in seeing further research conducted on this topic involving long-term use of chondroitin use since osteoarthritis is a chronic disease.

[PR]

Glad to know that new clinical trials on chondroitin use have been of better-quality quality. On Natural Standard’s website, acupuncture and chondroitin sulfate/Glucosamine have strong scientific evidence for osteoarthritis. Chondroitin reduces pain and improves function according to this study. However, results from some studies indicate that chondroitin sulfate may not prevent or delay muscle soreness, and it may not help with inflammation and muscle damage. Glucosamine may exert mild anti-inflammatory effect, thus it would be interesting to see high quality studies involving both chondroitin and glucosamine together and its effect on inflammation.

[BR]

SG, you make an interesting observation. That is somewhat of a strange way to quantify pain in the hand. I am glad that they looked at function too, not just pain, because I feel that function is an important factor when it comes to osteoarthritis, especially in the hands. I know the pain and morning stiffness can be a real problem for some people, so perhaps chondroitin could be a helpful option for reducing those burdens. I would also like to see if chondroitin could be used beyond relieving symptoms in the hands, as many people experience arthritis pain in other areas.

[SG]

This is an interesting conclusion, based on studies many of us have heard of before. What interests me is why they used a pain scale of mm in the hand. Why did they not rate the pain in their hands on a 1-10 scale? Also, I wonder about the applicability of these findings to using chondroitin for osteoarthritis of the knees, since that is also a current use.