

Question: Are there any vitamins or herbal supplements that can be used to treat pain resulting from osteoarthritis?

Answer: There are a number of dietary supplements that could be used to help with the pain and discomfort of osteoarthritis. But there are three that have research behind them and are the most popular. Those include glucosamine sulfate, devil's claw, and bromoline.

Glucosamine most people are familiar with. It has quite a lot of research behind it showing that it can help ease the pain of osteoarthritis, and there is some evidence suggesting it may actually slow the progression. There's very little downside with glucosamine, it's quite safe and effective. The thing about glucosamine you need to remember is that it's rather slow acting, so it may take eight to 10 weeks to really start to feel the effect. And at that time patients may need to continue taking their regular analgesics -- their Tylenol or their ibuprofen. But generally you can wean off of those medicines the longer you're on the glucosamine.

The second is an herb that's less commonly known in the United States but is very popular in Europe, where it's been available as a prescription for arthritis and back pain for almost 50 years -- and that's devil's claw. It's a South African herb that has been traditionally used for pain conditions. A large review is published a couple of years ago that looked at the 12 clinical trials that evaluated it for back pain and for osteoarthritis. And the authors of that review actually concluded that devil's claw is quite effective for these conditions. Now remember you need to take this as a standardized extract, and that's how you want to purchase it at a store to make sure you get a good quality.

Finally is bromoline, which is actually the name of a group of protein digesting enzymes that are found in pineapple. And when you eat pineapple you actually get some of this bromoline, but it's primarily concentrated in the stem of the pineapple. Bromoline is also available in Europe and is one of their most popular selling herbal medicines. It is used for acute injuries, and also to ease the pain of osteoarthritis. What's the trick with bromoline is it's rather quick acting. But you have to take it in an enterit-coated form. Otherwise the stomach acids break it down and make it ineffective. So you purchase an enterit-coated form of bromoline. It's quite safe. The only caveat is for people who are taking blood thinning medications -- or things that are preventing them from having a blood clot -- there may be an interaction in that, so it really shouldn't be used in this situation.

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