Newsletters

Issue 17

Glucosamine and the War on Osteoarthritis...

The long anticipated research. Trying to overcome the limitations of living with Osteoarthritis is a common patient complaint. Treating this condition is made more complex with the major prescription drug, Viox being pulled from the market (due to the harmful cardiovascular consequences), as well as the negative long term effects on the Gastro-intestinal system of other NSAIDS. With the release of the results of two major clinical studies, many GP's are now recommending Glucosamine (something the alternative medicine fraternity have known for years...). Clegg et al (2005) conducted the Glucosamine/Chondroitin Arthritis Intervention Trial (GAIT Trial) with 1500 osteoarthritis sufferers, and found "combination glucosamine and chondroitin sulphate is effective in treating moderate to severe knee pain due to osteoarthritis." This result is also backed up by the European based GUIDE trial by Herrero-Beaumont et al (2005), whereby Glucosamine was found to be more effective than over-the-counter painkillers. What can we take from this research? The Osteoarthritis sufferer will surely benefit with a multi-pronged wholistic approach with manual therapy combined with Glucosamine.

Knee pain in winter

Many patients present to the clinic with knee pain during the colder months, often without any obvious trauma. Why is this so common and what is the solution? The common causes are mechanical irritation (undue wear) due to poor joint alignment, ligament strain, muscle weakness or imbalance and degenerative changes to cartilage and joint capsule. Cold will reduce circulation of blood and other body fluids, this reduces delivery of nutrients and removal of wastes which exacerbates the pain. Use it or lose it! There is a time for rest of acute injuries, but appropriate exercise is vital to knee rehabilitation, stability and maintenance. Impact or jarring should be avoided. Specific knee exercises can improve the stability and mechanical alignment of this vital, load bearing joint. One of the best favours that you can do for knees is to lose excess weight, thus minimising the wear factor. Glucosamine is the much talked about "raw material" of cartilage. We are constantly breaking down old cells and laying down new. With age, the former happens faster than the latter. Clinical studies have shown that regular doses of Glucosamine and Chondroitin can slow the process. (ref: Glucosamine article above)

Therapeutic Goods

Chondro Caps
Suitable for patients with early symptoms of osteo or rheumatoid arthritis who experience knee, hip, neck or shoulder stiffness, yet little pain or inflammation.

Condrosamine plus MSN powder
This naturally derived product combines glucosmine sulphate and chondroitin to treat cartilage disorders with Methylsulfonylmethane (MSM) which is both an analgesic and anti-inflammatory agent. This complex is indicated when patients have arthritis with pain and stiffness, and cold rather than hot joints.

Chondrosamine capsules
Relief of symptoms in more advanced osteo or rheumatoid arthritis where joints have degenerated and are painful and hot.

What is Tennis Elbow?

Pain on the outside of the elbow, or lateral epicondylalgia, is a common overuse injury to the upper limb. Whilst prevalent in tennis players, it could just as easily be called Builders or Mechanics elbow, as any activity with repetitive stress can cause this condition. It can often be a lingering pathological condition, so it is vital that it is promptly treated with a wholistic approach, i.e. treating areas of dysfunction distant to the elbow.and yes, unfortunately you have to do the exercises prescribed by your Osteopath (Smidt et al, 2002 found a 91% success rate at 52 weeks with a combined manual therapy/ exercise program). Treatment includes improvement in the elbow's structural/ functional relationship with the neck, thoracic spine, pelvis and the Thoracic Outlet (the neuro-vascular bundle of the upper limb passes through here, and inadequate blood flow to/ and drainage from the elbow can maintain dysfunction). Also nutrition and hydration is important for healing (for example coffee and alcohol increase acidity and inflammation).

Why do I have this nagging pain between my shoulder blades?

If you look at someone from side-on you will notice that they have curves to the shape of their back from the base of the skull to their pelvis. These curves are there for a reason, one of which is to distribute forces in a reasonably even way during our daily lives of being dynamic creatures. Between the shoulder blades you will find thoracic vertebrae which constitute a curve called Kyphosis. Some people have a greater or lesser curve, both of which cause problems to not only the ribs which are attached to the thoracic vertebrae, but also the shoulder blades. The shoulder blade requires the thoracic vertebrae and ribs to rest and move effectively when you reach into the cupboard for that coffee cup or hang clothes on the clothes line or drive the car etc.

Between the shoulder blades lie muscles (rhomboids) that are designed to allow us to draw our shoulders back and to keep our posture upright and tall. Located at the front of the chest are our pectoral muscles that attach to the front of the shoulders, and these need to counteract our rhomboids. If these muscles are out of balance the result is to be bent forward or to be excessively flat in the upper back.

Ribs are designed to move 15 or so times per minute in a specific way.. Do you think there is an effect on not only muscles in the back, but also the ligaments holding ribs to the thoracic vertebrae and all manner of other soft tissue between the shoulder blades, due to the change in the normal curve? Absolutely!!! You see, we really are a bunch of joints from top to bottom, and each joint is designed to move in certain ways, to give us not only movement, but to provide health to soft tissues around the joint. If the normal function is lost at any joint, problems will arise at some stage due to a build-up of waste products in and around the joint. It's like a pumping mechanism - each time you move the joint correctly or a joint is allowed to function correctly, health is supplied to the surrounding soft tissue.nutrients are pumped in and wastes are pumped out.

Now, this is the kicker... the pain receptors, which normally detect painful stimuli, such as someone whacking you in the back, or you lying in a sleeping bag over a sharp rock etc, are now hyper-alert due to the waste products incorrectly stimulating the pain receptors in your back. So now just sitting there, bending forward, reaching for a coffee cup or brushing your hair are perceived as being painful.

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Thank You

Thanks to all who have supported the practice over the past years by recommending your friends, colleagues and families. We look forward to continuing to support your Vital Lifestyle.