pills and injections for Osteoarthritis Treatment

Osteoarthritis: Key Facts And Symptoms Of The Condition

Osteoarthritis (abbreviated OA) is a condition that annually affects millions of people around the globe, worsening their health, quality of life, and overall mood. A widespread form of arthritis, osteoarthritis causes the extensive ‘tear and wear’ of the protective cartilage found on the ends of bones that form a joint. 

Normally, the cartilage is sufficiently thick to cushion bones from pressure and grinding, and joint liquid lubricates the cartilage surfaces to ensure smooth and painless movements. OA makes the cartilage shrink and wear away, and hard bone ends come into close, almost direct contact with every move. OA also affects the connecting tissues, joint lining, and bone itself, thus making the patient’s life painful and unsatisfying. Usually, OA develops in the knees, spine, hands, and hips – the areas that carry a significant daily load of movement.

Symptoms of OA include: 

– Pain in joints

– Tenderness

– Other unusual sensations in joints

– Swelling

– Stiffness and lowered mobility 

– Sensation of grating or ‘creaking’ in joints

– Sometimes, bone spurs can form. 

The damage to health created by OA makes the question of treatment and osteoarthritis prevention supplements all the more essential.

The causes that trigger the development of OA are older age, gender (women are at a greater risk of developing OA), obesity, genetics, jobs that put excessive daily wear on joints, and joint injuries. 

Osteoarthritis treatment: types of treatment and when to recommend them

Unfortunately, OA cannot be cured completely, i.e., the damage to joints cannot be fully repaired. Yet, with proper treatment and lifestyle adjustments, the health of joints can be improved and maintained on a satisfactory level, thus ensuring the absence of pain and relative comfort to patients. 

– Conservative treatment begins with providing efficient pain relief to patients. To achieve it, typically, nonsteroidal anti-inflammatory drugs (like ibuprofen) or acetaminophen are prescribed in the form of pills. 

– The second step is to prevent further inflammation in joints, somewhat restore the level of lubricating liquid in joints, and slow down the tissue degradation process. Food supplements of certain types can help accomplish this task. 

– Injections into joints have two critical functions: reducing the inflammation and providing an additional source of viscous liquid to facilitate the bones’ traction in a joint.

– The last resort is surgery, which means replacing the joint completely or modifying it to provide support in a movement without causing pain. 

Conservative Treatment: pills, herbals, and food supplements

Are Food Supplements Really That Efficient Against Osteoarthritis?

Although views on the efficiency of food supplements for osteoarthritis differ, several substantial randomized trials and studies have shown that certain types of components, when added to a daily ration, do help alleviate pain and inflammation and reduce overall discomfort. This effect is not created overnight, for sure, so it is a consistent therapy over the course of time that will deliver measurable and palpable results.

Hence, the answer is yes; particular types of food supplements are efficient as a part of complex OA therapy. 

Important Ingredients to Look for in The Best Joint Supplements

So what components should be present in the best supplements for osteoarthritis?

– Chondroitin and glucosamine. Patients’ reports prove that these components are good for pain relief. Besides, these substances are responsible for the health and protective functions of cartilage in joints, to put it shortly. 

– Collagen. It may be denatured or undenatured type II collagen, depending on the type of supplement. This component is responsible for joint tissue elasticity and resilience to deformation.

– Methylsulfonylmethane (MSM). This component is responsible for maintaining the health of ligaments and provides pain- and inflammation-relieving effects. 

– Turmeric. This ingredient has a long-proven history of acting as an anti-inflammatory agent. 

– Boswellia serrata extract. This natural herbal component has a proven record of acting as an anti-arthritic, anti-inflammatory, and analgesic treatment. 

– Omega-3. Usually taken in the form of fish oil, omega-3 is known to relieve pain and stiffness in joints. It also provides some protection to joints from further damage.

It’s a complicated task to evaluate some of the best vitamins for osteoarthritis because every supplement is rich in various active ingredients. Yet it is their combination and efficiency that make the featured products stand out.

  1. Move MD by 1MD Nutrition. This supplement is based on clinically tested and federally approved ingredients, so its safety and medical reliability are confirmed by the US certifying bodies. Namely, the supplement includes several types of collagen and hyaluronic acid that provide support and relief for damaged cartilage. Another important ingredient is the proprietary Astaxanthin, a powerful antioxidant and anti-inflammatory agent. The final key ingredient is the painkiller, ApresFlex, the enhanced form of Boswellic acid, the derivative of Boswellia serrata.
  2. Physio Flex Pro. This supplement contains a boost of pain-relieving, anti-inflammatory, and joint-protecting components, which makes it one of the best supplements for knee arthritis relief. This product includes chondroitin, glucosamine, MSM, turmeric, bromelain, ginger extract, and selenium. The supplement is reported to alleviate pain, reduce inflammation and take part in the production of valuable lubrication in joints.
  3. Nuzena Joint Support. The supplement’s primary goal is the maintenance of well-functioning joints and cartilages, and the ingredients were chosen with this in mind. Glucosamine, Boswellia extract, turmeric, chondroitin, quercetin, and bromelain operate together to reduce inflammation and boost the resilience of cartilage and bones in ailing joints.
  4. Turmeric by Care/Of. It is a solo-ingredient supplement, as is clear from its name. The content of each capsule is aqueous turmeric and purified turmeric supercritical extract, which makes this supplement more efficient in comparison to one-type turmeric products. 
  5. BioTRUST Joint 33X. The triple-ingredient supplement aims to maintain the health of joints, increase mobility and reduce inflammation. It contains collagen (undenatured type II), the patented Mobilee ingredient (with hyaluronic acid), glucosamine, collagen, and Boswellia extract as a part of the complex ApresFlex formula. 
  6. Calm by Relief Factor. The supplement was designed specifically to be a wholly natural composition aimed at reducing pain in joints. The supplement includes turmeric, omega-3, icariin, and resveratrol which act as analgesics and stress-reducing agents. The benefit of this product is the absence of artificial components.
  7. Omega XL. The marking XL in this supplement points to its composition, which includes an array of 30 healthy fatty acids necessary for maintaining the health of cartilage, bones, ligaments, and surrounding tissues. These acids also help reduce pain, swelling, and inflammation that can trigger further deterioration of the joint. The price of this supplement may seem high, yet this particular composition is definitely worth the money.

Minimally Invasive Treatment: injections delivered directly into joints (intra-articular injections) 

Is Injection Treatment Really That Efficient Against Osteoarthritis?

Intra-articular injections are a local treatment solution that provides significant relief from joint pain in the mid-term perspective (6 to 8 months on average). Injectables aim to emulate natural components found in the joints and tissues around them. Injections deliver a sufficient dose of viscous liquid that cushions the bones and worn cartilage and prevents them from further degradation (at least temporarily). So yes, injections do assist in reducing pain and protecting joints during the complex OA treatment.

Important Ingredients To Look for In The Best Joint Injections

Currently, after years of research and trials, sodium hyaluronate is believed to be the most optimal ingredient for these cushioning injections. It is natural, safe, and possesses unique properties that make it indispensable in treating OA-affected joints. Once injected, it replenishes the thinning and disappearing synovial fluid (the lubricating fluid in the joint). The viscous slippery gel acts as a perfect padding between worn cartilages and gradually wears away, acting as a natural lubricant for the smooth movement of bones in a joint. 

The only concern that should arise during the selection of the injectable is the origin of the sodium hyaluronate. It can be of animal or non-animal origin, a factor to consider for patients with allergies.

Now let’s explore the cutting-edge injectables fit for treating osteoarthritis. 

1) Euflexxa. It is a sterile and safe transparent gel of viscous texture, and its composition is sodium hyaluronate of non-avian nature enhanced by hydrogenated phosphates. The injected implant improves joint mobility, cushions the cartilage, and alleviates pain. 

The treatment consists of three injections delivered at weekly intervals. If the treatment proves successful, the procedure can be repeated every 6 months on average.

2) Cingal. This injectable is an innovative combination of sodium hyaluronate and corticosteroids responsible for strong anti-inflammatory action. The sterile viscous gel is made of hyaluronic acid of non-animal origin and enhanced by Triamcinolone Hexacetonide. The effect is protecting the ailing joint and treating inflammation and pain. 

The treatment procedure includes one injection only, and it should be repeated approximately 6 months after the first one. 

3) Crespine Gel Plus. Hyaluronic acid in this product is created through the bacterial fermentation process, thus being hypoallergenic and safe for sensitive patients. Hyaluronic acid is combined with Prilocaine, an anesthetic that makes the injection painless and comfortable. 

Crespine Gel Plus is designed for one-injection treatment, and the next injection can be administered in 6 months or even in a year.

Crespine Gel Composition, Ingredients and Dosage Summary – read more.

4) Durolane. This viscous injectable gel contains only hyaluronic acid (cross-linked after the patented NASHA technology) mixed with sodium chloride (water for injections) for a smoother injection procedure. This product is excellent for those patients who do not want their hyaluronic supplements for knee osteoarthritis to contain additional medications. 

Durolane is intended for the one-injection treatment, and the injection can be repeated over time, a minimum of 4 months after the initial one, a maximum of 4 injections per year.

5) Hyalgan. This injectable is also based solely on hyaluronic acid without additional agents, but there is a caveat: it’s avian-based (extracted from rooster combs, usually). So it should be administered to patients who are not allergic to avian products. Its advantage is that its price is very affordable compared with other brands on the market.

The product is to be administered throughout three to five injections with one-week spacing each. If needed, the treatment can be repeated in 6 months.

Hyalgan vs Synvisc: Similarities and Differences Reviewed – read more.

6) Orthovisc. This product is also a mono-component viscous gel; the only ingredient is sodium hyaluronate. However, hyaluronic acid in this injectable is of non-animal origin (i.e., lab-made), so the gel is safe for patients with various allergies to animal products. The price is also one of the most affordable on the medical market.

Three injections of Orthovisc are recommended as a first-time treatment (delivered as one injection per week). Afterward, the repetitive treatment can happen every 6 months. 

Orthovisc vs Supartz: Are They Made from Same Material? – read more.

7) Synvisc One. This injectable gel consists of hylan, a derivative of hyaluronan found in the human body in general and in synovial liquid in joints in particular. This gel is an excellent viscosupplementation agent, free from any additional chemicals. Hylan is cross-linked for higher stability of this viscoelastic implant, so it lasts longer in the human body. However, this product is of animal origin (avian-based).

Synvisc One is a one-injection treatment solution, and the procedure should be repeated on average every 6 months. 

8) Synvisc. The only difference that separates this injectable from Synvisc One is the volume of the gel filled into a syringe. If Synvisc One is a one-injection treatment, with 6 ml of gel loaded into a single syringe, then Synvisc is a lighter treatment option, with three separate injections (a 2 ml syringe for each) spread over three weeks. 

Otherwise, the composition is the same: hylan-based gel, sterile, and animal-based (of avian origin).

As said, treatment includes 3 injections performed once per week. Repeated treatment may be necessary after 6 months or so.

Orthovisc Vs Synvisc – read more.

Simple Rules For Choosing High-Quality Supplements

Whether you plan to obtain osteoarthritis herbal supplements or injectables for your clinic or your patients, it’s vital to choose the best and approved medications. 

So the first requirement is a license or approval of a supplement issued by the USA or European regulating authorities. 

The following requirement is the content of a supplement: it should include ingredients that actually work for the benefit of patients and are safe. 

The final consideration is the price since not everyone can afford expensive top-class supplements. More affordable options can also be efficient while accessible to a broader range of patients. 

Warning! Please be aware that mentioned products are to be prescribed and administered under the supervision of a licensed medical professional only. They are sold to medical workers, clinicians, and representatives of medical institutions holding a license. Dispensing or administering the products by a non-professional and/or without prior medical consultation may create adverse health effects and induce other unwanted consequences.

FAQ

Are there ingredients in supplements that are often used but have no proven healing effect?

It’s hard to pinpoint ingredients that are not effective because, for various groups of patients, some components may be more effective than others and vice versa. For example, to some patients, chondroitin and glucosamine are excellent supplements, while others do not feel their effect. So every supplement should be selected individually, with attention to other conditions a patient may have. 

What reasonable treatment effect should one expect from supplements?

Essentially, they reduce inflammation, alleviate pain, and provide protection and additional layers of lubrication for cartilage. Some supplements can also induce the production of collagen for maintaining a satisfactory level of health in joints.

What specific reasons may trigger acute osteoarthritis flare-ups?

The most common reason is an excessive amount of movement, carrying loads, conducting a sequence of repetitive moves, or causing additional trauma to an ailing joint. Other reasons for flare-ups may be cold, stressful situations, infection getting into a damaged joint, or even rapid changes in the weather. Another reason may be gaining weight that puts additional pressure on joints.

Is there the best natural pain relief for osteoarthritis as an alternative to artificial substances? 

It’s difficult to pinpoint the single natural ingredient that can relieve pain. Some patients may benefit from traditional painkillers like ibuprofen, while others may find collagen, MSM, chondroitin, or omega-3 helpful in their condition. It’s a matter of testing and adjusting the painkilling protocol for every patient. 

Afterword

Osteoarthritis is a condition that can seriously degrade the quality of life and cause deep physical and emotional suffering in patients. Although it cannot be cured completely, medical advances enable alleviating pain, protecting the joints, and even restoring the level of synovial liquid to a satisfactory level. Oral supplements and injectables play a significant role in this treatment process. We did our best to provide an extensive guide on the new supplements to help you in this noble and rewarding task. 

References 

Dunkin, Mary Ann. Hyaluronic Acid Injections for Osteoarthritis. April 27, 2021. Available at 

https://www.webmd.com/osteoarthritis/hyaluronic-acid-injections-for-osteoarthritis

Osteoarthritis. https://www.mayoclinic.org/diseases-conditions/osteoarthritis/diagnosis-treatment/drc-20351930

Vad, Vijay. Do Hyaluronic Acid Injections Work for Knee Osteoarthritis? March 28, 2019. Available at https://www.arthritis-health.com/treatment/injections/do-hyaluronic-acid-injections-work-knee-osteoarthritis

https://www.healthcanal.com/health/best-joint-supplements

https://www.verywellhealth.com/top-joint-supplements-2549657

https://www.medicalnewstoday.com/articles/joint-supplements

https://www.discovermagazine.com/lifestyle/25-best-supplements-for-joint-pain-in-2022

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