Pain Series

A Matter of Lifestyle

Despite the results of GAIT, glucosamine and chondroitin remain popular alternatives to prescription and over-the-counter drugs, as consumers continue to look for joint health products that “fit their active lifestyles,” said Micah Osborne, president, ESM Technologies.

“They are asking for supplements that work faster and require a lower dose,” he continued. “You can see an example of this in a leading pain relief manufacturer’s new marketing campaign touting fewer pills per day for the same results as its leading competitor. The same holds true for supplements; consumers want the same or better results in fewer and smaller dosages and with the safety of natural products. They are also asking for more convenient dosage forms. This would include beverages, bars or chews, which fit their active lifestyles.”

Sabinsa’s Dr. Prakash, agreed, saying, “As functional foods become more accepted, premixed beverages, granules, candies and other food forms are becoming popular for a variety of health conditions.”

Mr. Osborne reiterated that consumers are asking for convenient joint health products that offer results in less time with smaller doses. “Products made with NEM (Natural Eggshell Membrane) not only have been proven to be efficacious for improving joint comfort and flexibility in as little as 7 to 10 days, but they also come in a very convenient dosage of one small, 500 mg pill per day.”

Consumers are also looking for controlled clinical studies or comparisons with known analgesics, said Dr. Prakash. “Current trends favor supplements supported by sound clinical studies and safety information.” Pet care supplements in this category are also gaining attention, she added.

Referring to several natural ingredients supported by clinical evidence, Dr. Prakash said a recent clinical study showed ginger may support pain management in muscle injury after exercise, “offering athletes a natural option.” Ginger extract has also been shown to offer support in managing migraines and joint inflammation.

“Earlier studies established the healthful role of Boswellia serrata extract (Indian frankincense) in supporting the management of symptoms of osteoarthritis, including pain,” she added.

Sabinsa offers a proprietary, sustained release blend comprising Boswellin (Boswellia serrata extract), Curcumin C3 Complex (turmeric root extract), glucosamine and Bioperine (black pepper extract, a nutrient bioavailability enhancer), which showed significant improvement in subjects with knee OA, and reduced pain and swelling scores. “These are examples of supplements that function like NSAIDs without the associated gastrointestinal side effects,” said Dr. Prakash. “They are also suitable for topical use.”

In addition, capsaicinoids (from hot chili peppers) are often used to provide topical pain relief in over-the-counter creams, she noted. “Several botanical oils soothe and offer pain management support (e.g., celery seed oil, clove oil, lavender oil, olibanum oil and others). White willow bark, devil’s claw and other materials with a history of traditional use and scientific data, and nutritional approaches such as magnesium salts and omega 3 fatty acids, appear in supplements as well.”

Curcumin, a compound derived from the popular Indian spice turmeric, inhibits multiple inflammation pathways in the body, according to Europharma. Some of the benefits associated with curcumin include immune system modulation, protection from oxidative stress and support for the body’s natural anti-inflammatory response. According to NBJ, sales of turmeric were up 38% in 2009 to $60 million.

EuroPharma’s Curamin combines BCM-95 bioavailable curcumin, “which has seven to 10 times the absorption of plain curcumin,” said the company’s Ms. Myers. “Known for its ability to balance the body’s natural inflammatory response, BCM-95 has been proven in published clinical studies to provide consistent, long-lasting effects. Curamin also contains a potent form of the anti-inflammatory herb boswellia, as well as Dl-phenylalanine (DLPA) for its ability to sustain endorphins and enkephalins in the brain, and the enzyme nattokinase, which supports healthy circulation so that important nutrients can be better carried to the areas of need, and waste materials more efficiently removed.”

Studies also indicate collagen can play a role in relieving pain associated with OA. According to BioCell Technology LLC, Newport Beach, CA, a new human study involving 80 patients supports previous evidence that its BioCell Collagen II improves various physical activities of subjects suffering from joint conditions associated with OA, including pain, stiffness, mobility and overall quality of life. The multicenter, double-blind, placebo-controlled trial indicated that a significant portion of OA patients experienced substantial improvement of their joint conditions, as measured by VAS and WOMAC scores.

Other popular joint pain ingredients include MSM (methylsulfonylmethane), which brought in $90 million in U.S. sales for 2009, according to NBJ. However, that figure is down 10% from the previous year. SAMe (S-adenosyl methionine), which was recently shown to help depressed patients who don’t respond to prescription antidepressant treatment, also helps reduce the pain associated with OA. SAMe generated $120 million in sales in 2009, up 11%.

Larry Kolb, president, U.S. operations, TSI Health Sciences, Inc., Missoula, MT, said he believes the most sought after indication areas will continue to include joint pain, headaches, lower back pain and muscle pain. However, he acknowledged a lack of innovation that has kept category growth down. “It’s a crowded marketplace with multiple brands and little innovation in terms of new ingredients that are proven. I believe the category will continue to grow in the single digits over the next five years, but it has matured and the large growth rates will not come until alternative ingredients bring innovation to the category.”

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