Spelling Relief to Pain

Spelling Relief to Pain

With more consumers focused on general health and wellness goals, demand for post-exercise recovery products has gained significant strength, according to ESM’s Mr. Haynes. “Aging population demographics are obvious and in front of us every day,” he said. “A natural extension of an aging population is more people are looking to maintain a healthy lifestyle by exercising later into their lives. With this exercise there is going to be more pain and stiffness related symptoms. Workout regimens are getting more intense. Pain and soreness levels become standard, but workout enthusiasts are looking for quicker recovery times so they can get back in the gym.” Consumers are also more educated about their options, he added. “The ingredients or products with the best scientific results—that can market those results—win.”

As established stars of the natural pain relief market, glucosamine and chondroitin have gained support from clinical evidence that confirms their efficacy in combating osteoarthritis. U.S. consumer sales of glucosamine/chondroitin in 2009 totaled $800 million, down 4% from the previous year, according to Nutrition Business Journal (NBJ), Boulder, CO.

Glucosamine is a natural compound that is found in healthy cartilage. Glucosamine sulfate is a normal constituent of glycosaminoglycans in cartilage matrix and synovial fluid. According to the Natural Standard monograph for glucosamine, “Available evidence from randomized controlled trials supports the use of glucosamine sulfate in the treatment of osteoarthritis, particularly of the knee. It is believed that the sulfate moiety provides clinical benefit in the synovial fluid by strengthening cartilage and aiding glycosaminoglycan synthesis. If this hypothesis is confirmed, it would mean that only the glucosamine sulfate form is effective and non-sulfated glucosamine forms are not effective.”

Glucosamine is commonly taken in combination with chondroitin, a glycosaminoglycan derived from articular cartilage. But glucosamine may also treat OA in combination with other nutritional ingredients, such as omega 3 fatty acids, which have been recognized for their ability to combat inflammation.

Research published in Advances in Therapy in September 2009 studied a total of 177 patients with moderate to severe hip or knee OA who were tested during a period of 26 weeks in a two-center, two-armed, randomized, double-blind, comparison study. Researchers aimed to see if a combination of glucosamine sulfate (1500 mg/day) and the omega 3 polyunsaturated fatty acids EPA and DHA would be more effective than glucosamine sulfate alone.

Pain, stiffness and function were evaluated using the Western Ontario and McMaster Universities Arthritis index (WOMAC) score. Results indicated a therapeutic and statistical superiority for the combination product of glucosamine sulfate and omega 3 fatty acids in patients who complied with the study protocol.

Ben Winters, director of Christchurch-based Aroma New Zealand, said green lipped mussel powder is rich in omega 3 fatty acids, glucosamine sulfate and glycosaminoglycans, which reduce inflammation, pain and increase joint mobility.

“Our GlycOmega greenshell mussel powder is sourced from New Zealand greenshell mussel meat, Perna canaliculus, which is native to New Zealand and one of the most sustainable omega 3 fatty acid products in the world. We have been manufacturing and exporting GlycOmega for over 25 years into the joint care market and sales continue to increase every year as the positive pain relief effects take place. Joint pain is the biggest market for GlycOmega, for both humans and animals, as it provides natural anti-inflammatory activity.”

Research results for natural pain relief products have not always been positive. For example, glucosamine and chondroitin may have suffered somewhat of a setback following the Glucosamine/Chondroitin Arthritis Intervention Trial (GAIT). Results were published in the New England Journal of Medicine (NEJM) in February 2006.

The six-month study funded by the National Institutes of Health (NIH) involved nearly 1600 OA patients who were given a placebo or daily doses of 1500 mg of glucosamine hydrochloride and/or 1200 mg of chondroitin sulfate or 200 mg of the common NSAID celecoxib (Celebrex).

Overall, those taking celecoxib experienced statistically significant pain relief versus placebo—about 70% of those taking celecoxib had a 20% or greater reduction in pain versus about 60% for placebo. There were no significant differences between the other treatments tested and placebo, according to researchers.

However, for a subset of participants with moderate to severe pain, glucosamine combined with chondroitin sulfate provided statistically significant pain relief compared with placebo—about 79% had a 20% or greater reduction in pain versus about 54% for placebo. These findings prompted an ancillary GAIT study that later investigated whether these dietary supplements could diminish structural damage from OA of the knee.

In the ancillary study, interested GAIT patients were offered the opportunity to continue their original study treatment for an additional 18 months, for a total of 2 years. At the end of the study, the team had gathered data on 581 knees. After assessing X-ray data, researchers concluded glucosamine and chondroitin sulfate, together or alone, appeared to fare no better than placebo in slowing the loss of cartilage in OA of the knee. Interpreting the study results was complicated, however, because participants taking placebo had a smaller loss of cartilage, or joint space width, than predicted. Results were published in Arthritis & Rheumatism in October 2008.

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