Potential Role of Nutraceuticals in the Management of Knee and Hip Joint Osteoarthritis

Abstract

Nutraceuticals is a broad umbrella term that is used to describe any product derived from food sources with extra health benefits in addition to the basic nutritional value of that food. Over the years nutraceuticals have attracted considerable interest due to their potential nutritional, safe and therapeutic effects in a variety of chronic and life style related diseases like coronary blockage, diabetes and osteoarthritis. Osteoarthritis, better considered as a wear and tear of joint is a result of gradual deterioration of underlying cartilage tissue. The disease results in joint pain, stiffness and its long term effect leads to functional impairment. The current treatment modalities of OA include physical, pharmacological and surgical interventions. Use of nonsteroidal anti-inflammatory drugs (NSAIDs), analgesics, corticosteroids and hyaluronic injections have proved significantly effective in pain relief and symptomatic management of this disease however their prolonged use have proven side effects on kidney, heart and liver functioning. The surgical methods like total joint arthroscopy, joint debridement, joint irrigation etc. are employed in severe disease state however recovery and post surgical complications are inevitable. In this view focus is being shifted on the use of alternative therapies and nutritional supplements as pain relieving and cartilage protective agents. In the past 3-4 decades significant research has been conducted on the clinical and in vitro testings of nutraceuticals like Glucosamine, Chondroitin sulfate, Hyaluronic acid and others on osteoarthritic subjects and tissues. A large number of dietary supplements are used for a long time for pain relief like cod liver oil for arthritic patients and nowadays as many as one third of suffering populations is using them to improve their clinical condition. The common food sources of these compounds are spinach like leafy vegetables, shark shell, skinned meat etc. Some of the studies have suggested that the efficacy of these nutritional compounds in joint pain relief is equal to non steroidal antiinflammmatory drugs however their onset action is slow. One of the most important limitations associated with their use in treatment of joint related disease is that their clinical efficacy and trials are still lacking. Since nutraceuticals are marketed in a variety of forms like food supplements, injections and powders which have made their effect nonspecific and uncontrollable. In this paper we have covered the results of studies on three well established nutraceuticals (Glucsamine, Chondroitin and Hyaluronic acid) as joint protectors especially in two large weight bearing joints of the body i.e. knee and hip. The results of the studies have indicated that nutraceuticals could represent good alternative means of management of OA however further controlled clinical studies are required for differentiating the effect of purified compound and dose with that of whole food source.