Q What can I do about osteoarthritis of the knee? For several months, I've been taking a glucosamine supplement, but I still get painful flare-ups. Do these supplements really work? What else can I do to ease the pain?

A Osteoarthritis (OA) or joint inflammation is a degenerative disease resulting from the gradual breakdown of joint cartilage (soft bone).

Glucosamine has been proposed to have beneficial properties in OA, as it is incorporated into the cartilage by the body during the natural joint-building process.

Currently, there is no concrete evidence that glucosamine supplementation has benefits for OA: variable results have occurred in scientific trials. Positive results were mainly from two European trials, in which participants experienced reduced pain and improved physical function of the affected joints. Further deterioration of the joints was prevented for the duration of the trials.

Studies have also shown that the combination of glucosamine and chondroitin may be more effective in moderate to severe knee pain than either component alone.

The formulation of glucosamine also appears to affect its efficacy, with glucosamine sulphate showing more positive results than glucosamine hydrochloride.

At recommended dosages, the common side effects reported have been abdominal pain and stomach discomfort, though there have been reports that glucosamine may affect blood glucose control in diabetics whose blood glucose levels are poorly controlled.

To manage the condition, one should not over-strain the joints. Non-strenuous exercises that are of low impact can be carried out in moderation as part of maintaining a healthy lifestyle. Some examples of low-impact sports are swimming and walking. In overweight sufferers, losing weight to an ideal level can also reduce strain - and, hence, pain - on the joints, particularly the weight-bearing joints.

During flare-ups, the application of a heat pad or pain-relieving ointments to the joints can give relief. Painkillers like paracetamol and non-steroidal anti-inflammatory drugs can be taken when necessary. It is best to consult your doctor or pharmacist for advice on the consumption of medications for pain.

If you experience pain that persists for longer than two weeks, do seek medical attention, especially if the joints become swollen, red or tender.

More information and advice can be obtained from your pharmacist. Send your questions to sthealth@sph.com.sg

TAN JIANMING, PHARMACIST, PHARMACEUTICAL SOCIETY OF SINGAPORE