Arthritis Treatment without Side Effects: Topical Options Complement Glucosamine and Chondroitin

Arthritis Treatment without Side Effects: Topical Options Complement Glucosamine and Chondroitin

i-bottleEach patient has a defining demeanor as they enter an orthopedic clinic. Some hobble in slowly, others use crutches like they recently competed in an Olympic event. Patients with arthritis are different from the rest, however. They can’t shake an unmistakable aura of weariness caused by years of living with unrelenting pain.

Orthopedic surgery is a treatment of last resort for arthritis. Long before they visit doctors, these patients repeatedly visit their local pharmacy, to fill a prescription or search for new OTC pain relief products. As a compounding pharmacist, you are positioned to catch them in an earlier stage of the disease and recommend topical pain relief, glucosamine and chondroitin sulfate for arthritis treatment without side effects.

Leading Cause of Disability

Mention disabling diseases and the first conditions that come to mind are usually heart disease, diabetes, back disorders and lung disease. In reality, arthritis is the leading cause of disability in the United States, with prevalence rates reaching 22 percent of all adults.1

Most people in this diverse group are advised to watch their diet, lose weight if necessary and follow an appropriate exercise regimen. But let’s face it—they can’t devote attention to lifestyle efforts unless they can keep pain under control. Compounding pharmacists can offer these patients a better chance to live life beyond the limitations of arthritis by working with them to coordinate different treatments and develop customized pharmaceuticals.

Management of Pain and Inflammation

Physicians often recommend OTC pain relief products as a first line of treatment for arthritis, but many patients make that choice on their own before they decide it’s time to consult a doctor. Be on the lookout for these patients; even if they know about the gastrointestinal, cardiovascular, renal and hepatic risks associated with NSAIDs and acetaminophen, finding pain relief is often a more urgent concern. As a result, they may take large doses or remain on NSAIDs longer than is recommended.

Patients in the early stages of arthritis and who haven’t talked to a health care provider would benefit greatly from the advice of a compounding pharmacist, perhaps more than they realize. Most aren’t even aware that topical NSAIDs are an option that prevents systemic side effects and provides pain relief equal to oral meds for some types of arthritis, such as osteoarthritis of the knee and hand. They’re also highly recommended for older adults and people with kidney disease.

Topical NSAIDs: A variety of NSAIDs can be compounded for topical pain relief. Piroxicam and indomethacin are effective for musculoskeletal pain, but ibuprofen, ketoprofen and diclofenac provide the best results.2 Diclofenac sodium is specifically approved for topical treatment of arthritis pain, with clinical trials showing it’s just as effective as oral diclofenac.3

Complementary Capsaicin: Using a complementary product may be a personal preference or a medical necessity in some patients, including those with kidney disease. Menthol and camphor offer some temporary pain distraction, but topical capsaicin is recommended, as its ability to block pain signals is effective for relieving arthritis pain. Whether patients approach the counter with an OTC capsaicin cream or consult about compounded options, you can help ensure their compliance by discussing with them proper use and the sensations caused by capsaicin.

Glucosamine and Chondroitin Sulfate to Relieve Pain and Protect Cartilage

Glucosamine and chondroitin sulfate hold second place on the National Health Interview Survey’s list of most-used natural products. While both are widely marketed as oral supplements, some people may not be aware that they can be formulated as topical treatments as well. Or perhaps they have seen OTC glucosamine cream and doubted its effectiveness, which gives compounding pharmacists an opportunity for outreach.

Glucosamine stimulates proteoglycan synthesis. Chondroitin sulfate is the most abundant glycosaminoglycan used to build proteoglycans and proteoglycans ensure that cartilage fulfills its job as a shock absorber. Healthy cartilage simply can’t be maintained without glucosamine and chondroitin sulfate, which is why so many people turn to them to ease joint pain, whether it’s caused by overuse, injury or arthritis.

Symptom Relief: Chondroitin sulfate provides small to moderate relief of arthritis pain, although patients with osteoarthritis of the knee reported a 20 percent improvement in symptoms.4 Glucosamine offers at least the same benefit and is generally considered better at relieving pain than chondroitin sulfate alone.

Impact on Cartilage Degeneration: When it comes to preventing or slowing down cartilage degeneration, the evidence remains mixed. The second phase of the Glucosamine Chondroitin Arthritis Intervention Trial found that participants who took either glucosamine alone or chondroitin alone had less degeneration than participants taking both.5 More recent studies reported that both have a small but significant ability to curb the progression of osteoarthritis of the knee.

Providing Effective Relief Through Topical Pain Meds

One of the most important tasks for compounding pharmacists is counseling patients so that they know the facts and may have realistic expectations regarding particular treatments. This is especially true for glucosamine and chondroitin sulfate. They’re safe options that can be used for an extended period of time and may help patients cut down on oral NSAIDs. But patients also need to know that their pain relief will be moderate and these slow-acting ingredients take a while to produce results. The bottom line is that a combination of treatments, including topical NSAIDs, glucosamine, chondroitin and capsaicin, often achieve optimal results for patients with arthritis. Such customized treatments are only found from reliable compounding pharmacies.

Pharmaceutica North America offers a variety of products targeted to relieve symptoms of arthritis, including diclofenac sodium, glucosamine and chondroitin, and Medrox, which contains methyl salicylate, capsaicin and menthol. Please contact us today to learn about our quality ingredients.

Show 5 footnotes

  1. “About Arthritis Disabilities and Limitations, November 2014, http://www.cdc.gov/arthritis/data_statistics/disabilities-limitations.htm
  2. “Topical NSAIDs for Acute Musculoskeletal Pain in Adults,” June 2015, http://www.ncbi.nlm.nih.gov/pubmed/26068955
  3. “Topical Nonsteroidal Anti-Inflammatory Drugs for Osteoarthritis,” November 2010, http://www.ncbi.nlm.nih.gov/pubmed/21084786
  4. “Chondroitin for Osteoarthritis,” November 2013, http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0072091/
  5. “Chondroitin Sulfate and Glucosamine Supplements in Osteoarthritis,” 2008,
    http://www.arthritis.org/living-with-arthritis/treatments/natural/supplements-herbs/glucosamine-chondroitin-osteoarthritis.php
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