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NOW what do I take for my arthritic knee?

3K views 27 replies 18 participants last post by  bad andy 
#1 ·
First off, Happy New Year to all! Long time, no post. Haven't been around these parts in ages. How's everybody? Celly, *rt*, Snookums, T.O.M. (still racing them trick mtbs and playing music, Bud?), Bob D., hedgehog, BT, CT in CT, Prisoner(?!), Fly Southwest, et al.???

Of course I learned of *some* risk of taking Ibuprofen over the long run, but after reading the below article, I feel I should now stop altogether. Can't take Aspirin anymore, and Tylenol provides very little arthritis relief for my post-op knee.

What to do next? Glucosamine?

Here's the article. I hope you're all getting in some great rides. Jeez, I just went skiing after 23 years of staying off the slopes. It was great to realize that even post-op, I could do some leisurely skiing and not rack my knee. Gotta find some good bindings now to mount on my retro skis. Anybody know some good ski boots for wider feet (like EE)?

Happy trails!

Schwinng (a.k.a., Herb)

------------------------------ ARTICLE --------------------------

Painkillers Damage Intestine, U.S. Expert Says

Mon Jan 3, 6:26 PM ET

By Maggie Fox, Health and Science Correspondent

WASHINGTON (Reuters) - More than 70 percent of patients who took painkillers such as ibuprofen for more than three months suffered damage to their small intestines, U.S. researchers reported on Monday.

The study is yet another blow to patients trying to find ways to treat arthritis pain, after reports that the most advanced drugs, called COX-2 inhibitors, can raise the risk of heart death.

Dr. David Y. Graham of the Baylor College of Medicine in Houston and colleagues studied 21 patients taking a range of drugs called non-steroidal anti-inflammatory drugs, or NSAIDS. They compared them to 20 patients taking either acetaminophen, an unrelated painkiller, or nothing.

"Small-bowel injury was seen in 71 percent of NSAID users compared with 10 percent of controls," they wrote in Monday's issue of the journal Clinical Gastroenterology and Hepatology.

"We have always known that NSAIDs can cause potentially deadly stomach complications, but the extent of the impact on the small intestine was largely unknown until now," Graham added.

Arthritis pain is incurable but can be treated with a range of drugs, including NSAIDS such as aspirin, ibuprofen or naproxen; acetaminophen; or the newer drugs called COX-2 inhibitors.

NSAIDS work very well but damage the stomach and intestine. They are blamed for 16,500 deaths a year in the United States alone, Graham said.

BENEFIT VS. RISK

"Anybody who takes aspirin or (other) NSAIDS for a year has a 1 to 4 percent risk of serious gastrointestinal complications," Graham said in a telephone interview.

"If the drugs didn't have such benefits, we'd have taken them off the market some time ago."

Acetaminophen, sold generically and also under the brand name Tylenol, does not work for many patients, Graham said.

The COX-2s were designed specifically to overcome the deadly side-effects of NSAIDS. But a series of studies has linked them to heart disease and one, Merck and Co. Inc.'s Vioxx, was pulled from the market in September.

In December the U.S. Food and Drug Administration (news - web sites) issued an advisory telling doctors to limit their prescribing of other COX-2s, including Pfizer's Celebrex and Bextra.

And a study published in December indicated that an over-the-counter NSAID called naproxen might also raise the risk of heart attack and stroke.

Graham's team used an endoscope in the form of a swallowed camera in a capsule to examine the intestines of their volunteers. Although people taking NSAIDs frequently suffer stomach pain or anemia, none of the volunteers in this study had any symptoms.

"We saw some ulcers and we saw lots of erosions," Graham said.

Some experts have recommended using antacid drugs called proton pump inhibitors (PPI (news - web sites)) to reduce the damaging effects of stomach acid in NSAID patients. But PPIs do not affect the small intestine, Graham said.

Instead, he said, an older drug called misoprostol can help protect the stomach lining.

"It is the only drug approved to reduce the rate of bleeding," Graham said.

A U.S. government study published last month found that acupuncture can help to further relieve arthritis pain in the knee in patients getting more standard treatment.

The American Gastroenterological Association estimates that more than 30 million Americans take over-the-counter or prescription drugs for headaches and arthritis.

-------------------------- END --------------------------------
 
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#2 ·
Tylenol Arthritis

I've been taking Ibuprofen for nearly 20 years and have also recently become concerned about it. I recently switched to Tylenol Arthritis and it works pretty well. About 18 months ago I began taking some liquid Glucosamine I saw advertised on this site. Don't know if it helps but I'm desperate. I also have several ice packs in the freezer and I ice my knees several times a day.
 
#3 ·
Just do the Celebrex!

http://forums.mtbr.com/showthread.php?t=67169&highlight=celebrex

I took a lot of ibuprophen in the past and never had problems with it. Maybe I didn't take it long enough...but I always worried about my liver more than anything...drinking beer and doing ibuprophen! I had a CT last June and was all good.

Celebrex is sweet...no side affects at all and works like a miracle drug. Sure you might have a heart attack, but you will pass in a blissful state!;)
 
#4 ·
I heard that it does matter if you take Glucosamine in tab vs. liquid form -- I guess the liquid is supposed to be better? After 18 months, haven't you noticed any sort of noticeable benefit from taking liquid Glucosamine??? If you've been taking it as directed, and haven't noticed ANY benefit at all, gosh it doesn't seem like the stuff works at all, eh?

I bought some Glucosamine with Chondrotin tabs from Trader Joe's, but haven't been taking it regularly. But, I'm going to start taking it as directed for the next 3 months and see if I detect any noticeable benefit. Like you, I've gotta find something that helps with the arthritic knee.

Schwinng
 
#6 · (Edited)
give it the heat miser treatment....

After I go skiing or alot of jamming on the cranks my left knee gets sore. Icing it down, then get in the hot tub and/or use some of the strong lotions that have capsaicin in it and apply sparingly because even after a day the stuff heats up when hit with water. I guess it gets the blood flowing to the knees which don't usually get that much blood.Just don't fall asleep with the ice bag on your knee.You'll wake up to some seriouus pain before it thaws out.Just like a giant toothache in your knee. Oh yeah, and many Sam Adams help to....

evs
 
#7 ·
Definitely give the Gloucosamine a try. At 46, I developed arthritis in my left elbow. It got to the point where I could not even lift a 5 lb weight without encountering excruitiating pain. I started taking Gloucosamine, Chontrtin with MSM from GNC. After 3 months, my elbow was back to normal. I quit taking the suppliments, thinking I was "healed" and within 6 months, I was back where I started from. Resumed taking it but this time it took about 6 months for me to get back to normal. I am now a devoted Gloucosamine, Chontrotin, MSM junkie. I tried the liquid form at one time but did noy have any luck with it. I believe you need to take this everyday, religiously, in order to see results.
 
#8 ·
Glucosamine, Ice, Stretch, Strength

I've had my left knee scoped 4 times plus an acl, then blew my "good knee" acl after that. I've spent a considerable amount of my life re-habbing knee injuries. And, now at 42, I know I've got arthritic stuff going on.

I've found that getting your muscles balanced - quads to hams and quads left to right (developing that little triangular shaped muscle next to your kneecap) makes a big difference. It took me a long time to get my kneecap to float and track correctly. Stretching also helps - I hate doing it, but find that stretching my quads and hams helps my knees.

That said, I've been taking glucosamine for several years and it does help a lot. It take it like clockwork at dinner each day. When things are really bad, ice can't be beat. And, taking advil occasionally is my last resort.

Good luck, I feel your pain.
 
#9 ·
This is a question a lot of people are asking right now.
For simple musculo-skeletal pain NSAIDS are still the ticket (ibuprofen, naprosyn etc...) So long as you are not using them for more than a few weeks and stay within the recommended dose they are still great.
Provided you do not have risk factors for strokes or coronary artery disease you should be able to get away with taking a Cox-2 (Celebrex, Bextra, Vioxx) inhibitor.
The other options, notibly aspirin and acetaminophen can help with the pain but neither does much for inflammation. Aspirin that old wonder drug had a lot of benefits, but also a lot of risks. With all the trauma going on in mtn biking I would be worried about bleeding risk. Tylenol I'm sure is salivating over their potential new market share.
Essentially though you'll be taking aspirin and tylenol for pain and not treating the inflammation. For that matter narcotics while potentially addictive are great for pain and very safe. Cold packs work very well for reducing swelling, and are probably the best thing to use overall.
If you have a chronic condition requiring regular doses of medications to handle joint disease you are indeed in a bind. For flare-ups you can use whatever. If you have no or mild risk factors the benefits of the Cox-1s or Cox-2s probably outweigh the risks.
If you do have risk factors then you need to have a serious discussion with a medical professional who you really trust. You may elect to take the risk if the pain is that debilitating.
So now the thing that medicine has been snickering at and long regarded as an illigitimate cousin comes to the forefront. Homeopathic medicine and things like Chondroitin and Glucosamine seem to make more sense. Although the data is limited there have been some efforts at looking at their long term benefits and risks. Most of the stuff I've seen is not that impressive. But for some people they swear by the stuff.
Exercise is also a staple at managing joint disease, so keeping active is an ironic twist to artritis. Here ergonomics plays a huge role, so make sure your bike fits right and you are pedaling correctly. Using lower gears and higher cadence is prob a good idea too.
Crashtoomuch really knows what he's talking about. Stay active, try out alternative medications to see if they work for you, ice after every ride, stretch and when things get out of hand then reach for the meds.
While you're at it check your cholesterol, watch your blood pressure, for gods sake quit smoking and get out and throw some dirt.
 
#10 ·
I take celebrex, vioxx, ibuprofen, aleve, mobic, and bextra as needed. (Not at the same time mind you.) I am not afraid of any of them. I have no history of ulcers, and no risk of heart disease that I know of. It's worth the small risk in my book. You know, the same risk you take when riding in a car, or heavens be, mountain biking (That thar sport is DANGEROUS and makes me have to keep taking NSAIDS!) ;)

All NSAIDS can cause GI problems including the COX-2 inhibitors. I've seen people with bleeding ulcers from celebrex, vioxx, etc as well as aspirin. Or heck, from alcohol. It's a risk you take, none of this is new news to those working in the health field. All medicines have potential side effects. The media takes a headline and runs with it yet one more time.

The withdrawal of vioxx from the marketplace was completely litigation driven. It's a pity as many people who were benefitting from it no longer have access, even if they have no risk factors for heart disease. Instead of letting people decide if the medicine was worth the risk, or have doctors help people make that decision, they just pulled it. *poof*

I only have it because of samples.

The only anti-inflammatory I don't take is aspirin, as it makes my stomach hurt consistantly, and I seem to bruise plenty badly without it.

Anyway, that's my 2 cents, from a quack and a regular NSAID user.

edit: as far as glucosamine, it seems to help some people, and doesn't help others. Only glucosamine has had any benefit proven, chondroitin, MSM, whatever else its bound with have not been proven. Take it 2-3 times a day consistantly for 2-3 months to see if you get a benefit or not.

If I was better at taking vitamins/pills I'd take it daily as a preventative for arthritis. But I am a crappy patient and I can't remeber my calcium half the time.
 
#12 ·
Thanks, all!

Some great, informative replies. Thanks, y'all.

Okay, despite limited empirical proof, I'm going on Glucosamine and since I already have 2 bottles .... I also looked at the ingredients, and they also look harmless.

Yes, remaining active, although seemingly counter-intuitive, helps with joints and joint pain. I've always found that my arthritis is worse when I DON'T remain active.

Stretching ... yep, I too hate spending time doing something that seems/feels so innane, but this, too, has not only helped with my arthritic knee pain, but also lower back and sciatica (sp?).

Yeah, yeah, so long as we don't take stuff with Ibu in it for a sustained period of time, we should be okay. But, still, over time ....

Weird, too, although the emprical proof is not conclusive, Ibuprofen's anti-inflamatory benefit supposedly reduces people's risk of getting Alzheimer's disease. Like a lot of things in life, there are pros and cons to Ibu. It's just I choose not to take anything, if I don't need to. And, when I do, I'd like it to be something without any side-effects or long-term risks. "Is That So Wrong??????" :)

Happy trails, all. Thanks again for your input. This board has some very bright, articulate folks on it. I sincerely appreciate this aspect of this board.

*rt* ... you're plenty smarts, kiddo. Keep on finding solutions to Americans' health risks and diseases at CDC.

Schwinng
 
#14 · (Edited)
Wherewolf said:
I've had five Synvisc treatments for each knee, totaling 30 injections, and they definitely help. I probably would not be riding at all without them.
Here's a good review of use of synvisc. (Canadians rock in among other things providing unbiased reviews in healthcare.) And another out of JAMA showing not so much of a benefit. The safety profile seems to be pretty good, but variable between manufacturers.

Canadian Family Physician. 50:249-56, 2004 Feb.

Abstract
OBJECTIVE: To determine whether viscosupplementation with intra-articular hyaluronic acid (HA) injections improves pain and function in patients with osteoarthritis (OA) in their knees. DATA SOURCES: We searched MEDLINE, Pre-MEDLINE, and Cochrane databases using the MeSH headings and key words osteoarthritis (knee) and hyaluronic acid. STUDY SELECTION: English-language case series and randomized controlled trials (RCTs) were selected. Studies with biologic, histologic, or arthroscopic outcomes were excluded. SYNTHESIS: Five case series and 13 RCTs were critically appraised. Data from three case series and three RCTs using injections of high-molecular-weight HA (Synvisc) demonstrated significant improvement in pain, activity levels, and function. The beneficial effect started as early as 12 weeks. Studies using low-molecular-weight HA had conflicting results. CONCLUSION: Viscosupplementation with high-molecular-weight HA is an effective treatment for patients with knee OA who have ongoing pain or are unable to tolerate conservative treatment or joint replacement. Viscosupplementation appears to have a slower onset of action than intra-articular steroids, but the effect seems to last longer. [References: 32]

Then we have JAMA

JAMA. 290(23):3115-21, 2003 Dec 17.

Abstract
CONTEXT: Intra-articular hyaluronic acid is a US Food and Drug Administration-approved treatment for knee osteoarthritis (OA); however, its efficacy is controversial. OBJECTIVE: To evaluate whether intra-articular hyaluronic acid is efficacious in treating knee OA. DATA SOURCES: We searched for human clinical trials in MEDLINE (1966 through February 2003) and the Cochrane Controlled Trials Register, using the search terms (osteoarthritis, osteoarthrosis, or degenerative arthritis) and (hyaluronic acid, Hyalgan, Synvisc, Artzal, Suplasyn, BioHy, or Orthovisc). We also hand searched manuscript bibliographies that met inclusion criteria, selected rheumatic disease journals, and abstracts from scientific meetings. STUDY SELECTION: Included were published or unpublished, English and non-English, single- or double-blinded, randomized controlled trials comparing intra-articular hyaluronic acid with intra-articular placebo injection for the treatment of knee OA. Trials also were required to have extractable data on pain reported by 1 of the outcome measures recommended by the Osteoarthritis Research Society. DATA EXTRACTION: Two reviewers independently performed data extraction using standardized data forms. For each trial, we calculated an effect size (small-effect sizes, 0.2-0.5; large-effect sizes, 1.0-1.8, equivalent to a total knee replacement). We used a random-effects model to pool study results, the Cochrane Q test to evaluate heterogeneity, and a funnel plot and the Egger test to evaluate publication bias. DATA SYNTHESIS: The overall dropout rate in the 22 selected trials was 12.4%. The pooled effect size for hyaluronic acid was 0.32 (95% confidence interval [CI], 0.17-0.47). There was significant heterogeneity among studies (P<.001). Two outlier trials, both evaluating the highest-molecular-weight hyaluronic acid, had effect sizes in excess of 1.5. However, the third trial of the same compound showed a nearly null effect. When the 3 trials of this compound were removed, heterogeneity was no longer significant (P =.58), and the pooled effect size for intra-articular hyaluronic acid decreased to 0.19 (95% CI, 0.10-0.27). There was evidence of publication bias with an asymmetric funnel plot, a positive Egger test, and identification of 2 unpublished trials whose pooled effect size was 0.07 (95% CI, - 0.15 to 0.28). CONCLUSION: Intra-articular hyaluronic acid has a small effect when compared with an intra-articular placebo. The presence of publication bias suggests even this effect may be overestimated. Compared with lower-molecular-weight hyaluronic acid, the highest-molecular-weight hyaluronic acid may be more efficacious in treating knee OA, but heterogeneity of these studies limits definitive conclusions.
 
#15 · (Edited)
Good advice here!

crashtoomuch said:
I've found that getting your muscles balanced - quads to hams and quads left to right (developing that little triangular shaped muscle next to your kneecap) makes a big difference. It took me a long time to get my kneecap to float and track correctly.
Yep, if we are talking about patella-femoral pain syndrome, doing as crashtoomuch says has helped me. For me, to build and balance muscles surrounding the knee caps (patellas), singlespeeding was the trick. My knees hurt BEFORE I started singlespeeding, have not hurt since!

crashtoomuch said:
Stretching also helps - I hate doing it, but find that stretching my quads and hams helps my knees.
The older you get, the more you have to stretch like a madman! I just do hamstrings and lower back, it is all I need right now.
 
#18 ·
Adequan?

Lots of good, sensible advice has already been offered, so I thought I'd submit a less conventional, more irresponsible suggestion. Adequan - polysulfated glucosaminoglycan (PSGAG) - has been used for years in veterinary medicine, and I believe is approved for human use in Europe under the brand name Arteparon. The injection is bound to hurt for a couple days, but it was very effective on my old dog before he finally passed away. I'll definitely consider taking it if my arthritis ever gets too debilitating and I find that glucosamine, chondroitin and MSM are having no effect.
- Joe
 
#20 ·
COMMITTED said:
Definitely give the Gloucosamine a try. At 46, I developed arthritis in my left elbow. It got to the point where I could not even lift a 5 lb weight without encountering excruitiating pain. I started taking Gloucosamine, Chontrtin with MSM from GNC. After 3 months, my elbow was back to normal. I quit taking the suppliments, thinking I was "healed" and within 6 months, I was back where I started from. Resumed taking it but this time it took about 6 months for me to get back to normal. I am now a devoted Gloucosamine, Chontrotin, MSM junkie. I tried the liquid form at one time but did noy have any luck with it. I believe you need to take this everyday, religiously, in order to see results.
I have thought about giving the Gloucosamine a try, but I have not heard of the Chontrtin with MSM; is there an added benefit for taking this too or can you just take the Gloucosamine?

JG
 
#21 ·
Acupuncture and Herbs

I would like to recomend Acupuncture and Chinese Herbs...
I have a strong belief in Traditional Chinese Medicine, first as a patient, secondly as a practitioner...
My prior profession as a Paramedic with the F.D.N.Y. for eleven years damaged my body and the Doctors treating me poisoned my body...
I finally acheived results treating pain and the subsequent depression by seeing an Acupuncturist. I was so impressed with the results that I resigned from my job and attended four years of grad. school to become licensed...
As for as the best choice for inflamation, you can use an herbal Cox-2 inhibitor that will provide you with multiple benefits (improved digestion, anti-oxidants, immunity enhancement...)
The brand I recommend is Zyflamend from New Source. It is formulated with Ginger,Turmeric, rosemary, green tea...it is a clinically proven Cox-2 anti-inflamatory that enhances the bodies production of helpful Cox-1 enzyme...
I would encourage that you research this, I trust nature more than Pharmacutical companies.
Good Luck !
 
#22 ·
Natural Cox-2's? Not a good idea.

There is a tendency to think of naturopathic medicine as inherently safer because it is closest to natural products. Maybe it is, maybe it's not.
Little is known about their efficacy, and less of their safety. Anecdotal information just doesn't cut it, you need to see how these drugs effect a large amount of people, taking the drugs for a prolonged period in statistically controlled environments. Most of the reason that this is not done with alternative medicine is financial, without anyone willing to foot the bill for a large study (which can cost millions to billions) they don't get done. Also there is no standardization. The relative concentration of pharmacologically active substances can differ logarithmically between batches of naturally extracted botanicals.
The most promising of these substances do sometimes make it to FDA testing and the NIH will fund some of it (as was the case with glucosamine). The results for the most part have not been that impressive, but sometimes they look promising. For instance accupunture does seem to work very well for some patients suffering from arthritis. Even if it is a placebo effect...what the hell so long as it's not hurting you.
But sometimes it can hurt you. Ephedrine was such an instance. Remarkably even when faced with incontrovertible evidence of its danger, homeopathic retailers and manufacturers fought the FDA ban with lawyers as bloodthirsty as the best at Eli Lilly.
Zyflamend stinks of this zealousness.
The problem is not that Vioxx doesn't grow on a tree. Likewise it's not because it is produced by Merck. The problem most likely is that the infammatory cascade that Cox-2s inhibit, is having an arthrosclerotic effect. ie. it's making people have more heart attacks and strokes. It's a biochemical problem with the enzyme you are inhibiting. So a naturally derived Cox-2 inhibitor in all likelyhood does the same thing, and has the same risks. Hence all Cox-2 inhibitors have been underfire, and Zyflamend should be considered just as risky. The Cox-1s (ibuprofen etc..) are suspect too since they also have a lot of Cox-2 inhibitory effect. Agreed a lot may be overzealousness by the press, but it is concerning none the less.
Zyflamend may be a case of homeopathics jumping on a market opening. And doing so with a remarkable amount of hubris and disregard for safety.
It is not about what you believe in. Anything that you take or do, whether from homeopathic medicine or traditional medicine should be considered with the same amount of criticism. Naturopathic medicine is not inherently safe.
 
#23 ·
dr.dirt said:
There is a tendency to think of naturopathic medicine as inherently safer because it is closest to natural products. Maybe it is, maybe it's not.
...
It is not about what you believe in. Anything that you take or do, whether from homeopathic medicine or traditional medicine should be considered with the same amount of criticism. Naturopathic medicine is not inherently safe.
Well put.

On the bright side, this thread has got me taking my glucosamine and vitamins again. :D
 
#25 ·
I grew up in a Chiropractic family and have seen one thing work over and over every time for people who suffer with arthritis. My step-dad would put people on Knox Gelatin, which you can get in the grocery store, it'll be shelved with the Jello and pudding. It is basically an unflavored gelatin for cooking but it contains amino acids that help the body to produce collagen. Since arthritis cannot be cured It is important to remember that Knox is supplimental just like Gloucosamine, Chontrotin, and MSM so it must be taken religiosly EVERYDAY. Most people will take Knox for 2-3 months before they get any results......because of this people stop taking it before it has had time to build up in their system. It is important to give it time.

In the late 90's the medical world did some studies on Knox and accepted the idea that Knox is a functional suppliment for joint therapy. Since then Knox has come out with a "Nutra Joint" formula which is Knox + Gloucosamine, Chontrotin, and MSM in one mixture.

http://www.drugstore.com/products/prod.asp?pid=78764

This is what I would suggest taking. Now I'm not a chiropractor or a doctor and I don't have athritis but I have seen simple Knox do wonders and the Nutra Joint Knox has all the other goodies in it.
 
#26 ·
Dr. Dirt speaks the truth...good advice...one more point...

One of the largest concepts people fail to realize is that "arthritis" (or shall we say degenerative joint disease - DJD) is unfortunately an expected part of aging. A large percentage of the population will have evidence of joint degeneration by their 30's. Staying lean and active is about the best you can do but there is no cure. Medicine has come a long way with the treatment of many maladies, but we're still in the "Dark Ages" when it comes to DJD.

Mike

dr.dirt said:
This is a question a lot of people are asking right now.
For simple musculo-skeletal pain NSAIDS are still the ticket (ibuprofen, naprosyn etc...) So long as you are not using them for more than a few weeks and stay within the recommended dose they are still great.
Provided you do not have risk factors for strokes or coronary artery disease you should be able to get away with taking a Cox-2 (Celebrex, Bextra, Vioxx) inhibitor.
The other options, notibly aspirin and acetaminophen can help with the pain but neither does much for inflammation. Aspirin that old wonder drug had a lot of benefits, but also a lot of risks. With all the trauma going on in mtn biking I would be worried about bleeding risk. Tylenol I'm sure is salivating over their potential new market share.
Essentially though you'll be taking aspirin and tylenol for pain and not treating the inflammation. For that matter narcotics while potentially addictive are great for pain and very safe. Cold packs work very well for reducing swelling, and are probably the best thing to use overall.
If you have a chronic condition requiring regular doses of medications to handle joint disease you are indeed in a bind. For flare-ups you can use whatever. If you have no or mild risk factors the benefits of the Cox-1s or Cox-2s probably outweigh the risks.
If you do have risk factors then you need to have a serious discussion with a medical professional who you really trust. You may elect to take the risk if the pain is that debilitating.
So now the thing that medicine has been snickering at and long regarded as an illigitimate cousin comes to the forefront. Homeopathic medicine and things like Chondroitin and Glucosamine seem to make more sense. Although the data is limited there have been some efforts at looking at their long term benefits and risks. Most of the stuff I've seen is not that impressive. But for some people they swear by the stuff.
Exercise is also a staple at managing joint disease, so keeping active is an ironic twist to artritis. Here ergonomics plays a huge role, so make sure your bike fits right and you are pedaling correctly. Using lower gears and higher cadence is prob a good idea too.
Crashtoomuch really knows what he's talking about. Stay active, try out alternative medications to see if they work for you, ice after every ride, stretch and when things get out of hand then reach for the meds.
While you're at it check your cholesterol, watch your blood pressure, for gods sake quit smoking and get out and throw some dirt.
 
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