Over the counter options
Here you can find an overview of evidence supporting some of the most
popular options for joint pain that can be bought over the counter.
GOPO® is a natural compound derived from the seeds and husks of rosehips.
Experts believe the active GOPO® compound represents a promising option for OA with significant anti-inflammatory and clinical benefits, including improvements in joint pain, suppleness and mobility. GOPO® is the only rosehip derived compound to have been rigorously evaluated in randomised, controlled clinical trials.
The studies – although relatively small – are well conducted and GOPO® appears to be effective and well tolerated. Joint pain experts have suggested GOPO® could be beneficial for OA sufferers.
Warholm O, Skaar S, Hedman E, et al. The Effects of a Standardized Herbal Remedy Made from a Subtype of Rosacanina in Patients with Osteoarthritis: A Double-Blind, Randomized, Placebo-Controlled Clinical Trial. Curr Ther Res Clin Exp 2003;64(1):21–31.
Rein E, Kharazmi A, Winther K. A herbal remedy, Hyben Vital (stand. powder of a subspecies of Rosa canina fruits), reduces pain and improves general wellbeing in patients with osteoarthritis--a double-blind, placebo-controlled, randomised trial. Phytomedicine 2004;11(5):383–91.
Winther K, Apel K, Thamsborg G. A powder made from seeds and shells of a rose-hip subspecies (Rosa canina) reduces symptoms of knee and hip osteoarthritis: a randomized, double-blind, placebo-controlled clinical trial. Scand J Rheumatol 2005;34(4):302–8.
Paracetamol is a popular over the counter medication but in the last few years concerns have been raised over its safety when taken long term.
A number of studies have been completed to establish how beneficial taking paracetamol is to those with OA, and its associated side effects.
These studies have concluded that paracetamol provides minimal, if any, long-term pain relief in OA and there appears to be good evidence of potential harm under certain circumstances. Recently joint pain experts have advised that until more is known about the potential risks, paracetamol should be used with caution in the long-term management of OA.
Machado GC, Mahler CM, Ferreira PH, et al. Efficacy and safety of paracetamol for spinal pain and osteoarthritis: systematic review and meta-analysis of randomised placebo controlled trials. BMJ 2015; BMJ 2015 Mar 31;350:h1225. doi: 10.1136/bmj.h1225.
Roberts E, Delgado Nunes V, Buckner S, et al. Paracetamol: not as safe as we thought? A systematic literature review of observational studies. Ann Rheum Dis 2015 Mar 2. pii: annrheumdis-2014-206914. doi: 10.1136/annrheumdis- 2014-206914. [Epub ahead of print]
Moore RA, Derry S, Wiffen PJ, et al. Overview review: comparative efficacy of oral ibuprofen and paracetamol (acetaminophen) across acute and chronic pain conditions. Eur J Pain 2014; Dec 22. doi: 10.1002/ejp.649. [Epub ahead of print]
NSAIDs (Non steroidal anti inflammatory drugs) such as ibuprofen are powerful anti-inflammatory drugs which have been found to be very effective in relieving pain for those with OA.
However, their long-term use should be limited as they can cause a range of side effects, and special care must be taken by the elderly and those with certain other health conditions when taking them. Anyone taking an oral NSAID to manage their OA should be monitored carefully by a healthcare professional. Topical NSAID’s (rubbed into the skin) are also becoming increasingly popular and are a lower risk option to oral forms.
Scarpignato C, Lanas A, Blandizzi C, et al. Safe prescribing of non-steroidal anti-inflammatory drugs in patients with osteoarthritis – an expert consensus addressing benefits as well as gastrointestinal and cardiovascular risks. BMC Med 2015 Mar 19;13:55. doi: 10.1186/s12916-015-0285-8.
Glucosamine and chondroitin are popular joint health supplements that are available individually or in combination products.
Glucosamine is a substance found naturally in the human body and is used by the body as one of the ‘building blocks’of joint structures. Chondroitin is also found naturally in the body and is an essential component of cartilage. The clinical evidence supporting the use of glucosamine and chondroitin is mixed with only marginal benefits observed in clinical trials. Due to the lack of evidence, GP’s have been advised not to prescribe glucosamine and chondroitin on the NHS; some people however do feel they see benefits from these supplements.
Towheed TE, Maxwell L, Anastassiades TP, et al. Glucosamine therapy for treating osteoarthritis. Cochrane Database Syst Rev 2005 Apr 18;(2):CD002946.
Singh JA, Noorbaloochi S, MacDonald R, et al. Chondroitin for osteoarthritis. Cochrane Database Syst Rev 2015 Jan 28;1:CD005614.
Fish oil supplements are popular among those with OA although their effectiveness and precise benefits are still debated.
Fish oils are rich in omega-3 fatty acids, which have strong anti-inflammatory properties and may also play a role in lowering cholesterol and triglyceride levels. Most fish oil research has been conducted in patients with rheumatoid arthritis (RA), with studies showing consistently that daily fish oil supplements reduce the use of other medications and improve joint pain.
Unfortunately, there is no good quality evidence that these supplements work in OA and experts have suggested they should not be recommended as a treatment for this condition.
Boe C, Vangsness CT. Fish Oil and Osteoarthritis: Current Evidence. Am J Orthop (Belle Mead NJ). 2015;44(7):302-5.
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