Will supplements help my knees?
QI have osteoarthritis in my knees. I exercise regularly and have tried to lose weight to help the pain, but want to avoid drugs. Are any supplements effective?
AI’m constantly faced with patients who swear by one remedy or another, but that doesn’t mean they would work for anyone else. Prescribed medicines are only licensed if trials show that their benefits are likely to outweigh their risks when they’re compared with placebo or current best treatments. The same doesn’t apply to many herbal remedies – but they do have to be made to safe standards. So if you’re buying a herbal remedy, always look for an official ‘THR’ (traditional herbal remedy) logo on the packet to guarantee this.
However, a new study suggests that chondroitin sulphate is more effective than placebo and as effective as at least one anti-inflammatory, in this case celecoxib. The study looked at patients who had symptoms caused by osteoarthritis of the knee. After six months, patients taking chondroitin showed similar benefits to the anti-inflammatory in terms of reduced pain and improved physical function. Given the recent safety concerns about long-term use of anti-inflammatories, the researchers suggest we should be considering it as a first-line treatment for arthritic knee pain.
QI have one gallstone that is not giving me a problem right now, and I’ve only had two attacks. Would you advise me to have an operation, or leave well alone?
AGallstones are very common – about one in three women and one in six men get them – but about two-thirds of those never have any symptoms. Pregnancy, the contraceptive pill and obesity increase your risk, as does being Caucasian. Age is a risk factor, so they are more common in the over-40s, but they also run in families, so if other relatives are affected, you may develop them earlier.
Gallstones can cause a variety of symptoms, usually if they leave the gallbladder and get stuck in the duct that drains bile into your digestive tract. This can cause a logjam of bile, which stretches the gallbladder and leads to painful inflammation, called cholecystitis. The gallbladder contracts to try and dislodge the stone, which can cause severe, colicky pain in the upper right side of your abdomen, called biliary colic. Fatty meals can trigger similar but less intense pain. Inflammation of the pancreas, which sits nearby, or jaundice from a build-up of bile in the bloodstream, are less common complications.
Medication to dissolve gallstones is rarely effective in the long term, so the only permanent treatment is to remove your gallbladder. These days this can be done with keyhole surgery, but it is still a fairly big procedure, and up to half of people get intermittent mild pain or bloating afterwards. Losing weight may reduce the risk of further attacks, but the surgery decision is ultimately up to you.