Preparations chondroprotectors for the treatment of joints
Long-term chronic joint diseases are always associated with dystrophic changes in articular cartilage - its condition and determines the form and stage of the disease. To stop the destruction of cartilaginous tissue and restore its structure, chondroprotectors are used successfully - drugs whose action is directed to nutrition and the formation of new cells of cartilaginous tissue, as well as to the production of synovial fluid - joint lubrication.
Chondroprotectors are one of the main medicines for the treatment of joints.
Chondroprotectors: application point
To better understand the role of cartilage, consider the structure of the joint. The joint surfaces of the bones are lined with a smooth and always moistened layer of cartilaginous tissue. The role of lubrication is synovial fluid, which is produced by cartilage cells. An important condition for its development is movement in the joint: the more actively the joint works, the more liquid is produced. Synovial grease, in addition, also nourishes the cartilage.
If, for one reason or another, the cartilage begins to deteriorate, the underlying bone is exposed, the surface of which is coarse and rough. The opposite cartilage, when in contact with the bone, is also damaged. Because of this defect, the development of the synovial fluid is disrupted: the joint does not receive lubrication, and the cartilage does not receive nutrition. As a result, the cartilage tissue gradually dies, and the joint loses its functions.
Chondroprotectors hinder the development of this process. Their use reduces pain and to some extent helps to relieve inflammation. The composition of these drugs include substances that are normally produced in the human body and are necessary for the formation of synovial fluid.
The active substances of chondroprotectors are chondroitin sulfate and glucosamine. The drugs are available in various dosage forms:
- injection solutions;
- tablets, capsules and powders for oral administration;
- ointments, creams and gels.
How to take chondroprotectors?
It should be noted that can only be restored with cartilage that has not yet been completely destroyed, therefore the use of chondroprotectors is most effective in the early stages of the disease. When the total death of cartilage cells has already occurred - the medicines are completely useless. Also important is the lengthy course. Doctors recommend not to be limited to 1 to 2 courses, since this is clearly not enough for a complete regeneration of the cartilage.
Restorative processes in the cartilaginous tissue are rather slow, so do not wait for quick results. For joints, chondroprotectors become, as it were, a source of permanent make-up. If you stop treatment before the time - the cartilage will start to break up again. The average time of course therapy lasts from six months to one and a half years - during this period, a lasting long-term effect is achieved. In some cases, the reception is extended to 2 - 3 years. The daily dose and duration of the course is determined by the doctor.
Chondroprotectors are easily tolerated by patients and have virtually no side effects( in some cases, intestinal disorders may occur).With care appoint these drugs to people with diabetes, because the glucose contained in them should be compensated for by increasing the dose of insulin. Contraindication to the use of drugs will be allergic intolerance, pregnancy and early childhood.
Comparison of chondroitin and glucosamine. Click on the picture to enlarge
The choice of the drug
The choice of preparations of this group is quite wide, and it is not easy for everyone to understand what exactly suits him. Given that the price of chondroprotectors can be very high, and the effect does not come immediately - before buying it is worth to consult with a doctor and together with him choose the most suitable medicine.
Often the course of treatment begins with intraarticular or intramuscular injections, gradually switching to the reception of tablets and capsules. At the same time, ointments, creams and gels with chondroitin and glucosamine are used.
According to arthrologists, the following drugs have proved themselves well:
- Artra tablets manufactured in the USA.Contain glucosamine and chondroitin, are well absorbed, easily tolerated. Produced in packages of 30 - 100 tablets, the price, depending on the size of the package 500 - 2000 rubles.
- Dona - glucosamine powder for oral administration and solution for injection. Produced in Italy( Rottafarm).The cost of packing of 6 ampoules or 20 doses of powder is 900 - 1500 rubles.
- Teraflex is a complex preparation of Sagmel( USA), contains chondroitin and glucosamine, is available in capsules and as a cream. The package contains from 30 to 120 capsules, the price of packing 450 - 1500 rubles. Simultaneously with taking capsules inside to strengthen the effect, it is recommended to use Teraflex cream.
- Chondrolon is an ampoule solution of chondroitin sulfate of Russian origin. The package contains 10 ampoules. Price 1000 - 1300 rubles per packing.
- Structum is a French preparation of chondroitin sulfate in capsules manufactured by Sotex. Produced in packages of 60 capsules in two different dosages( 250 and 500 mg).The cost of the 1st package is 500 - 1300 rubles.
- Elbona is a Russian-made product from Ellara, a solution of glucosamine for intramuscular injection. The package contains 6 ampoules. The price is from 900 rubles.
The group of chondroprotectors is referred to as drugs, the effectiveness of which is clinically proven, as well as food additives, which may not contain the active substance at all, since they are not subject to mandatory testing. Therefore, always buy only proven drugs and on the advice of your doctor.
List of modern medicines and joint preparations
NVVC: an ambulance for joints - for and against
Non-steroidal anti-inflammatory drugs is the most common group of drugs used for pain and inflammation of any organs.
best-known representatives are:
mechanism of action
wide popularity due to the rapid elimination of symptoms due to the triple effect of this groupmedicines:
The anti-inflammatory effect is due to other mechanisms than hormonal drugs, which is emphasized in the name - non-steroid agents. Maximum it is expressed in indomethacin, flurbiprofen and diclofenac, and minimal anti-inflammatory effect should be expected from ibuprofen, amidopyrine and aspirin.
These drugs block prostaglandins - mediators of inflammation, which are released when tissue is damaged. As a result, all the symptoms of inflammation decrease: redness, swelling, pain, fever and disruption of function.
Pain syndrome better eliminates ketorolac, ketoprofen, diclofenac and indomethacin. Less analgesic activity is possessed by aspirin, ibuprofen and naproxen.
The strength of different drugs depends on the structure of the molecule. However, individual sensitivity to different drugs can not be ruled out.
Prolonged use of NSAIDs necessary for the treatment of gonarthrosis is limited to the development of dangerous undesirable reactions, most often from the digestive tract and kidneys.
Because the anti-inflammatory effect is blocked by prostaglandins, a side effect is a decrease in the protective factors of the stomach. Most of the members of this group of medicines are acids, so they additionally irritate the gastric mucosa.
The result may be NSAIDs-gastropathies: erosive or ulcerative defects of the gastrointestinal mucosa, the most severe manifestation of which is gastrointestinal bleeding.
It is believed that indomethacin, ketoprofen, piroxicam are more aggressive in this respect. Rarely, such complications develop when taking small doses of ibuprofen and diclofenac.
How to avoid side effects from the digestive tract:
With a high gastric acidity, gastritis and a history of an ulcer, severe concomitant pathology, the elderly have a higher chance of developing gastrointestinal bleeding. In such situations, the use of selective drugs( meloxicam, nimesulide, celecoxib) that do not reduce the protective factors of gastric mucus is more justified and can be used for a long time.
You can use drugs that reduce the acidity of the stomach( proton pump inhibitors), however long-term therapy is estimated as economically unprofitable.
Side effects of NSAIDs are often manifested by the development of cardiovascular complications in the form of strokes, heart attacks and thromboses. More safe in this regard are naproxen and ibuprofen. The use of diclofenac significantly increases the risk of heart and vascular disease.
The development of arterial hypertension, heart failure, acute renal failure may be a consequence of decreased blood flow in renal vessels due to oppression of prostaglandin synthesis.
Possible development of aspirin bronchial asthma, Reye's syndrome( bleeding) and many other side effects.
Such formidable unwanted reactions do not allow self-treatment and dictate certain rules of application:
NSAIDs should not be taken for a long time. They are used as an "ambulance", quickly and effectively eliminating the symptoms of arthrosis of the knee joint.
The use of anti-inflammatory drugs masks the picture of the disease, without eliminating its cause, which often causes a delayed treatment to the doctor.
The choice of drugs is broad both in strength of action and in side effects. The physician will be able to select the optimal drug in a safe dosage and prescribe the necessary studies to prevent the development of complications.
Chondroprotectors: is it possible to restore cartilaginous tissue?
Because arthrosis of the knee joint is caused by damage to the cartilage of articular surfaces, the ideal preparation should be able to restore them. Such hope appeared in the allocation of a group of chondroprotectors( CP), the most studied of which were glucosamine( HA) and chondroitin sulfate( cholesterol).
The last 25 years of conducting numerous studies have accumulated a vast base, both confirming the effectiveness of HP, and refuting it. As much as contradictory reviews on the use of drugs.
You should not expect a speedy recovery on the background of taking chondroprotectors: minimal results should be evaluated not earlier than after 6 months of therapy. Reducing the dosage of NSAIDs in the treatment of arthrosis of the knee joint is the first symptomatic effect of CP administration. These drugs are most effective at stages 1 and 2 of arthrosis.
Glucosamine and chondroitin, like nonsteroidal drugs, have anti-inflammatory effects by suppressing "inflammation cells"( interleukins and prostaglandins).However, unlike NSAIDs, chondroprotectors have excellent tolerability.
Prevention of the progress of the disease( on the roentgenogram - slowing down the rate of narrowing of the joint space) is also an important effect of this group of medicines.
Initially, HA and XC were used in isolation and in the form of injection forms, which limited their use. Then oral forms of release were developed. Here is an example of several drugs with chondroprotective effect.
Drugs containing chondroitin sulfate
Chondrolon( Russian company "Microgen") - is available in the form of ampoules of a dry substance for intramuscular injection.
Chondroitin AKOS( Sintez, Russia) - capsules for oral administration of 250 mg and ointment for topical application. In a day you need to take 4 capsules.
Structum( "Pierre Fabre", France) - capsules of 250 and 500 mg. The daily dosage is 1000 mg.
Drugs containing glucosamine
A study in Belgium showed a greater efficacy of glucosamine in arthrosis of the knee than CS.
Elbona( CJSC "Moscow Pharmaceutical Factory") is a preparation for intramuscular injection of 400 mg of active substance in an ampoule.
Dona( "Rottapharm") - is available in the form of powder and capsules for oral administration, as well as a solution for intramuscular injection. In 1 sachet powder contains 1500 mg of active substance, and in one capsule - 250 mg.
Drugs containing HA and CS
Numerous studies have shown that the efficacy of the two components improves the treatment outcome by 60% and the monotherapy by 30.
Arthra( Unifarm, USA) and Teraflex( Bayer, Germany) - complex preparations containing both chondroprotectors, differ somewhat by the dosages of the incoming components: 500 mg of HA and XC in the first and 500 mg of HA and 400 XC in the second.
Means for insertion into the joint cavity
In severe pain, the doctor can recommend the administration of the drug directly into the joint cavity.
As preparations that quickly eliminate symptoms of inflammation, glucocorticosteroids are most commonly used:
Chondroprotectors, called the "liquid prosthesis", are more optimal. Sodium hyaluronate in preparations:
They practically replace articular fluid, improving nutrition of cartilaginous surfaces. However, these medicines are not yet available to everyone at a cost.
Drugs for topical therapy are additional methods for the treatment of arthrosis of the knee joint. Usually the active substance is an NSAID, such as in the preparations Voltaren-gel, Fastum-gel, Menovazine, diclofenac ointment, indomethacin and butadione. Medical compresses with bischofite( an oil derivative), dimexidom( anti-inflammatory drugs), medical bile expand the range of therapeutic measures for gonarthrosis.
Absorption of the drug with local treatment is no more than 7-8%, so monotherapy is rarely effective.
As the course of the disease is accompanied by periods of exacerbation and remission, it is important to combine different methods of treatment, to apply effective physiotherapy procedures, sanatorium treatment, possibly traditional medicine.
The doctor will help with recommendations at any stage of the disease!
Innovative BAA for joints
Food supplements are not medicines, but biologically active substances( food additives), which consist of natural components and are considered as an addition to the basic therapy.
For the treatment of joint diseases, all companies - the world leaders in the manufacture of dietary supplements( such as NSP, Vision, Vitaline Inc) and Russian manufacturers - offer a huge number of complexes.
They can contain components that have different effects:
herbs with anti-inflammatory activity;
vitamins and minerals for the activation of metabolic processes;
calcium, vitamin D, collagen to strengthen bone tissue.
There are even components that improve blood circulation, and detoxicants( for example, Dectox in Vision).
Innovative drugs for the treatment of inflammatory degenerative diseases of the joints are chondroprotectors - a means that protect against inflammation and repair cartilage tissue.
Before their appearance in joint diseases it was possible to perform only symptomatic therapy, that is, the elimination of pain syndrome. The era of chondroprotectors marked the possibility of influencing the cause of the disease - cartilaginous tissue.
Glucosamine and Chondroitin were the first to use this group. They have been actively studied in official medicine for more than 40 years. Recent years of use have accumulated numerous evidence of the effectiveness of chondroprotectors in the pathology of both large and small joints. For example, a study in Belgium showed that patients taking chondroprotectors for 1 to 3 years were less likely to need joint replacement for arthrosis of the hip joints by 60% less than those taking a placebo( a substance-free tablet).
In 2014, they entered the mandatory algorithm for the treatment of residual arthritis, recommended by the European Society of ESCEO.
Most manufacturers of dietary supplements have in their arsenal Chondroitin and Glucosamine in the form of 100% natural product of high purity.
Chondroitin sulfate( ChS) is a specific component of cartilage, it is a natural mucopolysaccharide. In patients with joint diseases, its concentration in the synovial fluid is reduced. It is found in cartilages, ligaments of animals, fish.
Chondroitin sulfate has regenerative( restoring) activity:
is involved in the process of calcium deposition in the bones, preventing the development of osteoporosis;
increases the synthesis of collagen, strengthening ligaments, tendons, cartilage;
retains the cellular structure of the cartilage, thereby increasing the strength of bones;
increases the production of intra-articular fluid, which prevents cartilage friction;
slows the narrowing of the joint gap in gonarthrosis;
reduces the destruction of chondrocytes( cells of the cartilaginous tissue), making them resistant to the action of inflammatory enzymes.
In addition, chondroitin sulfate has an anti-inflammatory effect by suppressing the activity of "inflammation cells" - the enzymes and mediators involved in the cascade of inflammatory reactions. Due to this, soreness in the joint decreases, and its mobility increases.
BUD Chondroitin sulfate is usually available in the form of capsules of 250-350 mg( 50-60 pieces per pack).It is more often recommended to take 1-2 capsules a day. Note that the drugs have a much higher dosage: 500-1500 mg 3 times a day.
The cost per month of treatment varies considerably, depending on the manufacturer, and is 300-2500 rubles.
Contraindications for use are increased bleeding of blood vessels and individual intolerance, pregnancy and lactation.
Glucosamine( HA) is a component of chondroitin and a precursor of glycosaminoglycan, the main component of cartilage. It is isolated from chitin( a substance that is part of the shell of crustaceans).
GA has similar effects with chondroitin: symptomatic( reduction of soreness in movements and improvement of joint function) and regenerative( restoration of cartilage tissue with prolonged use).
In addition, Glucosamine has some differences from Chondroitin:
has better results and the highest level of evidence in the treatment of arthrosis of the knee joints( cholesterol showed the best effect with arthrosis of the hip joints);
is a more preferred building material for the formation of glycosaminoglycans in the human body( in particular, hyaluronic acid).
Often used association that Glucosamine in the structure of the cartilage is a brick, and chondroitin - cement.
BAA Glucosamine is also available in capsules, the cost varies depending on the manufacturer's company in approximately the same range as chondroitin.
Contraindications to use are similar to those of cholesterol.
Both drugs are transferred very well, no side effects are reported.
Due to the peculiarities of the action of glucosamine and chondroitin sulfate, complexes appeared containing both preparations. In 1999, a convincing study was carried out, which showed that, when combined, cartilage cells began to produce twice as many glycosaminoglycans, and in single-agent therapy, only one-third.
The combination of two drugs is on average the same as one drug. For example, Doppelgerz asset offers a complex at a budget price - 250-300 rubles per month of treatment. It contains 700 mg of glucosamine and 100 mg of chondroitin sulfate in a capsule.
Different manufacturers try to improve the complexes with other components. So, Glucosamine Forte - BAA, containing, in addition to HS and HA, the grass root "Devil's Claw" and shark cartilage ecstasy( Santegra, USA)."SOLGAR Glucosamine-Chondroitin Plus" has additional components in the form of vitamin C and manganese.
Thanks to the latest research in medicine, it can be said that the best BADs for joints combine the 4th component: Glucosamine, Chondroitin, Methylsulfonylmethane and Celadrin.
Methylsulfonyl methane( MSM, DMSO2, dimethylsulfone) - is called the "third whale" in the treatment of joint diseases. This organic compound contains sulfur and is present in all tissues of the body. MSM improves the supply of nutrients through the cell membrane. With its deficiency, trophic tissue disorders are formed.
Sulfur is the fourth mineral in the human body by mass fraction, which has many positive effects: antioxidant, antihistamine, analgesic and anti-inflammatory. It is the latter two effects that are used in the treatment of inflammatory joint diseases. Sulfur is found in many foods: vegetables, fruits, cereals, milk, meat, but is destroyed when cooked. With age, the need for it increases.
MSM promotes faster muscle recovery after exercise, so it has long been used as a sports nutrition in Ice Power Plus, Bone Boost from SAN, Animal Flex from Universal Nutrition and others.
The use of MSM with chondroitin and glucosamine has become the next step in the treatment of joint diseases. It turned out that it enhances the effect of both drugs.
The French company Arkofarma developed such a complex preparation and named it "Inzhoy Enti"( Vision).The composition of BAA includes Glucosamine, Chondroitin, Methylsulfonylmethane and Bamboo Extract, rich in silicon.
To avoid allergic reactions associated with the isolation of a preparation from bovine protein, Glucosamine and Chondroitin are of marine origin. To maximize the preservation of useful properties of components in the production process, cryocorrelation technology is used.
The preparation is available in the form of capsules of 30 pieces per pack, take 1 capsule per day. The month of treatment "Inzhoy Enti" will cost 2300-2500 rubles.
Supplements "Glucosamine Chondroitin Super Formula" is characterized by a higher content of 3 specified components than analogues. Also included are Selenium, Magnesium and Vitamin E.
"Glucosamine chondroitin MSM"( Doctor's Best) contains additionally sodium and potassium.
The latest effective compound for the treatment of joint diseases is Celadrin.
Celadrin is a special complex of fatty acids( LC), isolated from bovine fat. LCs are part of the lipid of cell membranes responsible for transporting nutrients into the cell and the products of decay from it.
Celadrin has a whole complex of unique effects:
When exposed to negative factors, including inflammatory mediators, on the cell membrane, it quickly restores its integrity.
Oppresses the production of "inflammation cells" in the development of autoimmune and pathological inflammatory processes.
Improves the composition of the joint fluid, as a result of which the amplitude of movements in the joints increases, the friction of cartilage is not allowed.
Thanks to the listed properties, Celadrin improves the flexibility of the ligament apparatus, reduces pain, restores the volume of motion in the joint.
Celadrin 525 from the company Solgar( USA) is available in the form of capsules( 60 pieces per pack), a day is recommended to take 1-2 pieces. The cost of treatment will average 2100-2300 rubles.for 1-2 months.
New Celadrin &MSM from Now contains Celadrin and MSM.It is recommended to apply a daily dose of 3 capsules, a 20-day course of treatment will cost about 600-700 rubles.
To the group of preparations containing the four most important components for restoration of joint function, is Agel FLX( Agel Enterprises, USA).
It is available in the form of a gel with a taste of fruit( 21g) and contains active components in an increased amount: Chondroitin sulfate 1200 mg, Glucosamine sulfate 1500 mg, MSM 400 mg and Celadrin 750 mg. The monthly course of treatment with an innovative drug is about 3000 rubles.
While there is no information on large meta-analyzes confirming the effectiveness of Agel FLX, however, the drug is considered very promising. A three-year study conducted at the Department of Traumatology and Orthopedics of the St. Petersburg State Medical University named after. I.P.Pavlova, in which 134 patients participated, demonstrated a significant reduction in the pain syndrome and an increase in the amplitude of the movements.
What is important to remember the patient when using dietary supplements?
Does the doctor help?
The doctor can not prescribe dietary supplements officially, since they do not belong to the group of medicines. However, he can advise them as an additional method of prevention and treatment. The doctor may have experience in the application of dietary supplements to other patients with a similar pathology and long-term observations of the dynamics of the disease.
Can I treat food supplements as a waste of money?
It is possible, except that 35% of the world consumption of dietary supplements is in the US, where they take into account the economic validity of spending each dollar. On the second place - Europe( 32% of the market), on the third - Japan( the country of long-livers).It is important to choose the right manufacturer and full ownership of information that dietary supplements do not act quickly!
When to wait for the result?
When taking dietary supplements, it is important to follow the admission rules( multiplicity and timing of application), but do not treat them as medications that should help instantly( eg, NSAIDs).A group of chondroprotectors are drugs with a delayed effect( the minimum course is 3 months).Supplements act more gently, the result often has to wait longer than when taking medications.
How to evaluate the result?
The result can be assessed objectively by reducing the intake of NSAIDs not earlier than six months after the beginning of the application of dietary supplements. This indicates a reduction in pain syndrome, stiffness, and improved joint function. BADy for joint disease use for life, treatment is carried out by courses.
Side effects and contraindications
Tolerability of dietary supplements is usually good, no side effects are described. This is due to the fact that the basis - 100% natural substance without preservatives, additives and dyes. Seldom can be an individual intolerance. Contraindications in dietary supplements are usually very small: pregnancy and lactation. There is no danger of addiction and overdose.
There are reviews of both the ineffectiveness of applying BADs and chondroprotectors. The reason for them is most often the discrepancy between expectations and reality: the patients suggest that after 1-3 months of application the cartilage tissue should be restored, and the pain syndrome should be left for good.
In fact, the correct approach to taking dietary supplements is this: use them as an additional method of therapy for a long time. BADs, like chondroprotectors, will work more effectively in the early stages of the disease. The very first result can be considered a reduction in the dose of NSAIDs, which indicates a decrease in the pain syndrome. About other effects in relation to cartilaginous tissue can be said no earlier than 1.5-2 years after admission. To suspend the course of the disease is already a huge result!
Author of the article: Alexeyeva Maria Yurievna, physician-therapist
Which chondroprotectors for joints
The pathogenesis of the majority of degenerative and dystrophic diseases of the joints and spine is the destruction of the intraarticular cartilaginous tissue, the condition of which determines the stage of the disease and its symptoms. Modern medicine has found a method of therapeutic effect on intraarticular cartilage - it's chondroprotectors for joints.
These medications are designed to stop the progression of pathological changes and, if possible, to repair the damaged cartilage. It should be noted immediately that the effect of such treatment will be observed only in the case of the initial stage of the disease, in far-reaching cases of arthrosis, even the best chondroprotectors( CP) will be ineffective, since there is already nothing to restore in the joint( all cartilaginous tissue is already destroyed).
Mechanism of action of chondroprotectors
To understand how these medications help with joint diseases, at what pathology they will be effective, and at what treatment it will be ineffective, it is necessary to understand how the joints of a person and what role of cartilaginous tissue are arranged.
At the heart of all arthrosis joints is the destruction of cartilaginous tissue
How are cartilage joints?
All articular surfaces of bones that form the joint are covered with cartilaginous tissue. It also includes intervertebral discs. The cartilage surface is smooth and constantly moistened due to a special intraarticular lubricant - synovial fluid. By the way, food for cartilage tissue is also due to the diffusion of substances from this fluid, as its cartilage does not have cartilage.
The main function of the cartilage is to provide smooth movements in the joint, in which the cartilage surfaces of the bones slide one against the other, this process is also facilitated by intraarticular lubrication.
Structure of cartilaginous tissue:
- Cells( chondroblasts and chondrocytes).These are young and mature cells of cartilaginous tissue. They produce an intercellular substance, a matrix, which constitutes the bulk of the cartilage. There are much fewer cells here.
- The intercellular substance of cartilage is characterized by high hydrophilic ability - binds water molecules, which constitute up to 80% of the matrix. It consists of intercellular substance from collagen fibers and chondromucoid. It is the latter substance that is responsible for the integrity, strength, shape and function of the hyaline cartilage of the joint. In its composition has a substance such as chondroitin and glucosamines( structural units of cartilaginous tissue).
Cartilage destruction( regardless of the underlying cause) begins precisely with a decrease in the amount of glucosamines and chondroitin, which leads to the unfolding of the cartilaginous tissue, the appearance of a roughness on its surface, cracking and a decrease in the thickness of the cartilage. In connection with this, or in parallel, the production of synovial fluid rich in hyaluronic acid decreases, which further aggravates the condition.
The movements in the joint become painful, the articular surfaces of the bones become bare, which leads to the development of arthrosis and osteochondrosis with all the ensuing consequences.
Application point for chondroprotective agents
Chondroprotective drugs with a timely appointment can stop the destruction of cartilaginous tissue and to some extent even repair the damaged cartilage structure. The fact that the basis of their composition are the above chondroitin and glucosamines, which, getting into the body, begin to "build in" the damaged cartilage, thus restoring their structure and function.
Action of the main components of chondroprotective agents
Classification of chondroprotectors
Chondroprotectors can be divided into three features:
- by composition;
- on the generation of medicines;
- by the method of reception.
Types of chondroprotectors depending on the composition of
- CP, which contain chondroitin sulfate( chondroxide, mucosate, chondrolon, chondroitin, Structum, Arthron chondrex, chondroitin-phytopharm).
- CP, which contain glucosamine( Arthron flex, Flexamine Glucosamine, Don).
- Combined CP( chondroitin + glucosamine) - Arthron complex, Teraflex, Chondroitin complex.
- Combined CP( chondroitin and / or glucosamine + NPZP - ibuprofen, diclofenac) - Triac, Artron, Moveks, Advance, Artrodar.
- CP, which are an extract of cartilage and bone marrow of animals( Alflutop, Rumalon).
Types of chondroprotectors depending on the generation
- The first generation is not purified extracts from cartilage and bone marrow of animals. Currently, only Alflutop is used. Has a large number of allergic reactions.
- The second generation is mono-preparations based on glucosamine or chondroitin, which are indicated above.
- The third generation is a combination medicine.
- Separately it is necessary to allocate hyaluronic acid for intraarticular injections( Ostenil, Fermatron, Sinocrom, Viscosil, Suplazin, Synvisc).
Syncope is a preparation of hyaluronic acid for intraarticular administration, not for HP, but is a liquid synovial fluid transplant
Types of chondroprotectors depending on the method of taking
- CP for oral administration( tablets, capsules) - Structum, Arthra, Teraflex. They are well tolerated by patients and practically do not cause side effects. The effectiveness of oral forms is low, since most of the active substance is lost during metabolic changes.
- CP in the form of injections( intramuscular and intraarticular) - Alflutop, Dona, all preparations of hyaluronic acid. More often cause allergic reactions, complications associated with injection, but their effectiveness is much higher.
- CP for external use( ointments, gels, creams) - Chondroxide. It is used only in complex treatment.
How to choose a drug?
To answer the question about how to choose a drug-chondroprotector for the treatment of joints, it's not so simple. Firstly, the assortment of such medicines in the modern pharmaceutical market is quite large. Secondly, the price of such treatment is very high, and given the need for a long course, which can reach a year or a half, for some patients the cost becomes prohibitive. Thirdly, the effect of chondroprotective therapy does not come immediately( the first positive signs can be noticed after 3-4 months of regular use).
Given all of the above, before you buy these medications, it is necessary to consult with a doctor who will determine whether there really is a need for such therapy and which drug is most suitable in your case.
Nevertheless, to somehow navigate the selection, it is necessary to evaluate the preparations-chondroprotectors according to the following criteria.
Mono-drug or combined?
With the above classification of HP, it can be seen that they can be single-component( mono-drugs) or combined. As a rule, the combination consists of two basic substances - chondroitin and glucosamine, while others do not. Some drugs in their composition have a non-steroidal anti-inflammatory drug( Ibuprofen or Diclofenac).And we recommend reading: What are the tablets for gout?
It would seem that it is better to choose a medicine in which to find both glucosamine and chondroitin, because both of these substances are equally important for the body. But in practice, there are some nuances of this choice: some sources of information claim that mono-drugs are more effective, while others are telling about the benefits of combined medicines.
Why are there so different opinions? First, chondroprotectors are "young" medicines( the experience of their use totals about 10-15 years).Secondly, the interest of pharmaceutical manufacturers of chondroprotectors plays an important role. It is known that in order to release one medicine to the market, billions of dollars are needed( the cost of clinical and other types of research, advertising campaign, etc.).Therefore, often the information that is received as a result of research sponsored by a certain company does not always correspond to the truth.
The recommendation is this: first you need to address this question to a practicing arthrologist who, based on his experience with the use of these drugs and knowledge, will be able to advise a really effective HP.Also, excellent help will be provided by patients' opinions about this or that drug.
This is a very important criterion of choice, because a well-known and respected pharmaceutical company in the world can afford the most expensive and accurate equipment, modern drug manufacturing techniques, high purification of medicines and real clinical studies of the effectiveness of drugs, unlike no known factories.
Buying branded drugs, not generics, you can be sure that for your money you will get only a high-quality medicine that will minimize all side effects, allergic reactions and inefficiency of therapy.
Arthra is a combined chondroprotector with a large evidence base and a well-known manufacturer
Medical product or dietary supplements?
If the chondroprotector claims to be a medical product, then there must necessarily be clinical studies that confirm its effectiveness, composition, indications, contraindications, side effects, etc.
In the case of a dietary supplement it is not necessary. But you should understand that then there can not be a talk about the chemical purity of the drug, the amount of active substance that is in one pill( and it may not be there at all) and the effectiveness of such treatment.
The instruction to the preparation is your main "weapon" - read it before buying it. There it is indicated whether the drug is a dietary supplement or a medicine.
Despite the fact that the Tooth Stone is a dietary supplement, many positive responses from
patients can be found about it. Stage of the disease
. As already mentioned, CP is effective only in the initial stage of the disease( stages 1 and 2 of arthrosis, osteochondrosis).If you have a pathological process already gone far( stages 3 and 4), then the expediency to take chondroprotectors is no longer, as the cartilage tissue is completely destroyed. And it is not possible to renew these medicines
Indications and prohibitions to use
Indications for the use of chondroprotectors are:
- deforming osteoarthritis of 1-2 stages( including coxarthrosis, gonarthrosis);
- osteochondrosis of the spine in the initial stages;
- prophylaxis of articular degenerative diseases in persons at risk( age after age 50, athletes, people who have occupational hazards - heavy physical work or, conversely, prolonged stay in one position, overweight persons after a traumatic injury, people withanother disease of the musculoskeletal system, with endocrinological and metabolic disorders).
Contraindications to the appointment of CP are the individual intolerance of the components, pregnancy and lactation.
The list of the most effective chondroprotectors of
The following list of the most effective HP has been compiled taking into account the patients' feedback, the recommendations of the physicians-arthrologists, the clinical research data and the reputation of the manufacturer:
The most popular and effective chondroprotectors
- Dona. This is a mono-drug of glucosamine sulfate. There is in the form of powder for ingestion and ampoules for intraarticular or intramuscular injections. Produces this medicine Rottafarm( Italy).
- Artra. Complex chondroitin and glucosamine. Produce these tablets in the US.It is characterized by high efficiency with long-term intake and safety.
- Teraflex. Complex HP, which is available in the form of capsules and an external cream by the American company Sagmel.
- Structur. The drug chondroitin in capsules for oral administration, is produced by the French pharmaceutical company Sotex.
- Alflutop. This is HP in ampoules of the first generation. It is an extract of 4 species of Black Sea fish. It is used for intraarticular and intramuscular injections. A frequent side effect is an allergy.
- Toasting stone. This dietary supplement on a plant basis. There are capsules for internal administration and an ointment for external use.
Summing up, it can be noted that choosing HP is really hard. Therefore, to get the maximum effect from the treatment and a minimum of side effects, this should be done by a specialist.
Treatment of joints with drugs and with the help of traditional medicine
Diseases of the joints are most affected by older people. Although today this ailment is found in young people, even if rarely, it does happen. In fact, this acute inflammatory disease of the joints, as a rule, a chronic nature( arthritis, arthrosis).Fortunately, it can, if not cure, then achieve a long-term remission, which is very good. The treatment of joints with folk methods, as well as with medicinal preparations, is popular. We will look at both ways.
Symptoms of joint disease
Before starting treatment, it is necessary to pinpoint the symptoms. Of course, it's better that a qualified doctor does this, but if there is not such a possibility, then you can quite manage on your own. If we are talking about a young body, the cause of inflammation of the joints is often an unnoticed or incompletely cured trauma of the knee, elbow, fingers, etc. But, despite the fact that inflammation can be detected only in the laboratory, the symptoms themselves are very bright. Localized pain in the outbreak, pronounced reddening of the skin, and stiffness during movement can indicate that your joints are inflamed. In 90% of cases the cause lies in arthrosis or arthritis. If the local temperature is raised, and the hearth feels burning, then you need to see a doctor for diagnosis. In the initial stages it is advisable to use conservative medicine.
Prophylaxis of the disease, or How not to pick up arthritis?
Agree, if you are healthy, it is unlikely there will be a need to spend large amounts of money on expensive drugs. So, it is necessary periodically to appear at the doctor and to examine joints for presence in them of salts. If the latter will be seen, then you can use an excellent folk remedy - laurel leaves. A decoction of these miracle-leaves will completely remove the salts from the desired place, and you will feel great. Another good approach is to enroll in a sanatorium. Treatment of joints will be exclusively preventive in nature, nevertheless, visiting such places at least once every 5 years, you will ensure yourself a painless old age. Sometimes the joints do not hurt because of the salts, but because you have picked up a viral or fungal disease. In this case, it is recommended to consult a drug treatment course.
Rheumatoid arthritis( RA) and osteoarthritis
In RA inflammation, most often the elbows, knees, shoulder and other joints are exposed. Physicians say that this is a chronic disease that worsens the health of the body as a whole. The essence of the disease is that the synovial membrane of the joint is stretched. A capsule containing a large amount of liquid is stretched, which causes the skin to turn red in this place, and any touch will be very painful. According to statistics, Armenia suffers from 2% of the world population, the overwhelming majority are women. At the initial stages, sanatoriums will help. Treatment of joints in this case will be conducted both with the use of infusions and trays, as well as medicamentous.
Osteoarthritis usually affects only a few joints and does not pass to others. This disease proceeds slowly enough, gradually eroding cartilage. As a result, the bones rub against each other, which causes the formation of osteophytes. Often, all this is accompanied by an increase in bone density and its deformation, which ultimately leads to a decrease in mobility. Overweight man only exacerbates the situation, as the pressure on the sore spot increases. In osteortritis, drug treatment is used. If the disease is stable, surgical intervention will be required.
Opportunities of Traditional Medicine
Alternative medicine has several undeniable advantages. First, you do not need to spend a large amount of money, as a rule, everything you need can be simply broken or bought from the herbalist or at the pharmacy at a small price. It is worth noting that the diseases of the hip joint, as well as the knee or any other can be treated externally( triturates, ointments), and systemically( juices, infusions, decoctions, etc.).In any case it is recommended to be treated by the course. Currently, there are a lot of effective methods of traditional medicine that allow not only to alleviate pain, but also almost completely to relieve inflammation. Let's look at some of the most effective recipes, in the opinion of those who tried it on themselves. Compresses of black radish and honey
We all know about the beneficial properties of radish. Here and in our case it is an indispensable tool. We will need a small radish, which must be washed and rubbed on a fine grater. The resulting gruel should be heated for a few minutes, then put a thin layer on a linen towel or napkin. Then you need to cover the radish with a towel and attach it to the sore spot. You need to hold as much as you can. So it is very effective to treat diseases of the knee joint. If necessary, you can use a cold radish.
Another good recipe is based on the miraculous action of honey. So, you need to take no more than 100 grams of this product and mix it with 50 g of aloe juice, as well as 157 g of vodka. The resulting mixture should be applied to gauze or a towel, and then to a sore spot. You can leave a compress all night. Very effective in the initial stages of the disease.
Comfrey ointment and treatment with sea sand
The essence of sand treatment is that it first heats up. You can do it on the stove or the sun. Please note that only sea sand will work, as it contains a large amount of iodine. Sore place completely covered by warm sand, and after a while you need to go to bed, so that the body does not cool. Sand is recommended to be used repeatedly. Direct contact with sand is considered more effective than through a towel or gauze. This treatment is ineffective in the progressing stages of the disease.
Ointment from the comfrey is considered to be quite effective and can significantly reduce inflammation. To prepare the mixture you will need a glass of comfrey leaves and as much vegetable oil. All this must be mixed and boiled for about half an hour. Then pour a quarter of a glass of beeswax( preferably passed through a meat grinder) and a little vitamin E. Cool the ointment and begin treatment of the disease of the knee, elbow or any other. Such a compress can be kept about a day. If dimexide was added to the formulation, then no more than half an hour.
Horseradish for pain in the joints will rid
As the main ingredient for cooking, we will use horseradish, which can both be bought and found in our own garden. Therefore, if you suffer from deforming arthrosis, then write down this prescription for yourself. Roots of horse-radish are ground on a small grater and steam, water is not brought to a boil. Moisten the linen fabric in such a solution and apply a little gruel to a rag, then attach it to the sore spot. Do not forget to stock up on the winter. Judging by the reviews, horseradish is one of the best methods of treatment of hip joint disease, especially if it is a fracture of the neck of the hip. As you know, in old age, the bones practically do not grow together, and the process is very painful and long. Part of the problem can be solved with the help of horseradish.
On the treatment of herbs
It can be said with certainty that most experienced herbalists never went to the hospital. The secret of this success is quite simple. The fact is that everything we need grows under our feet, the only thing that is required of a person is knowing how to prepare a miracle broth. If in our case, talk about arthrosis or arthritis, then there is a huge amount of broths and infusions.
One of the most popular is a mixture of elderberry leaves, dioecious nettle, and also the root of parsley and willow bark. All ingredients are taken in equal parts, crushed and filled with a glass of boiling water. Then the broth boils for about 5 minutes on a slow fire, cool and filter. Drink 2 cups a day for arthritis at any stage of development.
You can also use the following recipe. We take the usual lice or medium stellate. A glass of boiling water is needed on a tablespoon of herbs. We insist 4 hours, and it is desirable to wrap the mixture. Then filter and take a quarter of a glass 4 times a day before meals. Effective in the treatment of gout and arthritis.
In the event that herbs, tinctures and broths are impotent, pharmacological agents will be required. Pay attention that if the traditional treatment of joints does not practically require material costs, then in this case, the opposite is true. Most often, anti-inflammatory ointments are used on natural bases, that is, on the same herbs. For example, the "Collagen Ultra" remedy effectively removes inflammation of the joints. The composition contains hydrolyzed collagen, rosemary, mint extract, sage, etc. But, in fact, this ointment does not eliminate the disease, but only allows you to forget about it for a while. Nevertheless, if you have pain in the joints of your fingers, this kind of treatment can be the main one. Most often, the ointment is used as a supplement to the main course.
In the most severe cases, when pain can not be tolerated, and movements are severely limited, steroids are prescribed - potent drugs that almost instantly relieve pain and improve the general condition of the focus. But here there are their shortcomings. For example, steroids are always a large list of side effects. For this simple reason, elderly people are rarely prescribed steroids. For example, in case of peptic ulcer such a course of treatment is unacceptable, this also applies to other diseases. If, as an example, exacerbate gout, then in this case steroids are pricked only during an attack, after which it is necessary to ensure the immobility of the joint. Often prescribe antibiotics. When it is required treatment of the elbow joint, as well as the hip, knee, etc. simultaneously, a course of steroids is prescribed. After a while, the condition improves.
Joint treatment: patients' feedback
Before you start taking any action, you need to talk with people who know what helps. Based on this, you can get a free consultation. For example, most people who are treated for inflammation of joints with folk methods, note that this is really effective, and in some cases completely free. But, despite this, conservative medicine is not always effective. So, in particularly severe and neglected cases, surgical intervention is required, followed by a course of antibiotics or steroids. Many people who undergo medical treatment say that the only problem is a large number of side effects. But such drugs are effective at any stage of the disease.
Combined treatment ofAfter consultation with a doctor, you can use the so-called mixed method. Its essence lies in the fact that you will use both herbs, alcohol and other infusions and decoctions, and medicinal preparations. This approach is necessary in those cases when there is no possibility to drink or stain steroids, and also to do the operation. In this case, you can drink broths and smear foci of inflammation with ointments bought in pharmacies. As for painkillers, their effectiveness is rather low. But if it hurts a lot, then such a decision is also advisable.
Here we are and talked with you about how and how to treat joint inflammation. Remember that the treatment of the joints of the hands and feet requires a serious approach. In addition, it is extremely important to pay attention to the initial stages. It is due to the fact that if the disease is just beginning, then it is much easier to cure it, rather than at a neglected stage. Based on all of the above, we can conclude that conservative medicine is good in the early stages of development, but medical, as well as surgical intervention is necessary at later stages. Remember that arthritis and arthrosis is very serious, since these diseases can lead to complete immobilization of the joint. That it did not happen, be engaged in prophylaxis of an inflammation.
Drugs for medicamentous treatment of joints: chondoprotectors, intraarticular
The medical treatment of arthrosis often begins with the use of non-steroidal anti-inflammatory drugs. They have an analgesic effect and relieve inflammation. The most effective of these are indomethacin, diclofenac, ibuprofen. Even ordinary aspirin, albeit in a weaker degree, has the same effect. But due to strong side effects, they are prescribed mainly in small doses and short courses. The fact that the drugs of this group have a negative effect on the mucous membrane of the stomach, causing the occurrence of peptic ulcer. In addition, they adversely affect kidney function and heart function, although in the new generation of drugs( nimesulide, celecoxib, movalis) this effect is significantly reduced. Therefore, they are appointed when long-term use of such drugs is necessary.
Another reason why long-term non-steroidal anti-inflammatory drugs is avoided by patients is that they mask the symptoms of the disease. Drugs for the treatment of joints of this group, relieving pain and reducing the manifestations of the disease, make its symptoms unclear, making it difficult to diagnose. Many patients, after receiving a quick effect, refuse to be treated further, believing that there is a complete recovery. In fact, this indicates that the cartilage continues to degenerate, and the patient does not receive any signals from the body about this.
The main reason why anti-inflammatory drugs are prescribed by doctors is not so much to remove symptoms and alleviate the suffering of the patient, but to make possible further medical interventions that are difficult to achieve with pain.
This is the next group of medicines that is used in almost all cases of arthrosis. They protect the cartilaginous tissue and promote its enhanced synthesis in the body. This means that they not only eliminate unwanted symptoms, but work on the cause of the disease and are the most important for treatment. Among them, the most effective are chondroitin, dona, arthra, structum, chondroxide, chondrolon.
Preparations from the group of chondroprotectors contain such active substances as chondroitin sulfate and glucosamine. Some drugs have both of them. The most effective are arthra and teraflex. But there is a parallel scientific opinion that when combined, these substances weaken each other. Indeed, in some cases it is possible to succeed with mono-preparations containing an active substance of one type. So is Don, a cure for arthrosis containing only glucosamine. It is available in the form of sachets, capsules, ampoules. For the greatest success combine oral administration with intramuscular injection.
An example of another effective mono drug is chondroxide, the tablet containing 250 mg of chondroitin sulfate. There is also a 5% ointment under the same name. Patients with arthrosis when choosing the type of drug should rely on individual observations and sensations, giving preference to the products of well-known companies.
Features of treatment with chondroprotectors consist in their delayed action. The effect of their use is manifested not earlier than 3-5 months from the beginning of admission. The course of treatment is always long - from 6 to 12 months. It is important to consider that they act only at the initial stages of arthrosis. At the third stage, when the cartilaginous tissue is already destroyed, it makes no sense to take them.
Preparations for intraarticular administration of
A good effect in the treatment of arthrosis is given by drugs for the treatment of joints, which can be injected directly into the affected cavity. Thanks to this method, the drug substance immediately enters the synovial fluid. Often for such intraarticular administration, corticosteroids - hydrocortisone, kenalog, diprospan - are used. They quickly reduce pain and relieve inflammation. And when ingested they give a lot of side effects.
In recent years, such a method as the introduction of hyaluronic acid preparations into the joint cavity of the patient, which act as a liquid prosthesis, i.e., an additional synovial fluid, has started to be successfully practiced. In the joint due to this, a protective layer is created, which moistens the cartilaginous tissue and improves its nutrition. These include preparations fermatron, duralan, ostanil .This gives a very good curative effect, but a significant disadvantage of the method is high cost.
Drugs for Topical Use
In combination with the above-described treatment methods, topical preparations are often used. All kinds of ointments and medicinal gels can sometimes quickly remove the pain and pacify the inflammatory process without irritating the gastrointestinal tract. The disadvantage is that only 4-8% of the active substance gets to the diseased organ through the skin. Therefore, to enhance the effect, they are combined with drugs taken orally or intramuscularly. The most popular local remedies include Fastum-gel, Voltaren-gel, butadione and indomethacin ointments. Popular among patients and means for making compresses are medical bile, dimexide, bischofite.
We draw your attention to the fact that medical treatment and taking medications with arthritis should be under the constant supervision of a doctor!