Best supplements for joints?

[Tichtheid]

Hi TH,

Good to hear the turmeric is working so well for you.

I would strongly advise against repeating the same trick with the same amounts of chilli powder. Yes, it's capsaicin that is both the effective analgesic and anti-inflammatory drug as well as the stuff that makes chillies hot. So the hotter the powder, the more capsaicin is in it. But overdosing on capsaicin will just wreck your gut.

My suggestion would be to get capsaicin cream and apply that on the skin in the area that gives you the aches, but in particular near any joints that cause you pain. The skin doesn't let an awful lot of stuff through, but you can get enough of the capsaicin in that way and near the joints the distance between skin and joint pain receptors is at its shortest. Since you support Edinburgh, I assume cost is no issue for you - try and find a high-end cream with the highest capsaicin content. All the rest of the cream is feel-good tender skin stuff for fannies. Alternatively, the NHS might be willing to prescribe it?

In addition, spike your turmeric shot with some chilli powder, an amount that you can handle comfortably (without popping all the veins in your eyeballs and having to show your toilet bowl the Japanese flag every morning). If you notice further improvement, try and up the amount of chilli powder to train yourself to tolerate more. Then see if you can do without the skin cream.

Thank you

this made me chuckle

Since you support Edinburgh, I assume cost is no issue for you

Geography is my reason for supporting Embra, (it's certainly not for the glory-hunting) we were in the South of Scotland schools teams and we cheerily battered the posho city types when it came to it.

[Oxbow]

Asking for the missus. She's never had any problems with her knees before, but for about the past month or so her right knee has been hurting, and sometimes swollen and hot to the touch. During the school holidays she walked about 80 miles over the course of 10 days so wonders if that might have set it off.

She saw a nurse who said it was soft tissue damage and to take painkillers and rest it for a couple of weeks. She's done that (as much as is possible) but it hasn't got any better.

I suppose the best thing to do would be for me to persuade her to go back ("it'll get better on its own"), but any advice you can give in the meantime, however small, will be very gratefully received. Thanks.

[ASMO]

The doctor is most definately in....Clyde you may have opened Pandoras box here given what seems to be our main demographic of mostly old decrepit ex players

[Fangle]

How do you take your turmeric? Pills or powder in water etc? And how much daily! I should try it for my knees as well.

[Tichtheid]

How do you take your turmeric? Pills or powder in water etc? And how much daily! I should try it for my knees as well.

I put a heaped teaspoon of turmeric into a glass of water and stir it, then slug it down.

Putting black pepper into it is supposed to help the active ingredients be absorbed, but I haven't done that.

[Calculon]

Nice to read posts from a genuine expert.
Would running still be bad for your knees if you've never had knee pain and don't weigh much?

[clydecloggie]

Nice to read posts from a genuine expert.
Would running still be bad for your knees if you've never had knee pain and don't weigh much?

Nope. If you are running pain-free, by all means keep doing it. You might want to consider running with padded insoles if you're worried about long-term consequences - shock absorption is a good thing, contrary to what the barefoot might say (for your knees, that is).

[clydecloggie]

Asking for the missus. She's never had any problems with her knees before, but for about the past month or so her right knee has been hurting, and sometimes swollen and hot to the touch. During the school holidays she walked about 80 miles over the course of 10 days so wonders if that might have set it off.

She saw a nurse who said it was soft tissue damage and to take painkillers and rest it for a couple of weeks. She's done that (as much as is possible) but it hasn't got any better.

I suppose the best thing to do would be for me to persuade her to go back ("it'll get better on its own"), but any advice you can give in the meantime, however small, will be very gratefully received. Thanks.

Can you give a bit more detail?

- how often is it red / swollen / warm to the touch
- at which times? After exercise, after waking up, randomly?
- any morning stiffness in the knee, and if yes, how long does it last after getting out of bed?
- is it just the one knee, no other joints with the same issues?
- any history of other joint pain (hands, hips, lower back, shoulder)?

[Oxbow]

Spoiler

Show

Asking for the missus. She's never had any problems with her knees before, but for about the past month or so her right knee has been hurting, and sometimes swollen and hot to the touch. During the school holidays she walked about 80 miles over the course of 10 days so wonders if that might have set it off.

She saw a nurse who said it was soft tissue damage and to take painkillers and rest it for a couple of weeks. She's done that (as much as is possible) but it hasn't got any better.

I suppose the best thing to do would be for me to persuade her to go back ("it'll get better on its own"), but any advice you can give in the meantime, however small, will be very gratefully received. Thanks.

Can you give a bit more detail?

- how often is it red / swollen / warm to the touch
- at which times? After exercise, after waking up, randomly?
- any morning stiffness in the knee, and if yes, how long does it last after getting out of bed?
- is it just the one knee, no other joints with the same issues?
- any history of other joint pain (hands, hips, lower back, shoulder)?

Just heard back from her.

The pain is there pretty much all the time, the swelling etc seems to come and go but is worse when she's been walking more.

It is quite stiff in the morning, and takes around 10 minutes to loosen up a bit.

It's just the right knee, no other joints with the same issue though she has been getting a bit of pain in her right ankle recently. In her non-medical opinion that's because she's walking 'a bit funny' because of her knee.

No history of this sort of thing before, it's just flared up out of nowhere.

Thank for all this.

[Calculon]

Nice to read posts from a genuine expert.
Would running still be bad for your knees if you've never had knee pain and don't weigh much?

Nope. If you are running pain-free, by all means keep doing it. You might want to consider running with padded insoles if you're worried about long-term consequences - shock absorption is a good thing, contrary to what the barefoot might say (for your knees, that is).

Cheers

[Openside]

Rizla

I. was bout to say has anyone mentioned Rizla yet?

[Kawazaki]

Good post, CC.

Way to ruin my placebo effect, though!

Knowing a placebo is a placebo doesn't affect the placebo effect.

[Fangle]

How do you take your turmeric? Pills or powder in water etc? And how much daily! I should try it for my knees as well.

I put a heaped teaspoon of turmeric into a glass of water and stir it, then slug it down.

Putting black pepper into it is supposed to help the active ingredients be absorbed, but I haven't done that.

I appreciate the advice and will definitely try it for an extended period.

[Kawazaki]

How do you take your turmeric? Pills or powder in water etc? And how much daily! I should try it for my knees as well.

I put a heaped teaspoon of turmeric into a glass of water and stir it, then slug it down.

Putting black pepper into it is supposed to help the active ingredients be absorbed, but I haven't done that.

I appreciate the advice and will definitely try it for an extended period.

You can buy Turmeric pills with the black pepper added, cheap as chips. They also have the active ingredient concentrated so you get a big dose of it. I take them with my daily multi-vitamin pill and ibuprofen.

[Fangle]

Daily ibuprofen? Isn’t that bad for the stomach along with other anti-inflammatories? Sometimes I take Naproxen as an anti-inflammatory, but only a couple of days at a time.

[Kawazaki]

Daily ibuprofen? Isn’t that bad for the stomach along with other anti-inflammatories? Sometimes I take Naproxen as an anti-inflammatory, but only a couple of days at a time.

It's only 200mg a day, well within safe limits.

I've got a gammy shoulder which I'm waiting to get fixed once covid allows me back in to see the consultant.

[RichieRich89]

When my wee dog had spinal arthritis what helped her out was green-lipped mussel powder and CBD oil.

[clydecloggie]

Spoiler

Show

Asking for the missus. She's never had any problems with her knees before, but for about the past month or so her right knee has been hurting, and sometimes swollen and hot to the touch. During the school holidays she walked about 80 miles over the course of 10 days so wonders if that might have set it off.

She saw a nurse who said it was soft tissue damage and to take painkillers and rest it for a couple of weeks. She's done that (as much as is possible) but it hasn't got any better.

I suppose the best thing to do would be for me to persuade her to go back ("it'll get better on its own"), but any advice you can give in the meantime, however small, will be very gratefully received. Thanks.

Can you give a bit more detail?

- how often is it red / swollen / warm to the touch
- at which times? After exercise, after waking up, randomly?
- any morning stiffness in the knee, and if yes, how long does it last after getting out of bed?
- is it just the one knee, no other joints with the same issues?
- any history of other joint pain (hands, hips, lower back, shoulder)?

Just heard back from her.

The pain is there pretty much all the time, the swelling etc seems to come and go but is worse when she's been walking more.

It is quite stiff in the morning, and takes around 10 minutes to loosen up a bit.

It's just the right knee, no other joints with the same issue though she has been getting a bit of pain in her right ankle recently. In her non-medical opinion that's because she's walking 'a bit funny' because of her knee.

No history of this sort of thing before, it's just flared up out of nowhere.

Thank for all this.

Thanks for the extra info.

She's probably right that the ankle thing is due to the change in gait pattern because of the painful knee. Good to hear there are no other joints flaring up, as that could be indicative of more serious forms of arthritis that would need proper medical attention.

Relatively short morning stiffness in the knee and constant pain for a considerable length of time tend to be indicative of osteoarthritis as the most likely (and common) issue. Which does not have to be serious - pretty much everyone over 40 has osteoarthritis, it's just that not everyone has any symptoms.

The tricky bit is that exercise is the best medicine for it, but that it can exacerbate symptoms (like swelling and other signs of inflammation). A possible solution is to find exercise that puts less load on the knee. I don't know if it's feasible where you live and whether your wife would be interested in it, but both cycling and swimming can be really good ways of alleviating symptoms. Additionally, some people benefit greatly from either a knee brace or wedged insoles (which subtly change the way forces act on the knee) - they're relatively cheap and they are harmless, so if they don't work the worst that happened is that it cost a few quid. The brace might be a good idea if your wife experiences 'losing control' over her knee, where it suddenly buckles. The insoles I would consider if the pain is primarily in the medial part of the right knee (i.e. the bit closest to the left knee).

If none of this works and the pain persists, I'd be worried that the meniscus might be damaged - which can be very painful and lead to the inflammation you describe. If so, then please go see a real doctor .

[Oxbow]

Spoiler

Show

Can you give a bit more detail?

- how often is it red / swollen / warm to the touch
- at which times? After exercise, after waking up, randomly?
- any morning stiffness in the knee, and if yes, how long does it last after getting out of bed?
- is it just the one knee, no other joints with the same issues?
- any history of other joint pain (hands, hips, lower back, shoulder)?

Just heard back from her.

The pain is there pretty much all the time, the swelling etc seems to come and go but is worse when she's been walking more.

It is quite stiff in the morning, and takes around 10 minutes to loosen up a bit.

It's just the right knee, no other joints with the same issue though she has been getting a bit of pain in her right ankle recently. In her non-medical opinion that's because she's walking 'a bit funny' because of her knee.

No history of this sort of thing before, it's just flared up out of nowhere.

Thank for all this.

Thanks for the extra info.

She's probably right that the ankle thing is due to the change in gait pattern because of the painful knee. Good to hear there are no other joints flaring up, as that could be indicative of more serious forms of arthritis that would need proper medical attention.

Relatively short morning stiffness in the knee and constant pain for a considerable length of time tend to be indicative of osteoarthritis as the most likely (and common) issue. Which does not have to be serious - pretty much everyone over 40 has osteoarthritis, it's just that not everyone has any symptoms.

The tricky bit is that exercise is the best medicine for it, but that it can exacerbate symptoms (like swelling and other signs of inflammation). A possible solution is to find exercise that puts less load on the knee. I don't know if it's feasible where you live and whether your wife would be interested in it, but both cycling and swimming can be really good ways of alleviating symptoms. Additionally, some people benefit greatly from either a knee brace or wedged insoles (which subtly change the way forces act on the knee) - they're relatively cheap and they are harmless, so if they don't work the worst that happened is that it cost a few quid. The brace might be a good idea if your wife experiences 'losing control' over her knee, where it suddenly buckles. The insoles I would consider if the pain is primarily in the medial part of the right knee (i.e. the bit closest to the left knee).

If none of this works and the pain persists, I'd be worried that the meniscus might be damaged - which can be very painful and lead to the inflammation you describe. If so, then please go see a real doctor .

Enormous thanks for that, that's fantastic advice. I've already told her you're the top knee specialist in the country so she has to listen to what you say

[Kawazaki]

Hi folks, your resident knee expert here - knee arthritis has been my main research interest for the last 24 years and I hold a full University Chair in it. So for what it's worth, the evidence says:

1) Everything that you think works, works to some extent. It's called the placebo effect and is one of the most powerful healing mechanisms out there - if it works for you, it works. All subsequent points therefore relate to 'beyond placebo'.
2) Glucosamine and chondroitin don't work. There is no evidence that any meaningful molecule survives digestion and then ends up in the cartilage where it needs to be.
3) Capsaicin (the stuff that makes chillies hot) is the only proven effective nutrient that has an anti-inflammatory and analgesic effect; so much so it's actually available as a prescription drug.
4) Evidence is emerging that turmeric might have similar effects to capsaicin - should be clear within the next few years.
5) All other nutrient claims (most notably broccoli and red wine) are firmly in the bullshit camp. Some interesting chemical reactions have been observed when you put a specific molecule found in these foods/drinks in a petri dish and mix them with molecules known to be involved in various arthritic mechanisms, but that's it and it's miles and miles away from being meaningful to any processes in living human beings.
6) Exercise is a proven effective treatment improving outcomes across the board. The kicker obviously is that exercise can hurt and lots of people with arthritis stop exercising because of that. The good news is that even if exercise hurts, it doesn't do any (additional) joint damage - unless you're talking elite-level high-impact high-duration sport - don't go for that sub-3hr marathon with arthritic knees, folks. A good choice would be to switch from high-impact exercise (e.g. running) to low-impact exercise (cycling, swimming) which have the same cardiovascular benefits with less chance of adverse biomechanical loads affecting your joints.
7) Insoles, adapted shoes, knee braces and gait changes (in particular, walking with a toe-out gait i.e., a slight version of the Charlie Chaplin walk) can be effective if your arthritis is caused by adverse biomechanics - excessive loads on the wrong part of the knee. Current evidence strongly suggests that this is only true for a subset of arthritis patients, but also that these interventions do no harm - if they do not lead to pain reduction, you simply discontinue them and you haven't exposed yourself to harmful side effects unlike with most dug therapies.

Happy to field any questions on this.

I have a question for the expert...

Psoriatic arthritis

My other half suffers from this and it can get quite debilitating for her sometimes. She's had steroid injections which have helped but they wear off soon enough. She also takes Ibuprofen but only if she really has to. She will soon be on a new drug (biologic?) that she will have to self-inject but I'm not sure what the drug is called.

Any tips for this type of arthritis (I have no idea it existed before she told me)?

[clydecloggie]

Hi folks, your resident knee expert here - knee arthritis has been my main research interest for the last 24 years and I hold a full University Chair in it. So for what it's worth, the evidence says:

1) Everything that you think works, works to some extent. It's called the placebo effect and is one of the most powerful healing mechanisms out there - if it works for you, it works. All subsequent points therefore relate to 'beyond placebo'.
2) Glucosamine and chondroitin don't work. There is no evidence that any meaningful molecule survives digestion and then ends up in the cartilage where it needs to be.
3) Capsaicin (the stuff that makes chillies hot) is the only proven effective nutrient that has an anti-inflammatory and analgesic effect; so much so it's actually available as a prescription drug.
4) Evidence is emerging that turmeric might have similar effects to capsaicin - should be clear within the next few years.
5) All other nutrient claims (most notably broccoli and red wine) are firmly in the bullshit camp. Some interesting chemical reactions have been observed when you put a specific molecule found in these foods/drinks in a petri dish and mix them with molecules known to be involved in various arthritic mechanisms, but that's it and it's miles and miles away from being meaningful to any processes in living human beings.
6) Exercise is a proven effective treatment improving outcomes across the board. The kicker obviously is that exercise can hurt and lots of people with arthritis stop exercising because of that. The good news is that even if exercise hurts, it doesn't do any (additional) joint damage - unless you're talking elite-level high-impact high-duration sport - don't go for that sub-3hr marathon with arthritic knees, folks. A good choice would be to switch from high-impact exercise (e.g. running) to low-impact exercise (cycling, swimming) which have the same cardiovascular benefits with less chance of adverse biomechanical loads affecting your joints.
7) Insoles, adapted shoes, knee braces and gait changes (in particular, walking with a toe-out gait i.e., a slight version of the Charlie Chaplin walk) can be effective if your arthritis is caused by adverse biomechanics - excessive loads on the wrong part of the knee. Current evidence strongly suggests that this is only true for a subset of arthritis patients, but also that these interventions do no harm - if they do not lead to pain reduction, you simply discontinue them and you haven't exposed yourself to harmful side effects unlike with most dug therapies.

Happy to field any questions on this.

I have a question for the expert...

Psoriatic arthritis

My other half suffers from this and it can get quite debilitating for her sometimes. She's had steroid injections which have helped but they wear off soon enough. She also takes Ibuprofen but only if she really has to. She will soon be on a new drug (biologic?) that she will have to self-inject but I'm not sure what the drug is called.

Any tips for this type of arthritis (I have no idea it existed before she told me)?

Psoriatic arthritis (PsA) is a rarer form of arthritis which often develops in people with the skin condition psoriasis, although not everyone with psoriasis gets PsA and not everyone with PsA had psoriasis to start with.

Like other forms of inflammatory arthritis, it tends to be present at multiple locations in the body. It has a preference for tendons (like the Achilles tendon) compared to other forms of inflammatory arthritis.

Treatment is very similar to more common forms like rheumatoid arthritis. Standard biologics for that condition therefore tend to be prescribed for PsA as well: Enbrel, Humira or Remicade being the best known ones (those are brand names btw, generic names are etanercept, adalimumab and infliximab). Those are all drugs of a type called anti-TNF (Tumor Necrosis Factor). TNFs are part of the immune system and go into hyperactive mode in auto-immune diseases like PsA, so those drugs block TNF to calm down the immune system and suppress the chronic inflammation. They are very effective in a majority of patients.

It's probably good that she's coming off the steroid injections, which can wreak havoc with tendons in particular.

The same advice on exercise keeps applying: do as much as you can and try and go for types of exercise that combine good cardiovascular effort with low mechanical stress on joints and tendons, like cycling and swimming.

[Uncle fester]

Hi folks, your resident knee expert here - knee arthritis has been my main research interest for the last 24 years and I hold a full University Chair in it. So for what it's worth, the evidence says:

1) Everything that you think works, works to some extent. It's called the placebo effect and is one of the most powerful healing mechanisms out there - if it works for you, it works. All subsequent points therefore relate to 'beyond placebo'.
2) Glucosamine and chondroitin don't work. There is no evidence that any meaningful molecule survives digestion and then ends up in the cartilage where it needs to be.
3) Capsaicin (the stuff that makes chillies hot) is the only proven effective nutrient that has an anti-inflammatory and analgesic effect; so much so it's actually available as a prescription drug.
4) Evidence is emerging that turmeric might have similar effects to capsaicin - should be clear within the next few years.
5) All other nutrient claims (most notably broccoli and red wine) are firmly in the bullshit camp. Some interesting chemical reactions have been observed when you put a specific molecule found in these foods/drinks in a petri dish and mix them with molecules known to be involved in various arthritic mechanisms, but that's it and it's miles and miles away from being meaningful to any processes in living human beings.
6) Exercise is a proven effective treatment improving outcomes across the board. The kicker obviously is that exercise can hurt and lots of people with arthritis stop exercising because of that. The good news is that even if exercise hurts, it doesn't do any (additional) joint damage - unless you're talking elite-level high-impact high-duration sport - don't go for that sub-3hr marathon with arthritic knees, folks. A good choice would be to switch from high-impact exercise (e.g. running) to low-impact exercise (cycling, swimming) which have the same cardiovascular benefits with less chance of adverse biomechanical loads affecting your joints.
7) Insoles, adapted shoes, knee braces and gait changes (in particular, walking with a toe-out gait i.e., a slight version of the Charlie Chaplin walk) can be effective if your arthritis is caused by adverse biomechanics - excessive loads on the wrong part of the knee. Current evidence strongly suggests that this is only true for a subset of arthritis patients, but also that these interventions do no harm - if they do not lead to pain reduction, you simply discontinue them and you haven't exposed yourself to harmful side effects unlike with most dug therapies.

Happy to field any questions on this.

Used to work for a company making this stuff. Paid the bills and kept the lights on but everybody knew it's hokey medicine.

[Kawazaki]

Hi folks, your resident knee expert here - knee arthritis has been my main research interest for the last 24 years and I hold a full University Chair in it. So for what it's worth, the evidence says:

1) Everything that you think works, works to some extent. It's called the placebo effect and is one of the most powerful healing mechanisms out there - if it works for you, it works. All subsequent points therefore relate to 'beyond placebo'.
2) Glucosamine and chondroitin don't work. There is no evidence that any meaningful molecule survives digestion and then ends up in the cartilage where it needs to be.
3) Capsaicin (the stuff that makes chillies hot) is the only proven effective nutrient that has an anti-inflammatory and analgesic effect; so much so it's actually available as a prescription drug.
4) Evidence is emerging that turmeric might have similar effects to capsaicin - should be clear within the next few years.
5) All other nutrient claims (most notably broccoli and red wine) are firmly in the bullshit camp. Some interesting chemical reactions have been observed when you put a specific molecule found in these foods/drinks in a petri dish and mix them with molecules known to be involved in various arthritic mechanisms, but that's it and it's miles and miles away from being meaningful to any processes in living human beings.
6) Exercise is a proven effective treatment improving outcomes across the board. The kicker obviously is that exercise can hurt and lots of people with arthritis stop exercising because of that. The good news is that even if exercise hurts, it doesn't do any (additional) joint damage - unless you're talking elite-level high-impact high-duration sport - don't go for that sub-3hr marathon with arthritic knees, folks. A good choice would be to switch from high-impact exercise (e.g. running) to low-impact exercise (cycling, swimming) which have the same cardiovascular benefits with less chance of adverse biomechanical loads affecting your joints.
7) Insoles, adapted shoes, knee braces and gait changes (in particular, walking with a toe-out gait i.e., a slight version of the Charlie Chaplin walk) can be effective if your arthritis is caused by adverse biomechanics - excessive loads on the wrong part of the knee. Current evidence strongly suggests that this is only true for a subset of arthritis patients, but also that these interventions do no harm - if they do not lead to pain reduction, you simply discontinue them and you haven't exposed yourself to harmful side effects unlike with most dug therapies.

Happy to field any questions on this.

I have a question for the expert...

Psoriatic arthritis

My other half suffers from this and it can get quite debilitating for her sometimes. She's had steroid injections which have helped but they wear off soon enough. She also takes Ibuprofen but only if she really has to. She will soon be on a new drug (biologic?) that she will have to self-inject but I'm not sure what the drug is called.

Any tips for this type of arthritis (I have no idea it existed before she told me)?

Psoriatic arthritis (PsA) is a rarer form of arthritis which often develops in people with the skin condition psoriasis, although not everyone with psoriasis gets PsA and not everyone with PsA had psoriasis to start with.

Like other forms of inflammatory arthritis, it tends to be present at multiple locations in the body. It has a preference for tendons (like the Achilles tendon) compared to other forms of inflammatory arthritis.

Treatment is very similar to more common forms like rheumatoid arthritis. Standard biologics for that condition therefore tend to be prescribed for PsA as well: Enbrel, Humira or Remicade being the best known ones (those are brand names btw, generic names are etanercept, adalimumab and infliximab). Those are all drugs of a type called anti-TNF (Tumor Necrosis Factor). TNFs are part of the immune system and go into hyperactive mode in auto-immune diseases like PsA, so those drugs block TNF to calm down the immune system and suppress the chronic inflammation. They are very effective in a majority of patients.

It's probably good that she's coming off the steroid injections, which can wreak havoc with tendons in particular.

The same advice on exercise keeps applying: do as much as you can and try and go for types of exercise that combine good cardiovascular effort with low mechanical stress on joints and tendons, like cycling and swimming.

Cheers

We have had her new drugs delivered today. Have to be kept in the fridge (think it might be the adalimumab one). Nurse is coming to the house next week to show how to self-administer.

Fingers crossed.