Wednesday, 13 January 2016

Most Common Disease of elder: The Clinical trials and Studies of Musculo-Skeletal disorders(MSDs) - Osteoarthritis: Treatment In herbal and traditional Chinese medicine - The Individual herb

Kyle J. Norton (Scholar, Master of Nutrients, All right reserved)
Health article writer and researcher; Over 10.000 articles and research papers have been written and published on line, including world wide health, ezine articles, article base, healthblogs, selfgrowth, best before it's news, the karate GB daily, etc.,.
Named TOP 50 MEDICAL ESSAYS FOR ARTISTS & AUTHORS TO READ by Disilgold.com Named 50 of the best health Tweeters Canada - Huffington Post
Nominated for shorty award over last 4 years
Some articles have been used as references in medical research, such as international journal Pharma and Bio science, ISSN 0975-6299.

Musculoskeletal disorders (MSDs) are medical condition mostly caused by work related occupations and working environment, affecting patients’ muscles, joints, tendons, ligaments and nerves and developing over time. A community sample of 73 females and 32 males aged 85 and over underwent a standardised examination at home. Musculoskeletal pain was reported by 57% of those interviewed. A major restriction of joint movement range was frequent in the shoulder but uncommon in other joints(1).

Types of Musculo-Skeletal disorders in elder(2)

1. Osteoarthritis
2. Gout
3. Rheumatoid Arthritis
4. Polymalagia Arthritis
5. Cervical myleopathy and spinal canal stenosis
6. Osteoporosis
7. Low back pain
8. Fibromyalgia



                       Osteoarthritis


Osteoarthritis (OA), a form of arthritis, is defined as a condition of as a result of aging causes of wear and tear on a joint, affecting over 25 million people in the United States in alone. University of Porto Medical School indicated that one must understand the differences in prevalence and incidence estimates of osteoarthritis (OA), according to case definition, in knee, hip and hand joints(3).
The characteristics of osteoarthritis are aching pain(5), stiffness(6), or difficulty of moving the joint or joints(7). The pain usually gets worse in change of weather, at night and in the advanced diseases, the pain can occur even at rest(8). Today management of osteoarthritis (OA) focuses on pain relief and improved physical function through pharmacological, non pharmacological, and surgical treatments(4).


                                    The Treatment

B. In herbal  and traditional Chinese medicine perspective
B.2. Herbal and Traditional Chinese medicine 
Many herbal medicine have been found effectively for reduction of symptoms and treatment for patient with osteoarthritis(430), including 
B.2.1. Individual herb
1. Ginger
Ginger has been used internally and externally for over a thousand years in China to manage all types of arthritis symptoms, through its effective in compress therapy(431). According to Dr. Therkleson T., in the study of 20 adults with moderate to severe osteoarthritis(414). On a self-report arthritis Health Assessment Questionnaire, topical ginger  showed to relief osteoarthritic symptoms, in both  body physiological recordings and pain scale(415).
The Edith Cowan University, in the study of a self-treatment using the ginger patch for a further 24 week, showed that ginger treatment relieve symptoms, improve the overall health, and increase independence of people with chronic osteoarthritis(416).
Ginger extract, according to Frederiksberg Hospital, in adouble blind study conducted in accordance with Good Clinical Practice (European Guideline for GCP), exhibited a statistically significant effect on reducing symptoms of OA of the knee(432).

2. Willow bark
A herbal medicine used over thousands of years for treatment as an anti-inflammatory, antipyretic, and analgesic advocate in many culture(433). Its extract, according to studies may be a potential medicine  for treatment of patient with painful  osteoarthritis(434)(436) or used conjunction with NSAIDs and opioids(434).
In the trail of total of 78 patients (39 willow bark extract, 39 placebo),. researcher sat the Universität Tübingen showed that Willow bark extract reduces pain, stiffness and improvesphysical function
after 2 weeks of treatment for patient with OA, through its moderate analgesic effect with tolerate side effects(437).
Unfortunately, the study by the Eberhard Karls-Universität, in the 127 outpatients with hip or knee OA 2 randomized, controlled, double-blind trials with followup for 6 weeks, showed insufficient different of the herbal extract in comparison to the placebo(435).

3. Stinging nettle
Stinging nettle also known as Urtica dioica, a herbal medicine with long history for the effectiveness in treating of getting rid of water in the body and relieve pain, showed  to relive pain and reduce risk of progression of the disease patients with osteoarthritis(438)(439). Application of stinging nettle daily for one week to the painful area in patient with OA, effectively relieves more pain in comparison to placebo(442)
In a randomized double-blind parallel-groups clinical trial, conduced by the University of Bordeaux, Phytalgic (fish-oil, vitamin E, Urtica dioica) improve not only the symptoms of patient with osteoarthritis. but also reduced the need for analgesics and NSAIDs(440).
 Dr. Christensen R, and Dr. Bliddal H. said " Phytalgic... tested in a placebo-controlled trial for 3 months and according to the authors has a very large clinical effect, considerably larger than that of any other known product. Even experts endorsing nutraceuticals for OA symptoms.."(441).

4. Devil’s claw
Devil’s claw is also one most common used in alternative medicine for treatment of patient suffering from osteoarthritis(443), probably through anti inflammatory activity(446) in inhibition of different proinflammatory mediators(447)(448).
 In the review of the data of literature on Devil's Claw and OA from 1966 to 2006, research at the University of Southampton indicated that Devil's Claw exhibits effectively the reduction of the main clinical symptom of pain in OA patient but suggestion of it safety in use is necessary(444).
Dr. Chrubasik S said that preparations of devil's claw extract, should be taken account of the presence of the quantity of harpagoside of which has proven importantly in relived painful lower back or arthrotic pain as an attractive alternative to synthetic analgesics(445).

5. Hot Chilli (Capsaicin)
Topical capsaicin is considered as alternative therapy in patient with osteoarthritis, without any severe adverse effects, according to Dr Rains C, and Bryson HM(449).
Topical Capsaicin cream used for treatment of soft tissue with a pharmaceutical name of Finalgon®(420), may be effective for treatment of osteoarthritis in dependent to its concentration.
In a randomized, single-blind, 28-day study conducted by Research Testing Laboratories, capsaicin cream (0.25%) applied twice daily, showed to relieve severity of osteoartghritic pain with side effect of burning sensation(419).
Civamide cream produced by Winston Pharmaceuticals, approved by FDA, civamide cream is a cis-isomer of capsaicin topical medication used for treatment of osteoarthritis of the knee and other neuropathic pain(417). In the study by Northwestern University Feinberg School of Medicine, in patients with OA of the knee, civamide cream 0.075% or a lower dose of civamide cream, 0.01% effectively in relieve pain and improve physical functions(418).

5. Green Tea
Green tea  has been a precious drink in traditional Chinese culture and used exceptional in socialization for more than 4000 thousand years. 
In mouse model, epigallocatechin 3-gallate (EGCG), a polyphenol present in green tea, exhibited reduced OA palliative effect and progression, through less Safranin O loss and cartilage erosion(450) by attenuating the inflammation induced by calcium pyrophosphate crystals(452)(453).
Sunphenon, a green tea extract has shown to enhance bone mineralization, relieves osteoarthritis, and aids digestion, through its antioxidant effects(451).
According to the Texas Tech University Health Sciences Center, epigallocatechin gallate and green tea extract, suppressed the condition caused in part by injury, loss of cartilage structure and function, through their effects in balanced inflammatory and anti-inflammatory pathways(454),  probably caused by IL-1β, a major cytokine driving the inflammatory processes(455)(456).

6. Turmeric
Turmeric, a cooking spice used in many culture in South East Asian, especially in India, also has been used as herbal medicine over thousands of year as anti-oxidant, hypoglycemic, colorant, antiseptic, wound healing agent, and to treat flatulence, bloating, and appetite loss, ulcers, eczema, inflammations, etc.(457). Curcumin (Cur) and bisdemethoxycurcumin (BDMC), extracted from Curcuma longa slow osteoarthritis progression against bone turn over through the stimulation of interleukin (IL)-1β , downregulate the expression of inflammatory markers on osteoblasts(459).
The joint study St. Louis University School of Medicine and University of Nebraska Medical Center in review of research at the laboratory, translational and clinical levels data found that most the studies and trails supports the use of curcumin for various musculoskeletal disorders, including osteoarthritis, osteoporosis,..(458). In the antioxidant perspective, curcuminoids relieve osteoarthritis symptoms. through reduction of systemic oxidative stress(460)  in patients with knee osteoarthritis(460).
The Belgium study of 820 patients treated with a new Curcuma extract (Flexofytol®, 4-6 capsules per day), suggested that the extract improves patient pain, articular mobility, and quality of life. Within the first 6 weeks, more than half of participants were able to discontinue analgaesic and anti-inflammatory drugs with tolerate adverse effects(461)

7. Cat's claw
Cat's claw (Uncaria tomentosa), the very commonherbal medicine, has been used in traditional medicine over two thousand years as a tonic, contraceptive, anti-inflammatory and infectious agent, and to treat diarrhea, rheumatic disorders, acne, diabetes, cancer and diseases of the urinary tract, etc.(462). The The natural mineral supplement, sierrasil combined with a cat's claw extract, may be protential treatment to improved joint health, according to a a randomized controlled trial (466). Recently, according to the study by Case Western Reserve University, herbal and amino acid mixture containing extract of the Uncaria tomentosa, may be potentially useful as a new adjunct therapeutic/preventive agent for OA or injury recovery effectively, due to its anti inflammatory(464) and chondroprotective activities, in up-regulation of ACAN and COL2A1 expression in IL-1β-stimulated and inhibiting the activation of nuclear factor (NF)-kB in human OA chondrocytes(463) as well as reducing of pro-inflammatory mediators and effectors(464).
The Facultad de Medicina, in the comparison of the species U guianensis and U tomentosa, found that both herbal medicine are effective in treatment of Osteoarthritis, probably through its anti-inflammatory properties in inhibited TNFalpha and PGE2 production(465).

8. Bromelain
Bromelain, a group of protein digesting enzymes  found in pineapples (Ananas comosus) has been used in traditional medicine as inflammatory agent and to treat pains, strains, and muscle aches and pains and ease back pain and chronic joint pain, skin diseases, etc.(467). The herbal medicine may be used as valuable and safe alternative to NSAIDs in patients suffering acute and chronic OA pain from degenerative joint diseases due to its anti-inflammatory and analgesic effects(468).
According to the Rehabilitation Centre for Cardiovascular and Rheumatic Diseases, oral enzyme therapy (Phlogenzym-(PE)), has found effectively in treatment for patient with osteoarthritis with high levels of pain due to signs of inflammation(469). Other oral enzyme-rutosid combination (ERC) containing rutosid and the enzymes bromelain and trypsin, showed to consist the same effectiveness as NSAIDs in the treatment of painful episodes of OA of the knee(471).
Dr. Brien S and the research team in the study of the anti-inflammatory and analgesic properties in patient with osteoarthritis said that more studies and trials are necessary to trials to establish the efficacy and optimum dosage for bromelain as a safer alternative or adjunctive treatment for osteoarthritis(470).

10. Boswellia serrata 
 Boswellia serrata used as incense in religious and cultural ceremonies and in medicine over thousands of year may be the potential source for treatment of osteoarthritis due to its anti inflammatory(472), anti-arthritic and analgesic activity activity(473) in decreased knee pain, increased knee flexion and increased walking distance(473).
FlexiQule, the commercial Boswellia extract, improved pain, stiffness, physical, social/emotional functions and walking distance at 4 weeks of treatment with patient of symptomatic knee osteoarthritis (OA)(474), the Circulation Sciences and the International Irvine Network suggested.
DR. Kizhakkedath said that formula containing Curcuma longa and Boswellia serrata extracts (CB formulation) at 500 mg administered twice a day in a directly compared with the selective COX-2 inhibitor, celecoxib at 100 mg twice a day, induced more successful symptom scoring and clinical examination(475).
The study of Indira Gandhi Medical College also supported of  Boswellia extract effectiveness  by decreasing in knee pain, increasing knee flexion and walking distance of in the study of 30 patient with osteoarthritis of knee(476).

11. Gingko
Gingko is  also known as Ginkgo biloba, one of the oldest herbal medicine in human medical history, used in traditional herbal medicine in treating impotence, memory loss,respiratory diseases, circulatory disorders,,...(477).
Gingko extract, with anti inflammatory(478) and immune modulatory(479) activities may be a potential herbal medicine for treatment of osteoarthritis by inhibiting the interleukin-1 (IL-1)-stimulated human chondrocytes degeneration and MMP(matrix metalloproteinases)-1, MMP-3, and 13.causes of cartilage degradation(481)(482) found in patient of osteoarthritis(480) of which  make the extract the candidate as a potential therapeutic agent, according to the Postgraduate Institute of Medical Education and Research(480).
In Osteoarthritis (OA) rat model, the extract EGb761, a standardized extract of Ginkgo biloba leaves also expressed its anti inflammatory effect on human articular chondrocytes of which inhibited cartilage degradation(482).

12. Dan Shen
Dan Shen with the pharmaceutical name of Radix Salvia miltiorrhizae, is a bitter and slightly cold herb, used mainly in traditional Chinese medicine for tonifying blood(494), such as getting rid of clot blood, invigorate blood, breakup blood stasis,... through its effects on liver and heart meridians.
In the animal model study of rabbits, with severe articular cartilage degeneration and lower proteoglycan (PG), the herbal medicine Dan Shen showed effectively in against oxidative stress causes ofarticular cartilage degeneration in patient with Osteoarthritis OA(491).
According to Veterinary Herbal Medicine By Susan G. Wynn, Barbara Fougère, page 349. Dan Shen induced formation of dense callus and increased activity of osteoblasts of which enhanced the improvement of bone heeling(492). Certain studies found in Dan Shen (Salvia miltiorrhiza) in Medicine: Volume 2. Pharmacology ..., Volume 2 edited by Xijun Yan also supported the use of Dan Shen injection for treatment of osteoarthritis because of its anti inflammatory effect(493).

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References
(1) Prevalence of rheumatic symptoms, rheumatoid arthritis, ankylosing spondylitis, and gout in Shanghai, China: a COPCORD study by Dai SM1, Han XH, Zhao DB, Shi YQ, Liu Y, Meng JM.(PubMed)
(2) Musculoskeletal Disorders in the Elderly by Ramon Gheno, Juan M. Cepparo, Cristina E. Rosca,1 and Anne Cotten(PMC)
(3) The effect of osteoarthritis definition on prevalence and incidence estimates: a systematic review by Pereira D1, Peleteiro B, Araújo J, Branco J, Santos RA, Ramos E.(PubMed)
(4) Effect of therapeutic aquatic exercise on symptoms and function associated with lower limb osteoarthritis: systematic review with meta-analysis by Waller B1, Ogonowska-Slodownik A2, Vitor M3, Lambeck J4, Daly D5, Kujala UM6, Heinonen A7.(PubMed)
(5) Effects of therapeutic ultrasound on pain, physical functions and safety outcomes in patients with kneeosteoarthritis: A systematic review and meta-analysis by Zhang C1, Xie Y2, Luo X3, Ji Q3, Lu C3, He C4, Wang P3.(PubMed)
(6) Oral intake of purple passion fruit peel extract reduces pain and stiffness and improves physical function in adult patients with knee osteoarthritis by Farid R1, Rezaieyazdi Z, Mirfeizi Z, Hatef MR, Mirheidari M, Mansouri H, Esmaelli H, Bentley G, Lu Y, Foo Y, Watson RR.(PubMed)
(7) Functional ability, mobility, and pain before and after knee replacement in patients aged 75 and older: a cross-sectional study by Limnell K1, Jämsen E, Huhtala H, Jäntti P, Puolakka T, Jylhä M.(PubMed)
(8) The symptoms of OA and the genesis of pain by David J. Hunter, MBBS PhD,1,2 Jason J. McDougall, BSc PhD,3 and Francis J. Keefe4(PubMed)
(430) Herbal medicines for the treatment of osteoarthritis: a systematic review by L. Long, K. Soeken 1 and E. Ernst(Rheumatology)
(431) Ginger compress therapy for adults with osteoarthritis by Therkleson T1.(PubMed)
(432) Effects of a ginger extract on knee pain in patients with osteoarthritis by Altman RD1, Marcussen KC.(PubMed)
(433) Efficacy and Safety of White Willow Bark (Salix alba) Extracts by Shara M1, Stohs SJ2.(PubMed)
(434) Willow bark extract STW 33-I in the long-term treatment of outpatients with rheumatic pain mainly osteoarthritisor back pain by Uehleke B1, Müller J, Stange R, Kelber O, Melzer J.(PubMed)
(435) Efficacy and safety of willow bark extract in the treatment of osteoarthritis and rheumatoid arthritis: results of 2 randomized double-blind controlled trials by Biegert C1, Wagner I, Lüdtke R, Kötter I, Lohmüller C, Günaydin I, Taxis K, Heide L.(PubMed)
(436) Willow bark extract, a useful alternative for the treatment of osteoarthritis: comment on the editorial by Marcus and Suarez-Almazor by Chrubasik S, Pollak S, Black A.(PubMed)
(437) Efficacy and tolerability of a standardized willow bark extract in patients with osteoarthritis: randomized placebo-controlled, double blind clinical trial by Schmid B1, Lüdtke R, Selbmann HK, Kötter I, Tschirdewahn B, Schaffner W, Heide L.(PubMed)
(438) STINGING NETTLE CREAM FOR OSTFOARTHRITIS  by Keith Rayburn, MD; Eric Fleischbein, PharmD; Jessica Song, PharmD; Blaine Allen, RN; Mary Kundert, PharmD; Charles Leiter, PharmD; Thomas Bush, MD(Research letter)
(439) Stinging nettle cream for osteoarthritis by Rayburn K1, Fleischbein E, Song J, Allen B, Kundert M, Leiter C, Bush T.(PubMed)
(440) Phytalgic, a food supplement, vs placebo in patients with osteoarthritis of the knee or hip: a randomised double-blind placebo-controlled clinical trial by Jacquet A1, Girodet PO, Pariente A, Forest K, Mallet L, Moore N.(PubMed)
(441) Is Phytalgic(R) a goldmine for osteoarthritis patients or is there something fishy about this nutraceutical? A summary of findings and risk-of-bias assessment by Christensen R, Bliddal H.(PubMed)
(442) Randomized controlled trial of nettle sting for treatment of base-of-thumb pain by Randall C1, Randall H, Dobbs F, Hutton C, Sanders H.(PubMed)
(443) The use of glucosamine, devil's claw (Harpagophytum procumbens), and acupuncture as complementary and alternative treatments for osteoarthritis by Sanders M1, Grundmann O.(PubMed)
(444) Devil's Claw (Harpagophytum procumbens) as a treatment for osteoarthritis: a review of efficacy and safety by Brien S1, Lewith GT, McGregor G.(PubMed)
(445) [Devil's claw extract as an example of the effectiveness of herbal analgesics].[Article in German] by Chrubasik S1.(PubMed)
(446) A complex of three natural anti-inflammatory agents provides relief of osteoarthritis pain by Conrozier T, Mathieu P, Bonjean M, Marc JF, Renevier JL, Balblanc JC.(PubMed)
(447) Alteration of anti-inflammatory activity of Harpagophytum procumbens (devil's claw) extract after external metabolic activation with S9 mix by Hostanska K1, Melzer J, Rostock M, Suter A, Saller R.(PubMed)
(448) A review of the efficacy and safety of devil's claw for pain associated with degenerative musculoskeletal diseases, rheumatoid, and osteoarthritis by Denner SS1.(PubMed)
(449) Topical capsaicin. A review of its pharmacological properties and therapeutic potential in post-herpetic neuralgia, diabetic neuropathy and osteoarthritis by Rains C1, Bryson HM.(PubMed)
(450) Green tea polyphenol treatment is chondroprotective, anti-inflammatory and palliative in a mouse post-traumaticosteoarthritis model by Leong DJ, Choudhury M, Hanstein R, Hirsh DM, Kim SJ, Majeska RJ, Schaffler MB, Hardin JA, Spray DC, Goldring MB, Cobelli NJ, Sun HB.(PubMed)
(451) Antioxidant and pro-apoptotic effects of marine-derived, multi-mineral aquamin supplemented with a pine bark extract, Enzogenol, and a green tea extract, Sunphenon. by O'Callaghan YC1, Drummond E, O'Gorman DM, O'Brien NM.(PubMed)
(452) Epigallocatechin-3-gallate reduces inflammation induced by calcium pyrophosphate crystals in vitro by Oliviero F1, Sfriso P, Scanu A, Fiocco U, Spinella P, Punzi L.(PubMed)
(453) Epigallocatechin-3-gallate selectively inhibits interleukin-1beta-induced activation of mitogen activated protein kinase subgroup c-Jun N-terminal kinase in human osteoarthritis chondrocytes. by Singh R1, Ahmed S, Malemud CJ, Goldberg VM, Haqqi TM.(PubMed)
(454) Dietary polyphenols and mechanisms of osteoarthritis by Shen CL1, Smith BJ, Lo DF, Chyu MC, Dunn DM, Chen CH, Kwun IS.(PubMed)
(455) Green tea: a new option for the prevention or control of osteoarthritis by Katiyar SK, Raman C.(PubMed)
(456) Epigallocatechin-3-gallate selectively inhibits interleukin-1beta-induced activation of mitogen activated protein kinase subgroup c-Jun N-terminal kinase in human osteoarthritis chondrocytes by Singh R1, Ahmed S, Malemud CJ, Goldberg VM, Haqqi TM.(PubMed)
(457) Popular #Herbs - Turmeric (Curcuma longa) by Kyle J. Norton
(458) Role of Curcumin in Common Musculoskeletal Disorders: a Review of Current Laboratory, Translational, and Clinical Data by Peddada KV1, Peddada KV2, Shukla SK3, Mishra A3, Verma V4.(PubMed)
(459) Evaluation of the protective effects of curcuminoid (curcumin and bisdemethoxycurcumin)-loaded liposomes against bone turnover in a cell-based model of osteoarthritis by Yeh CC1, Su YH2, Lin YJ2, Chen PJ2, Shi CS3, Chen CN2, Chang HI2.(PubMed)
(460) Mitigation of Systemic Oxidative Stress by Curcuminoids in Osteoarthritis: Results of a Randomized Controlled Trial by Panahi Y1, Alishiri GH, Parvin S, Sahebkar A.(PubMed)
(461) A new curcuma extract (flexofytol®) in osteoarthritis: results from a belgian real-life experience by Appelboom T1, Maes N2, Albert A3.(PubMed)
(462) Cat's claw (Uncaria tomentosa) by Kyle J. Norton
(463) Effect of a Herbal-Leucine mix on the IL-1β-induced cartilage degradation and inflammatory gene expression in human chondrocytes by Akhtar N1, Miller MJ, Haqqi TM.(PubMed)
(464) Cat's claw: an Amazonian vine decreases inflammation in osteoarthritis by Hardin SR1.(PubMed)
(465) Efficacy and safety of freeze-dried cat's claw in osteoarthritis of the knee: mechanisms of action of the species Uncaria guianensis by Piscoya J1, Rodriguez Z, Bustamante SA, Okuhama NN, Miller MJ, Sandoval M.(PubMed)
(466) Early relief of osteoarthritis symptoms with a natural mineral supplement and a herbomineral combination: a randomized controlled trial [ISRCTN38432711] by Miller MJ1, Mehta K, Kunte S, Raut V, Gala J, Dhumale R, Shukla A, Tupalli H, Parikh H, Bobrowski P, Chaudhary J.(PubMed)
(467) Popular #Herbs - Bromelain by Kyle J. Norton
(468) A complex of three natural anti-inflammatory agents provides relief of osteoarthritis pain by Conrozier T, Mathieu P, Bonjean M, Marc JF, Renevier JL, Balblanc JC.(PubMed)
(469) Efficacy and tolerance of an oral enzyme combination in painful osteoarthritis of the hip. A double-blind, randomised study comparing oral enzymes with non-steroidal anti-inflammatory drugs by Klein G1, Kullich W, Schnitker J, Schwann H.(PubMed)
(470) Bromelain as a Treatment for Osteoarthritis: a Review of Clinical Studies by Brien S, Lewith G, Walker A, Hicks SM, Middleton D.(PubMed)
(471) Oral enzyme combination versus diclofenac in the treatment of osteoarthritis of the knee--a double-blind prospective randomized study by Akhtar NM1, Naseer R, Farooqi AZ, Aziz W, Nazir M.(PubMed)
(472) Boswellia Serrata, A Potential Antiinflammatory Agent: An Overview by M. Z. Siddiqui(PMC)
(473) Efficacy and tolerability of Boswellia serrata extract in treatment of osteoarthritis of knee--a randomized double blind placebo controlled trial by Kimmatkar N1, Thawani V, Hingorani L, Khiyani R.(PubMed)
(474) FlexiQule (Boswellia extract) in the supplementary management of osteoarthritis: a supplement registry by Belcaro G1, Dugall M, Luzzi R, Ledda A, Pellegrini L, Cesarone MR, Hosoi M, Errichi M, Francis S, Cornelli U.(PubMed)
(475) Clinical evaluation of a formulation containing Curcuma longa and Boswellia serrata extracts in the management of knee osteoarthritis by Kizhakkedath R1.(PubMed)
(476) Efficacy and tolerability of Boswellia serrata extract in treatment of osteoarthritis of knee--a randomized double blind placebo controlled trial by Kimmatkar N1, Thawani V, Hingorani L, Khiyani R.(PubMed)
(477) Popular Herbs - Ginkgo biloba by Kyle J. Norton
(478) Ginkgo biloba extract EGb 761 has anti-inflammatory properties and ameliorates colitis in mice by driving effector T cell apoptosis by Venkata S. Kotakadi,† Yu Jin,† Anne B. Hofseth, Lei Ying, Xiangli Cui, Suresh Volate, Alexander Chumanevich, Patricia A. Wood,1 Robert L. Price,2 Anna McNeal,2 Udai P. Singh,2 Narendra P. Singh,2 Mitzi Nagarkatti,2 Prakash S. Nagarkatti,2 Lydia E. Matesic,3 Karine Auclair,4 Michael J. Wargovich,5 and Lorne J. Hofseth(PMC)
(479) Effectiveness of oral Ginkgo biloba in treating limited, slowly spreading vitiligo by Parsad D1, Pandhi R, Juneja A.(PubMed)
(480) Ginkgo biloba extract individually inhibits JNK activation and induces c-Jun degradation in human chondrocytes: potential therapeutics for osteoarthritis by Ho LJ1, Hung LF2, Liu FC3, Hou TY3, Lin LC4, Huang CY2, Lai JH5.(PubMed)
(481) Inhibitory effects of EGb761 on the expression of matrix metalloproteinases (MMPs) and cartilage matrix destruction by Wang X1, Zhao X, Tang S.(PubMed)
(482) EGb761 inhibits inflammatory responses in human chondrocytes and shows chondroprotection in osteoarthritic rat knee by Chen YJ1, Tsai KS, Chiu CY, Yang TH, Lin TH, Fu WM, Chen CF, Yang RS, Liu SH.(PubMed)
(483) Phytodolor--effects and efficacy of a herbal medicine by Gundermann KJ1, Müller J.(PubMed)
(484) Phytodolor® in musculoskeletal disorders: re-analysis and meta-analysis by Uehleke B1, Brignoli R, Rostock M, Saller R, Melzer J.(PubMed)
(485) Selected CAM therapies for arthritis-related pain: the evidence from systematic reviews.
Soeken KL1.(PubMed)
(486) EFFECT OF A PROPRIETARY HERBAL MEDICINE ON THE RELIEF OF CHRONIC ARTHRITIC PAIN: A DOUBLE-BLIND STUDY by S. Y. MILLS, R. K. JACOBY*, M. CHACKSFIELD and M. WILLOUGHBY(Rheumatology)
(487) Effect of a proprietary herbal medicine on the relief of chronic arthritic pain: a double-blind study by Mills SY1, Jacoby RK, Chacksfield M, Willoughby M.(PubMed)
(488) [Gitadyl versus ibuprofen in patients with osteoarthrosis. The result of a double-blind, randomized cross-over study].[Article in Danish]by Ryttig K1, Schlamowitz PV, Warnøe O, Wilstrup F.(PubMed)
(489) Gitadyl versus ibuprofen in patients with osteoarthritis: a double-blind, randomized, cross-over study of clinical efficacy and effects on platelets and PMNs by Mieszczak CI1, Kharazmi A, Rein J, Winther K.(PubMed)
(490) [Gitadyl versus ibuprofen].[Article in Danish] by [No authors listed](PubMed)
(491) Danshen prevents articular cartilage degeneration via antioxidation in rabbits with osteoarthritis by Bai B1, Li Y2.(PubMed)
(492) Veterinary Herbal Medicine By Susan G. Wynn, Barbara Fougère, page 349.
(493) Dan Shen (Salvia miltiorrhiza) in Medicine: Volume 2. Pharmacology ..., Volume 2 edited by Xijun Yan 

Tuesday, 12 January 2016

Most Common Disease of elder: The Clinical trials and Studies of Musculo-Skeletal disorders(MSDs) - Osteoarthritis: Treatment In herbal and traditional Chinese medicine - The alternative natural treatment

Kyle J. Norton (Scholar, Master of Nutrients, All right reserved)
Health article writer and researcher; Over 10.000 articles and research papers have been written and published on line, including world wide health, ezine articles, article base, healthblogs, selfgrowth, best before it's news, the karate GB daily, etc.,.
Named TOP 50 MEDICAL ESSAYS FOR ARTISTS & AUTHORS TO READ by Disilgold.com Named 50 of the best health Tweeters Canada - Huffington Post
Nominated for shorty award over last 4 years
Some articles have been used as references in medical research, such as international journal Pharma and Bio science, ISSN 0975-6299.

Musculoskeletal disorders (MSDs) are medical condition mostly caused by work related occupations and working environment, affecting patients’ muscles, joints, tendons, ligaments and nerves and developing over time. A community sample of 73 females and 32 males aged 85 and over underwent a standardised examination at home. Musculoskeletal pain was reported by 57% of those interviewed. A major restriction of joint movement range was frequent in the shoulder but uncommon in other joints(1).

Types of Musculo-Skeletal disorders in elder(2)

1. Osteoarthritis
2. Gout
3. Rheumatoid Arthritis
4. Polymalagia Arthritis
5. Cervical myleopathy and spinal canal stenosis
6. Osteoporosis
7. Low back pain
8. Fibromyalgia



                       Osteoarthritis


Osteoarthritis (OA), a form of arthritis, is defined as a condition of as a result of aging causes of wear and tear on a joint, affecting over 25 million people in the United States in alone. University of Porto Medical School indicated that one must understand the differences in prevalence and incidence estimates of osteoarthritis (OA), according to case definition, in knee, hip and hand joints(3).
The characteristics of osteoarthritis are aching pain(5), stiffness(6), or difficulty of moving the joint or joints(7). The pain usually gets worse in change of weather, at night and in the advanced diseases, the pain can occur even at rest(8). Today management of osteoarthritis (OA) focuses on pain relief and improved physical function through pharmacological, non pharmacological, and surgical treatments(4).


                                    The Treatment

B. In herbal  and traditional Chinese medicine perspective
B.7. The alternative natural treatment 
Beside suggesting certain herbal medicine for treatment of osteoarthritis, modern herbal and TCM medicine doctors may also combine other natural treatment for alleviating symptoms of the disease
1. Use Ice or Heat Therapies therapy
Ice therapy such as repeated, rather than continuous, ice applications may be considered as an effective treatment for some patient with osteoarthritis(380) as it reduces swelling and pain(380), if the therapy is applied correctly to avoid side effects, and prevent possible further injury, but according to Dr. Mac Auley DC. as the therapy has shown to impair reflex activity and motor function  up to 30 following treatment.(378). The doctor also said that guidance on the duration, frequency, or length of ice treatment may be depending on the particular ice therapy, injury location, or severity(379). Heat therapy has shown to loosen tissues and relax stiff joints may also benefits to some patient of osteoartritis(381). According to the study by University of Haifathermal and athermal short-wave diathermyhave shown effectively for the management of knee osteoarthritis(382).

2. Acupuncture
The most oldest form of medical treatment in traditional Chinese medicine has been known for its function in relief pain(383) and functional limitation(384) for chronic patient, including patient with moderate or severe chronic knee pain(383), peripheral joint osteoarthritis(384) and hip osteoarthritis(385) with many different techniques, such as acupuncture techniques, moxibustion, transcutaneous electrical nerve stimulation(392).
In pain management, acupuncture is found to significant reduce pain intensity, improve functional mobility and quality of life in patient with osteoarthritis (386). According to the University of York, in patient with knee osteoarthritis, in a systematic review with network meta-analysis, indicated that
acupuncture is considered as one of the more effective physical treatments for alleviating osteoarthritis knee pain in the short-term, but due to poor quality of the study(387), larger sample size and multi sample studies are necessary to confirm this claim.
Dr. Vas J. and Dr..White A said "... optimal results from acupuncture treatment for osteoarthritis of the knee may involve: climatic factors, particularly high temperature; high expectations of patients; minimum of four needles; electroacupuncture rather than manual acupuncture, and particularly, strong electrical stimulation to needles placed in muscle; and a course of at least 10 treatments"(388)

3. Massage Therapy
Massage therapy has been used in traditional Chinese medicine over thousands of year for treatment of osteoarthritis (OA)(392)(389), especially for OA patient for short-term pain relief(389). In a sixty-eight adults with radiographically confirmed OA, massage therapy seems to be most efficacious relief pain, stiffness, and improve physical function limitation for patient OA of the knee(390).
According to the joint study by the University Medical Center and Avans University of Applied Scienc, in a systematic review of randomised clinical trials, said that there is a evidence indicated that massage improves function in the short term compared to no treatment in people with knee arthritis(391)

4. Spa therapy
Spa therapy may be one the effective technique for treatment of lower back pain, according to some studies(392)(393)9394). In patient with rheumatoid arthritis, spa therapy showed to relief symptoms of pain, stiffness and mobility(395). According to the joint study by the  University of Siena and Spa Centre of Fonteverde Natural Spa Resort, the clinical trials conducted exhibited the support of spa therapy on pain, function and quality of life in hand OA(396), if used conjunction with the application of thermal treatments(396). In patient with knee osteoarthritis, especially in European countries, although the spa treatment is still the subject of debate, the existence of data of some clinical trials suggested a beneficial effect of spa therapy on pain, function and quality of life in knee OA if the treatment cover the duration from six to nine months(397).
In the study conducted by the University of Siena, Viale Bracci, spa therapy showed effectively in modified plasma levels of leptin and adiponectin of which are, important mediators of cartilage metabolism and related to the development of knee osteoarthritis(398)

5. Hydrotherapy
Hydrotherapy, using water for the treatment of disease has shown some beneficiary for treating pain in patient with lower back pain(399), joint hemorrhages(400) and multiple sclerosis(401). In patient with knee osteoarthritis, water therapy reduced knee pain and increased knee function in participants with knee OA as effectively as conventional based therapy(402).
In a randomized controlled trial conducted among 152 older persons with chronic symptomatic hip or knee OA by the University of Sydney, hydrotherapy or Tai Chi classes showed to enhance large and sustained improvements in physical function for many older, sedentary individuals with chronic hip or knee OA(403).
In lower limb osteoarthritis, the study of 106 patients (93 women, 13 men) over the age of 60 years with confirmed hip and/or knee OA suggested that water exercise induced significantly reduction in pain and improvement in physical function of the participants after 1 year with a favourable cost--benefit outcome(404).
Unfortunately, the water gym study conducted by the Universidade Estadual Paulista Júlio Mesquita Filho, showed no beneficiary in improving symptoms of individuals with knee OA(405).

6. Tai Chi
Tai chi, an ancient form of mind-body exercise or technique used in Chinese with meditative movements that promote balance and healing of the mind and body induced mental concentration, physical balance, muscle relaxation, and relaxed breathing(406).
In chronic diseases, such as osteoarthritis, Tai Chi improve physical performance(408), such as walking distance (6MWD) and knee extensor strength and pain(408) and stiffness of patient with osteoarthritis(407) and knee osteoarthritis(408)(409).
In the assessing  the effectiveness of Tai Chi for knee osteoarthritis, conducted by Tufts University School of Medicine, Tai Chi therapy improved WOMAC pain(411) and stiffness scores, physical(411) and lower-extremity function, knee proprioception, ect., after 12, 24 and 48 weeks(410).

7. Yoga
An ancient form of medical technique originated from India, is become a popular multimodal mind-body exercise in the Western world for promoted flexibility, strength, endurance, and balance(412). According to the study by the University of Minnesota, Minneapolis (CC, JFW), Yoga 45 to 90 mins per session for 6 to 12 wks, reduced pain, stiffness, and swelling, inpatient with osteoarthritis of the knees(413) or osteoarthritis but the study showed an inconclusive outcome on physical function and psychosocial well-being(412).

8. Chiropractic
 Chiropractic is one the alternative therapy for diagnosis and treatment of Musculoskeletal disorders (MSDs), including osteoarthritis. It is one the primary care of hip osteoarthritis in Denmark(425)
According to the Cleveland Chiropractic College, chiropractic increased range of motion, improved balance and gait speed, and decreased disability after a 12-week course in a 70 year old geriatric patient with left hip pain, a history of repetitive falls, poor balance, myofascial dysfunction, and hip osteoarthritis(424) of that may contribute to a conservative management options for patient with hip osteoarthritis(426).
Chiropractic management showed to decreased WOMAC scores and increases in hip range of motion in patient of hip osteoarthritis, according to the study by Autralia(427) and may provide a short-term benefit to relieve hip pain for patients with hip osteoarthritis waiting for hip surgery(428), according to the report of Scandinavian College of Chiropractic. 
Used in conjunction with heat, chiropractic spinal manipulation,showed more effective for the treatment of low back pain in patient of osteoarthritis (OA) in comparison of the application of moist heat or chiropractic spinal manipulation alone(429).

9. Chinese Herbal Bath Therapy
Chinese herbal bath therapy (CHBT) has been used traditionally for its effects on analgesics and anti-inflammation against pain, especially for patient with knee osteoarthritis(495). According to the joint study by  reviewed of a total of 529 abstracts identified from 7 English
and Chinese databases conducted by the Shuguang Hospital affiliated to Shanghai University of Traditional Chinese Medicine, Tufts University and Tufts University School of Medicine, the therapy effectively reduced pain, improved physical performance, and wellness in comparison to  standard western treatment with little or no adverse effects(496).

Arthritis Is Curable
You Can Eliminate Osteoarthritis
By addressing the Underlying Causes through Clinical Trials and Studies

Ovarian Cysts And PCOS Elimination
Holistic System In Existence That Will Show You How To
Permanently Eliminate All Types of Ovarian Cysts Within 2 Months

Super foods Library, Eat Yourself Healthy With The Best of the Best Nature Has to Offer recommended by Kyle J. Norton

Back to Kyle J. Norton Home page http://kylejnorton.blogspot.ca


References
(1) Prevalence of rheumatic symptoms, rheumatoid arthritis, ankylosing spondylitis, and gout in Shanghai, China: a COPCORD study by Dai SM1, Han XH, Zhao DB, Shi YQ, Liu Y, Meng JM.(PubMed)
(2) Musculoskeletal Disorders in the Elderly by Ramon Gheno, Juan M. Cepparo, Cristina E. Rosca,1 and Anne Cotten(PMC)
(3) The effect of osteoarthritis definition on prevalence and incidence estimates: a systematic review by Pereira D1, Peleteiro B, Araújo J, Branco J, Santos RA, Ramos E.(PubMed)
(4) Effect of therapeutic aquatic exercise on symptoms and function associated with lower limb osteoarthritis: systematic review with meta-analysis by Waller B1, Ogonowska-Slodownik A2, Vitor M3, Lambeck J4, Daly D5, Kujala UM6, Heinonen A7.(PubMed)
(5) Effects of therapeutic ultrasound on pain, physical functions and safety outcomes in patients with kneeosteoarthritis: A systematic review and meta-analysis by Zhang C1, Xie Y2, Luo X3, Ji Q3, Lu C3, He C4, Wang P3.(PubMed)
(6) Oral intake of purple passion fruit peel extract reduces pain and stiffness and improves physical function in adult patients with knee osteoarthritis by Farid R1, Rezaieyazdi Z, Mirfeizi Z, Hatef MR, Mirheidari M, Mansouri H, Esmaelli H, Bentley G, Lu Y, Foo Y, Watson RR.(PubMed)
(7) Functional ability, mobility, and pain before and after knee replacement in patients aged 75 and older: a cross-sectional study by Limnell K1, Jämsen E, Huhtala H, Jäntti P, Puolakka T, Jylhä M.(PubMed)
(8) The symptoms of OA and the genesis of pain by David J. Hunter, MBBS PhD,1,2 Jason J. McDougall, BSc PhD,3 and Francis J. Keefe4(PubMed)
(376) Management of Osteoarthritis with Avocado/Soybean Unsaponifiables by Christiansen BA1, Bhatti S2, Goudarzi R3, Emami S4.(PubMed)
(377) Avocado/soybean unsaponifiables prevent the inhibitory effect of osteoarthritic subchondral osteoblasts on aggrecan and type II collagen synthesis by chondrocytes by Henrotin YE1, Deberg MA, Crielaard JM, Piccardi N, Msika P, Sanchez C.(PubMed)
(378) Ice therapy: how good is the evidence? by Mac Auley DC1.(PubMed)
(379) Do textbooks agree on their advice on ice? by MacAuley D1.(PubMed)
(380) Should I use heat or ice to ease knee pain from osteoarthritis?[No authors listed](PubMed)
(381) Osteoarthritis-dependent changes in antinociceptive action of Nav1.7 and Nav1.8 sodium channel blockers: An in vivo electrophysiological study in the rat by Rahman W1, Dickenson AH2(PubMed)
(382) Effectiveness of thermal and athermal short-wave diathermy for the management of knee osteoarthritis: a systematic review and meta-analysis by Laufer Y1, Dar G.(PubMed)
(383) Acupuncture for chronic knee pain: a randomized clinical trial by Hinman RS1, McCrory P2, Pirotta M3, Relf I3, Forbes A4, Crossley KM5, Williamson E6, Kyriakides M3, Novy K3, Metcalf BR1, Harris A7, Reddy P8, Conaghan PG9, Bennell KL1.(PubMed)
(384) Acupuncture for peripheral joint osteoarthritis by Manheimer E1, Cheng K, Linde K, Lao L, Yoo J, Wieland S, van der Windt DA, Berman BM, Bouter LM.(PubMed)
(385) Effect of physical therapy on pain and function in patients with hip osteoarthritis: a randomized clinical trial by Bennell KL1, Egerton T1, Martin J1, Abbott JH2, Metcalf B1, McManus F1, Sims K3, Pua YH4, Wrigley TV1, Forbes A5, Smith C5, Harris A6, Buchbinder R7.(PubMed)
(386) Pain management with acupuncture in osteoarthritis: a systematic review and meta-analysis. by Manyanga T1, Froese M, Zarychanski R, Abou-Setta A, Friesen C, Tennenhouse M, Shay BL.(PubMed)
(387) Acupuncture and other physical treatments for the relief of pain due to osteoarthritis of the knee: network meta-analysis by Corbett MS1, Rice SJ, Madurasinghe V, Slack R, Fayter DA, Harden M, Sutton AJ, Macpherson H, Woolacott NF.(PubMed)
(388) Evidence from RCTs on optimal acupuncture treatment for knee osteoarthritis--an exploratory review by Vas J1, White A.(PubMed)
(389) Gait analysis of patients with knee osteoarthritis before and after Chinese massage treatment by Qingguang Z, Min F, Li G, Shuyun J, Wuquan S, Jianhua L, Yong L.(PubMed)
(390) Massage therapy for osteoarthritis of the knee: a randomized controlled trial by Perlman AI1, Sabina A, Williams AL, Njike VY, Katz DL.(PubMed)
(391) Massage therapy has short-term benefits for people with common musculoskeletal disorders compared to no treatment: a systematic review by Bervoets DC1, Luijsterburg PA1, Alessie JJ2, Buijs MJ2, Verhagen AP1.(PubMed)
(392) Complementary and alternative medicine in osteoarthritis by De Luigi AJ1.(PubMed)
(393) Spa therapy and balneotherapy for treating low back pain: meta-analysis of randomized trials by Pittler MH1, Karagülle MZ, Karagülle M, Ernst E.(PubMed)
(394) The effect of spa therapy in chronic low back pain: a randomized controlled, single-blind, follow-up study by Tefner IK1, Németh A, Lászlófi A, Kis T, Gyetvai G, Bender T.(PubMed)
(395) Balneotherapy (or spa therapy) for rheumatoid arthritis by Verhagen AP1, Bierma-Zeinstra SM, Boers M, Cardoso JR, Lambeck J, de Bie R, de Vet HC.(PubMed)
(396) May spa therapy be a valid opportunity to treat hand osteoarthritis? A review of clinical trials and mechanisms of action by Fortunati NA1, Fioravanti A2, Seri G1, Cinelli S2, Tenti S3.(PubMed)
(397) Spa therapy: can be a valid option for treating knee osteoarthritis? by Tenti S1, Cheleschi S, Galeazzi M, Fioravanti A.(PubMed)
(398) Effects of spa therapy on serum leptin and adiponectin levels in patients with knee osteoarthritis. by Fioravanti A1, Cantarini L, Bacarelli MR, de Lalla A, Ceccatelli L, Blardi P.(PubMed)
(399) Effectiveness of Back School program versus hydrotherapy in elderly patients with chronic non-specific low back pain: a randomized clinical trial by Costantino C1, Romiti D.(PubMed)
(400) Effects of therapeutic exercise and hydrotherapy on pain severity and knee range of motion in patients with hemophilia: a randomized controlled trial by Mazloum V1, Rahnama N1, Khayambashi K1.(PubMed)
(401) Hydrotherapy for the treatment of pain in people with multiple sclerosis: a randomized controlled trial by Castro-Sánchez AM1, Matarán-Peñarrocha GA, Lara-Palomo I, Saavedra-Hernández M, Arroyo-Morales M, Moreno-Lorenzo C.(PubMed)
(402) Hydrotherapy versus conventional land-based exercise for the management of patients with osteoarthritis of the knee: a randomized clinical trial by Silva LE1, Valim V, Pessanha AP, Oliveira LM, Myamoto S, Jones A, Natour J.(PubMed)
(403) Physical activity for osteoarthritis management: a randomized controlled clinical trial evaluating hydrotherapy or Tai Chi classes by Fransen M1, Nairn L, Winstanley J, Lam P, Edmonds J.(PubMed)
(404) Randomised controlled trial of the cost-effectiveness of water-based therapy for lower limb osteoarthritis by Cochrane T1, Davey RC, Matthes Edwards SM.(PubMed)
(405) Effect of watergym in knee osteoarthritis by Guerreiro JP1, Claro RF1, Rodrigues JD1, Freire BF1.(PubMed)
(406) The effects of tai chi on depression, anxiety, and psychological well-being: a systematic review and meta-analysis by Wang F, Lee EK, Wu T, Benson H, Fricchione G, Wang W, Yeung AS.(PubMed)
(407) The effect of Tai Chi on four chronic conditions-cancer, osteoarthritis, heart failure and chronic obstructive pulmonary disease: a systematic review and meta-analyses by Chen YW1, Hunt MA1, Campbell KL1, Peill K2, Reid WD3.(PubMed)
(408) Patient-Reported Outcomes Measurement Information System (PROMIS) instruments among individuals with symptomatic knee osteoarthritis: a cross-sectional study of floor/ceiling effects and construct validity by Driban JB1, Morgan N2,3, Price LL4, Cook KF5, Wang C6.(PubMed)
(409) Tai Chi is effective in treating knee osteoarthritis: a randomized controlled trial by Wang C1, Schmid CH, Hibberd PL, Kalish R, Roubenoff R, Rones R, McAlindon T.(PubMed)
(410) Tai Chi for treating knee osteoarthritis: designing a long-term follow up randomized controlled trial by Wang C1, Schmid CH, Hibberd PL, Kalish R, Roubenoff R, Rones R, Okparavero A, McAlindon T.(PubMed)
(411) Efficacy of Tai Chi on pain, stiffness and function in patients with osteoarthritis: a meta-analysis by Yan JH1, Gu WJ, Sun J, Zhang WX, Li BW, Pan L.(PubMed)
(412) Effects of Yoga on Symptoms, Physical Function, and Psychosocial Outcomes in Adults with Osteoarthritis: A Focused Review by Cheung C1, Park J, Wyman JF.(PubMed)
(413) Iyengar yoga for treating symptoms of osteoarthritis of the knees: a pilot study by Kolasinski SL1, Garfinkel M, Tsai AG, Matz W, Van Dyke A, Schumacher HR.(PubMed)
(414) Topical Ginger Treatment With a Compress or Patch for Osteoarthritis Symptoms. by Therkleson T1.(PubMed)
(415) Ginger Therapy for Osteoarthritis: A Typical Case by Therkleson T1.(PubMed)
(416) Topical Ginger Treatment With a Compress or Patch for Osteoarthritis Symptoms by Therkleson T1(PubMed)
(417) Zucapsaicin(Wikipedia)
(418) Civamide cream 0.075% in patients with osteoarthritis of the knee: a 12-week randomized controlled clinical trial with a longterm extension by Schnitzer TJ1, Pelletier JP, Haselwood DM, Ellison WT, Ervin JE, Gordon RD, Lisse JR, Archambault WT, Sampson AR, Fezatte HB, Phillips SB, Bernstein JE.(PubMed)
(419) High strength capsaicin cream for osteoarthritis pain: rapid onset of action and improved efficacy with twice daily dosing by Schnitzer TJ1, Posner M, Lawrence ID.(PubMed)
(420) Effectiveness and safety of topical capsaicin cream in the treatment of chronic soft tissue pain.
Chrubasik S1, Weiser T, Beime B.(PubMed)
(421) Neuromuscular electrostimulation techniques: historical aspects and current possibilities in treatment of pain and muscle waisting by Heidland A1, Fazeli G, Klassen A, Sebekova K, Hennemann H, Bahner U, Di Iorio B.(PubMed)
(422) Osteoarthritis: physical medicine and rehabilitation--nonpharmacological management.
Stemberger R1, Kerschan-Schindl K.(PubMed)
(423) Transcutaneous electrostimulation for osteoarthritis of the knee by Rutjes AW1, Nüesch E, Sterchi R, Kalichman L, Hendriks E, Osiri M, Brosseau L, Reichenbach S, Jüni P.(PubMed)
(424) Chiropractic care of a 70-year-old female patient with hip osteoarthritis by Strunk RG1, Hanses M.(PubMed)
(425) Prevalence of hip osteoarthritis in chiropractic practice in Denmark: a descriptive cross-sectional and prospective study by Poulsen E1, Christensen HW, Overgaard S, Hartvigsen J.(PubMed)
(426) A randomized controlled trial of chiropractic management of the lower limb kinetic chain for the treatment of hiposteoarthritis: a study protocol by de Luca K1, Pollard H, Brantingham J, Globe G, Cassa T.(PubMed)
(427) Chiropractic management of the kinetic chain for the treatment of hip osteoarthritis: an Australian case series by de Luca K1, Pollard H, Brantingham J, Globe G, Cassa T.(PubMed)
(428) Effects of chiropractic care on pain and function in patients with hip osteoarthritis waiting for arthroplasty: a clinical pilot trial by Thorman P1, Dixner A, Sundberg T.(PubMed)
(429) Efficacy of treating low back pain and dysfunction secondary to osteoarthritis: chiropractic care compared with moist heat alone by Beyerman KL1, Palmerino MB, Zohn LE, Kane GM, Foster KA.(PubMed)
(495) Complementary and Alternative Medicine Use Among Adults and Children: United States, 2007 by Patricia M. Barnes, M.A., and Barbara Bloom, M.P.A., Division of Health Interview Statistics, National Center for Health Statistics; and Richard L. Nahin, Ph.D., M.P.H., National Center for Complementary and Alternative Medicine, National Institutes of Health
(496) Chinese Herbal Bath Therapy for the Treatment of Knee Osteoarthritis: Meta-Analysis of Randomized Controlled Trials by Chen B1, Zhan H1, Chung M2, Lin X1, Zhang M1, Pang J1, Wang C3.(PubMed)

Monday, 11 January 2016

Most Common Disease of elder: The Clinical trials and Studies of Musculo-Skeletal disorders(MSDs) - Osteoarthritis: Treatment In herbal and traditional Chinese medicine - The Incredible Electrostimulation

Kyle J. Norton (Scholar, Master of Nutrients, All right reserved)
Health article writer and researcher; Over 10.000 articles and research papers have been written and published on line, including world wide health, ezine articles, article base, healthblogs, selfgrowth, best before it's news, the karate GB daily, etc.,.
Named TOP 50 MEDICAL ESSAYS FOR ARTISTS & AUTHORS TO READ by Disilgold.com Named 50 of the best health Tweeters Canada - Huffington Post
Nominated for shorty award over last 4 years
Some articles have been used as references in medical research, such as international journal Pharma and Bio science, ISSN 0975-6299.

Musculoskeletal disorders (MSDs) are medical condition mostly caused by work related occupations and working environment, affecting patients’ muscles, joints, tendons, ligaments and nerves and developing over time. A community sample of 73 females and 32 males aged 85 and over underwent a standardised examination at home. Musculoskeletal pain was reported by 57% of those interviewed. A major restriction of joint movement range was frequent in the shoulder but uncommon in other joints(1).

Types of Musculo-Skeletal disorders in elder(2)

1. Osteoarthritis
2. Gout
3. Rheumatoid Arthritis
4. Polymalagia Arthritis
5. Cervical myleopathy and spinal canal stenosis
6. Osteoporosis
7. Low back pain
8. Fibromyalgia



                       Osteoarthritis


Osteoarthritis (OA), a form of arthritis, is defined as a condition of as a result of aging causes of wear and tear on a joint, affecting over 25 million people in the United States in alone. University of Porto Medical School indicated that one must understand the differences in prevalence and incidence estimates of osteoarthritis (OA), according to case definition, in knee, hip and hand joints(3).
The characteristics of osteoarthritis are aching pain(5), stiffness(6), or difficulty of moving the joint or joints(7). The pain usually gets worse in change of weather, at night and in the advanced diseases, the pain can occur even at rest(8). Today management of osteoarthritis (OA) focuses on pain relief and improved physical function through pharmacological, non pharmacological, and surgical treatments(4).


                                    The Treatment

B. In herbal  and traditional Chinese medicine perspective
B.6.  Electrostimulation
Use of electricity for treatment of pain, muscle dysfunction and sarcopenia can be dated back to Ancient Egyptians and later the Greeks and Romans(421). According to the Abteilung für Physikalische Medizin und Rehabilitation, transcutaneous electrostimulation may be effectively and positively in influence of pain and function, mobility, and quality of life in patients suffering from OA(422). Unfortunately, in the review of 14  trials resulting in the inclusion of 18 small trials in 813 patients, found that  electrosimulation does not offer pain relief for effective for pain relief. for patient with osteoarthritis of the knee with the relative droping out rate as high as 95%(423).


Arthritis Is Curable
You Can Eliminate Osteoarthritis
By addressing the Underlying Causes through Clinical Trials and Studies


Ovarian Cysts And PCOS Elimination
Holistic System In Existence That Will Show You How To
Permanently Eliminate All Types of Ovarian Cysts Within 2 Months

Super foods Library, Eat Yourself Healthy With The Best of the Best Nature Has to Offer recommended by Kyle J. Norton

Back to Kyle J. Norton Home page http://kylejnorton.blogspot.ca

References
(1) Prevalence of rheumatic symptoms, rheumatoid arthritis, ankylosing spondylitis, and gout in Shanghai, China: a COPCORD study by Dai SM1, Han XH, Zhao DB, Shi YQ, Liu Y, Meng JM.(PubMed)
(2) Musculoskeletal Disorders in the Elderly by Ramon Gheno, Juan M. Cepparo, Cristina E. Rosca,1 and Anne Cotten(PMC)
(3) The effect of osteoarthritis definition on prevalence and incidence estimates: a systematic review by Pereira D1, Peleteiro B, Araújo J, Branco J, Santos RA, Ramos E.(PubMed)
(4) Effect of therapeutic aquatic exercise on symptoms and function associated with lower limb osteoarthritis: systematic review with meta-analysis by Waller B1, Ogonowska-Slodownik A2, Vitor M3, Lambeck J4, Daly D5, Kujala UM6, Heinonen A7.(PubMed)
(5) Effects of therapeutic ultrasound on pain, physical functions and safety outcomes in patients with kneeosteoarthritis: A systematic review and meta-analysis by Zhang C1, Xie Y2, Luo X3, Ji Q3, Lu C3, He C4, Wang P3.(PubMed)
(6) Oral intake of purple passion fruit peel extract reduces pain and stiffness and improves physical function in adult patients with knee osteoarthritis by Farid R1, Rezaieyazdi Z, Mirfeizi Z, Hatef MR, Mirheidari M, Mansouri H, Esmaelli H, Bentley G, Lu Y, Foo Y, Watson RR.(PubMed)
(7) Functional ability, mobility, and pain before and after knee replacement in patients aged 75 and older: a cross-sectional study by Limnell K1, Jämsen E, Huhtala H, Jäntti P, Puolakka T, Jylhä M.(PubMed)
(8) The symptoms of OA and the genesis of pain by David J. Hunter, MBBS PhD,1,2 Jason J. McDougall, BSc PhD,3 and Francis J. Keefe4(PubMed)
(421) Neuromuscular electrostimulation techniques: historical aspects and current possibilities in treatment of pain and muscle waisting by Heidland A1, Fazeli G, Klassen A, Sebekova K, Hennemann H, Bahner U, Di Iorio B.(PubMed)
(422) Osteoarthritis: physical medicine and rehabilitation--nonpharmacological management.
Stemberger R1, Kerschan-Schindl K.(PubMed)
(423) Transcutaneous electrostimulation for osteoarthritis of the knee by Rutjes AW1, Nüesch E, Sterchi R, Kalichman L, Hendriks E, Osiri M, Brosseau L, Reichenbach S, Jüni P.(PubMed)

Sunday, 10 January 2016

Most Common Disease of elder: The Clinical trials and Studies of Musculo-Skeletal disorders(MSDs) - Osteoarthritis: Diet and Life style modification according herbal and TCM medicine specialist: Topical Remedies

Kyle J. Norton (Scholar)
Health article writer and researcher; Over 10.000 articles and research papers have been written and published on line, including world wide health, ezine articles, article base, healthblogs, selfgrowth, best before it's news, the karate GB daily, etc.,.
Named TOP 50 MEDICAL ESSAYS FOR ARTISTS & AUTHORS TO READ by Disilgold.com Named 50 of the best health Tweeters Canada - Huffington Post
Nominated for shorty award over last 4 years
Some articles have been used as references in medical research, such as international journal Pharma and Bio science, ISSN 0975-6299.

Musculoskeletal disorders (MSDs) are medical condition mostly caused by work related occupations and working environment, affecting patients’ muscles, joints, tendons, ligaments and nerves and developing over time. A community sample of 73 females and 32 males aged 85 and over underwent a standardised examination at home. Musculoskeletal pain was reported by 57% of those interviewed. A major restriction of joint movement range was frequent in the shoulder but uncommon in other joints(1).

Types of Musculo-Skeletal disorders in elder(2)

1. Osteoarthritis
2. Gout
3. Rheumatoid Arthritis
4. Polymalagia Arthritis
5. Cervical myleopathy and spinal canal stenosis
6. Osteoporosis
7. Low back pain
8. Fibromyalgia



                       Osteoarthritis


Osteoarthritis (OA), a form of arthritis, is defined as a condition of as a result of aging causes of wear and tear on a joint, affecting over 25 million people in the United States in alone. University of Porto Medical School indicated that one must understand the differences in prevalence and incidence estimates of osteoarthritis (OA), according to case definition, in knee, hip and hand joints(3).
The characteristics of osteoarthritis are aching pain(5), stiffness(6), or difficulty of moving the joint or joints(7). The pain usually gets worse in change of weather, at night and in the advanced diseases, the pain can occur even at rest(8). Today management of osteoarthritis (OA) focuses on pain relief and improved physical function through pharmacological, non pharmacological, and surgical treatments(4).

                                    The Treatment

B. In herbal  and traditional Chinese medicine perspective
B.5.. Topical Remedies
1. Topical Ginger 
Ginger, one of the herbal medicine used as cooking spice and best known for its treatment in warming the stomach, use as topical remedy, it has been found to consist the potential for treatment of osteoarthritis, according to Dr. Therkleson T., in the study of 20 adults with moderate to severe osteoarthritis(414). On a self-report arthritis Health Assessment Questionnaire, topical ginger  showed to relief osteoarthritic symptoms, in both  body physiological recordings and pain scale(415).
The Edith Cowan University, in the study of a self-treatment using the ginger patch for a further 24 week, showed that ginger treatment relieve symptoms, improve the overall health, and increase independence of people with chronic osteoarthritis(416).

2. Capsaicin cream
Topical Capsaicin cream used for treatment of soft tissue with a pharmaceutical name of Finalgon®(420), may be effective for treatment of osteoarthritis in dependent to its concentration.
In a randomized, single-blind, 28-day study conducted by Research Testing Laboratories, capsaicin cream (0.25%) applied twice daily, showed to relieve severity of osteoartghritic pain with side effect of burning sensation(419).
Civamide cream produced by Winston Pharmaceuticals, approved by FDA, civamide cream is a cis-isomer of capsaicin topical medication used for treatment of osteoarthritis of the knee and other neuropathic pain(417). In the study by Northwestern University Feinberg School of Medicine, in patients with OA of the knee, civamide cream 0.075% or a lower dose of civamide cream, 0.01% effectively in relieve pain and improve physical functions(418).

Arthritis Is Curable
You Can Eliminate Osteoarthritis
By addressing the Underlying Causes through Clinical Trials and Studies

Ovarian Cysts And PCOS Elimination
Holistic System In Existence That Will Show You How To
Permanently Eliminate All Types of Ovarian Cysts Within 2 Months

Super foods Library, Eat Yourself Healthy With The Best of the Best Nature Has to Offer recommended by Kyle J. Norton

Back to Kyle J. Norton Home page http://kylejnorton.blogspot.ca


References
(1) Prevalence of rheumatic symptoms, rheumatoid arthritis, ankylosing spondylitis, and gout in Shanghai, China: a COPCORD study by Dai SM1, Han XH, Zhao DB, Shi YQ, Liu Y, Meng JM.(PubMed)
(2) Musculoskeletal Disorders in the Elderly by Ramon Gheno, Juan M. Cepparo, Cristina E. Rosca,1 and Anne Cotten(PMC)
(3) The effect of osteoarthritis definition on prevalence and incidence estimates: a systematic review by Pereira D1, Peleteiro B, Araújo J, Branco J, Santos RA, Ramos E.(PubMed)
(4) Effect of therapeutic aquatic exercise on symptoms and function associated with lower limb osteoarthritis: systematic review with meta-analysis by Waller B1, Ogonowska-Slodownik A2, Vitor M3, Lambeck J4, Daly D5, Kujala UM6, Heinonen A7.(PubMed)
(5) Effects of therapeutic ultrasound on pain, physical functions and safety outcomes in patients with kneeosteoarthritis: A systematic review and meta-analysis by Zhang C1, Xie Y2, Luo X3, Ji Q3, Lu C3, He C4, Wang P3.(PubMed)
(6) Oral intake of purple passion fruit peel extract reduces pain and stiffness and improves physical function in adult patients with knee osteoarthritis by Farid R1, Rezaieyazdi Z, Mirfeizi Z, Hatef MR, Mirheidari M, Mansouri H, Esmaelli H, Bentley G, Lu Y, Foo Y, Watson RR.(PubMed)
(7) Functional ability, mobility, and pain before and after knee replacement in patients aged 75 and older: a cross-sectional study by Limnell K1, Jämsen E, Huhtala H, Jäntti P, Puolakka T, Jylhä M.(PubMed)
(8) The symptoms of OA and the genesis of pain by David J. Hunter, MBBS PhD,1,2 Jason J. McDougall, BSc PhD,3 and Francis J. Keefe4(PubMed)
(316) The use of calcium and vitamin D in the management of osteoporosis by John A Sunyecz(PubMed)
(414) Topical Ginger Treatment With a Compress or Patch for Osteoarthritis Symptoms. by Therkleson T1.(PubMed)
(415) Ginger Therapy for Osteoarthritis: A Typical Case by Therkleson T1.(PubMed)
(416) Topical Ginger Treatment With a Compress or Patch for Osteoarthritis Symptoms by Therkleson T1(PubMed)
(417) Zucapsaicin(Wikipedia)
(418) Civamide cream 0.075% in patients with osteoarthritis of the knee: a 12-week randomized controlled clinical trial with a longterm extension by Schnitzer TJ1, Pelletier JP, Haselwood DM, Ellison WT, Ervin JE, Gordon RD, Lisse JR, Archambault WT, Sampson AR, Fezatte HB, Phillips SB, Bernstein JE.(PubMed)




Saturday, 9 January 2016

Most Common Disease of elder: The Clinical trials and Studies of Musculo-Skeletal disorders(MSDs) - Osteoarthritis: Treatment In herbal and traditional Chinese medicine - The Fabulous Supplements

Kyle J. Norton (Scholar, Master of Nutrients, All right reserved)
Health article writer and researcher; Over 10.000 articles and research papers have been written and published on line, including world wide health, ezine articles, article base, healthblogs, selfgrowth, best before it's news, the karate GB daily, etc.,.
Named TOP 50 MEDICAL ESSAYS FOR ARTISTS & AUTHORS TO READ by Disilgold.com Named 50 of the best health Tweeters Canada - Huffington Post
Nominated for shorty award over last 4 years
Some articles have been used as references in medical research, such as international journal Pharma and Bio science, ISSN 0975-6299.

Musculoskeletal disorders (MSDs) are medical condition mostly caused by work related occupations and working environment, affecting patients’ muscles, joints, tendons, ligaments and nerves and developing over time. A community sample of 73 females and 32 males aged 85 and over underwent a standardised examination at home. Musculoskeletal pain was reported by 57% of those interviewed. A major restriction of joint movement range was frequent in the shoulder but uncommon in other joints(1).

Types of Musculo-Skeletal disorders in elder(2)

1. Osteoarthritis
2. Gout
3. Rheumatoid Arthritis
4. Polymalagia Arthritis
5. Cervical myleopathy and spinal canal stenosis
6. Osteoporosis
7. Low back pain
8. Fibromyalgia



                       Osteoarthritis


Osteoarthritis (OA), a form of arthritis, is defined as a condition of as a result of aging causes of wear and tear on a joint, affecting over 25 million people in the United States in alone. University of Porto Medical School indicated that one must understand the differences in prevalence and incidence estimates of osteoarthritis (OA), according to case definition, in knee, hip and hand joints(3).
The characteristics of osteoarthritis are aching pain(5), stiffness(6), or difficulty of moving the joint or joints(7). The pain usually gets worse in change of weather, at night and in the advanced diseases, the pain can occur even at rest(8). Today management of osteoarthritis (OA) focuses on pain relief and improved physical function through pharmacological, non pharmacological, and surgical treatments(4).


                                    The Treatment

B. In herbal  and traditional Chinese medicine perspective
B. 4. The Fabulous Supplements for osteoarthritis
1. Glucosamine
Glucosamine, a compound of the simple sugar glucose and the amino acid glutamine, is a precursor for glycosaminoglycans(194), a major component of joint cartilage(195). Treatment of glucosamine sulfate, chondroitin sulfate, hyaluronic acid, collagen hydrolysate, or nutrients, such as antioxidants and omega-3 fatty acids showed to prevent cartilage degeneration and treat arthritis, according to study(195).

2. Chondroitin
Sulfated glycosaminoglycan (GAG), found in cartilage around joints in the body id a chemical composed of alternating sugars (N-acetylgalactosamine and glucuronic acid).
The chemical compound has been used as nonsteroidal anti-inflammatory drugs for treatment of osteoarthritis by it self or combination with viscosupplementation, according to study(367).
The comparison of piascledine 300 and chondroitin sulfate for treatment of knee osteoarthritis study, also insisted that  3 capsules chondroitin sulfate per day or one capsule of avocado soybean unsaponifiable (ASU) improved the WOMAC-index decreased in both groups for approx. 50% to the end of therapy(368).
According to the Birmingham VA Medical Center, chondroitin, reliefs pain for patient with knee osteoarthritis with little adverse effects when compared with control(369) and its combination  with glucosamine showed a greater effect in reducing pain, stiffness, functional limitation and joint swelling/effusion after 6 months in patients with painful knee osteoarthritis(370)(371),

3. Avocado soybean unsaponifiables (ASU)
 Avocado soybean unsaponifiables (ASU) is a natural vegetable extract composed of  one-third avocado oil and two-thirds soybean oil, may be used effectively for treatment of knee osteoarthritis to replace the use of analgesics and nonsteroidal antiinflammatory drugs (NSAIDs), according to the three-month, prospective, randomized, double-blind, placebo-controlled, parallel-group trial(372).  In patients with symptomatic osteoarthritis (OA) of the knee or hip, The extract inhibited functional disability, especially for patient with hip OA(373).
According to the Erasmus University Hospital of Brussels, daily intake of 300mg or 600mg of ASU, reduced intake of NSAIDs and analgesics by more than 50% in 71% in patient aged 45 to 80 years with femoro-tibial knee osteoarthritis(374) and improved symptoms of patients with OA of the knee and hip, according to the Universities of Exeter and Plymouth, Devon(375) probably through modulating OA pathogenesis by inhibiting a number of molecules and pathways(376), such as preventing the osteoarthritic osteoblast-induced inhibition of matrix molecule production in induced cartilage repair (377),

Arthritis Is Curable
You Can Eliminate Osteoarthritis
By addressing the Underlying Causes through Clinical Trials and Studies

Ovarian Cysts And PCOS Elimination
Holistic System In Existence That Will Show You How To
Permanently Eliminate All Types of Ovarian Cysts Within 2 Months

Super foods Library, Eat Yourself Healthy With The Best of the Best Nature Has to Offer recommended by Kyle J. Norton

Back to Kyle J. Norton Home page http://kylejnorton.blogspot.ca


References
(1) Prevalence of rheumatic symptoms, rheumatoid arthritis, ankylosing spondylitis, and gout in Shanghai, China: a COPCORD study by Dai SM1, Han XH, Zhao DB, Shi YQ, Liu Y, Meng JM.(PubMed)
(2) Musculoskeletal Disorders in the Elderly by Ramon Gheno, Juan M. Cepparo, Cristina E. Rosca,1 and Anne Cotten(PMC)
(3) The effect of osteoarthritis definition on prevalence and incidence estimates: a systematic review by Pereira D1, Peleteiro B, Araújo J, Branco J, Santos RA, Ramos E.(PubMed)
(4) Effect of therapeutic aquatic exercise on symptoms and function associated with lower limb osteoarthritis: systematic review with meta-analysis by Waller B1, Ogonowska-Slodownik A2, Vitor M3, Lambeck J4, Daly D5, Kujala UM6, Heinonen A7.(PubMed)
(5) Effects of therapeutic ultrasound on pain, physical functions and safety outcomes in patients with kneeosteoarthritis: A systematic review and meta-analysis by Zhang C1, Xie Y2, Luo X3, Ji Q3, Lu C3, He C4, Wang P3.(PubMed)
(6) Oral intake of purple passion fruit peel extract reduces pain and stiffness and improves physical function in adult patients with knee osteoarthritis by Farid R1, Rezaieyazdi Z, Mirfeizi Z, Hatef MR, Mirheidari M, Mansouri H, Esmaelli H, Bentley G, Lu Y, Foo Y, Watson RR.(PubMed)
(7) Functional ability, mobility, and pain before and after knee replacement in patients aged 75 and older: a cross-sectional study by Limnell K1, Jämsen E, Huhtala H, Jäntti P, Puolakka T, Jylhä M.(PubMed)
(8) The symptoms of OA and the genesis of pain by David J. Hunter, MBBS PhD,1,2 Jason J. McDougall, BSc PhD,3 and Francis J. Keefe4(PubMed)
(194) Glucosamine inhibits the synthesis of glycosaminoglycan chains on vascular smooth muscle cell proteoglycans by depletion of ATP by Little PJ1, Drennon KD, Tannock LR.(PubMed)
(195) Effects of Glucosamine and Chondroitin Sulfate on Cartilage Metabolism in OA: Outlook on Other Nutrient Partners Especially Omega-3 Fatty Acid by Jörg Jerosch(PubMed)
(367) Osteoarthritis in Latin America: Study of Demographic and Clinical Characteristics in 3040 Patients by Reginato AM1, Riera H, Vera M, Torres AR, Espinosa R, Esquivel JA, Felipe OJ, Blas JR, Rillo O, Papasidero S, Souto R, Rossi C, Molina JF, Ballesteros F,Radrigan F, Guibert M, Chico A, Gil ML, Camacho W, Urioste L, Garcia AK, Iraheta I, Gutierrez CE, Duarte M, Castañeda O, Coimbra I, Muñoz Louis R, Reveille J, Quintero M; Pan-American League of Associations for Rheumatology (PANLAR) Osteoarthritis Study Group(PubMed)
(368) Efficacy and safety of piascledine 300 versus chondroitin sulfate in a 6 months treatment plus 2 months observation in patients with osteoarthritis of the knee by Pavelka K1, Coste P, Géher P, Krejci G.(PubMed)
(369) Chondroitin for osteoarthritis by Singh JA1, Noorbaloochi S, MacDonald R, Maxwell LJ.(PubMed)
(370) Combined chondroitin sulfate and glucosamine for painful knee osteoarthritis: a multicentre, randomised, double-blind, non-inferiority trial versus celecoxib by Hochberg MC1, Martel-Pelletier J2, Monfort J3, Möller I4, Castillo JR5, Arden N6, Berenbaum F7, Blanco FJ8, Conaghan PG9, Doménech G10, Henrotin Y11,Pap T12, Richette P13, Sawitzke A14, du Souich P15, Pelletier JP2; on behalf of the MOVES Investigation Group(PubMed)
(371) Glucosamine, chondroitin sulfate, and the two in combination for painful knee osteoarthritis by Clegg DO1, Reda DJ, Harris CL, Klein MA, O'Dell JR, Hooper MM, Bradley JD, Bingham CO 3rd, Weisman MH, Jackson CG, Lane NE, Cush JJ, Moreland LW,Schumacher HR Jr, Oddis CV, Wolfe F, Molitor JA, Yocum DE, Schnitzer TJ, Furst DE, Sawitzke AD, Shi H, Brandt KD, Moskowitz RW, Williams HJ.(PubMed)
(372) Efficacy and safety of avocado/soybean unsaponifiables in the treatment of symptomatic osteoarthritis of the knee and hip. A prospective, multicenter, three-month, randomized, double-blind, placebo-controlled trial by Blotman F1, Maheu E, Wulwik A, Caspard H, Lopez A.(PubMed)
(373) Symptomatic efficacy of avocado/soybean unsaponifiables in the treatment of osteoarthritis of the knee and hip: a prospective, randomized, double-blind, placebo-controlled, multicenter clinical trial with a six-month treatment period and a two-month followup demonstrating a persistent effect. by Maheu E1, Mazières B, Valat JP, Loyau G, Le Loët X, Bourgeois P, Grouin JM, Rozenberg S.(PubMed)
(374) Symptoms modifying effect of avocado/soybean unsaponifiables (ASU) in knee osteoarthritis. A double blind, prospective, placebo-controlled study by Appelboom T1, Schuermans J, Verbruggen G, Henrotin Y, Reginster JY.(PubMed)
(375) Avocado-soybean unsaponifiables (ASU) for osteoarthritis - a systematic review by Ernst E1.(PubMed)
(376) Management of Osteoarthritis with Avocado/Soybean Unsaponifiables by Christiansen BA1, Bhatti S2, Goudarzi R3, Emami S4.(PubMed)
(377) Avocado/soybean unsaponifiables prevent the inhibitory effect of osteoarthritic subchondral osteoblasts on aggrecan and type II collagen synthesis by chondrocytes by Henrotin YE1, Deberg MA, Crielaard JM, Piccardi N, Msika P, Sanchez C.(PubMed)