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Monday’s medical myth: osteoarthritis can be ‘cured’

Switch on daytime television on any given day and you’d be forgiven for thinking there was a cure for the debilitating and dreaded condition, osteoarthritis. Unfortunately, there’s not. And that’s not…

There aren’t any miracle cures but there are a number of treatments that can reduce its severity. Flickr/Algo

Switch on daytime television on any given day and you’d be forgiven for thinking there was a cure for the debilitating and dreaded condition, osteoarthritis.

Unfortunately, there’s not. And that’s not from want of trying. With the exception of the common cold, no everyday health problem has been as extensively studied with such little result.

Osteoarthritis is the most common form of arthritis, affecting around 1.6 million Australians. The hallmark of osteoarthritis is loss of cartilage which lines major joints – this causes the classic symptoms of pain and stiffness in the affected joints.

Or does it? One of the major frustrations in osteoarthritis research is the absence of research showing the correlation between the state of joints on X-rays and the degree of pain and disability the operator of the joint experiences.

To work out what creates the pain in osteoarthritis, researchers need to look beyond the joint.

Many studies using magnetic resonance imaging (MRIs) suggest the bone marrow around the joint is a potent source of pain. And further away, in the spinal cord and brain, there may be abnormal processing of pain signals.

When you add the standard physiological, genetic and psychological complexities common to all types of long-term pain, you begin to see why finding durable, meaningful relief from osteoarthritis pain is so difficult.

What osteoarthritis sufferers don’t need is to be presented with a steady stream of fake and cynical products which reflect none of this hard-won knowledge.

Tabloid media, particularly television, often feature products promising relief from arthritis pain. This story from A Current Affair is fairly typical of the genre. The product is usually presented as an infomercial, with no critical analysis from the reporter. A couple of testimonial cases are then wheeled out for breathless adoration.

There is also invariably some type of pseudoscientific angle presented as an explanation for the miraculous healing powers of the product. It’s often cast as a “secret breakthrough” discovered by a lone misunderstood genius, who is persecuted by vested interests in the pharmaceutical industry.

So how does this type of misinformation make its way onto our television screens and magazines?

The Therapeutic Goods Advertising Code contains what would be robust protection for consumers – if it were adequately policed.

But the Code is held in such low regard by product manufacturers and distributors that some don’t bother to follow the Code. Others don’t do their research to understand the Code before tipping thousands of dollars into promoting their questionable devices or pills.

Many of the less scrupulous operators simply ignore TGA sanctions, or make the minimum required changes to their advertising, while maintaining claims about efficacy.

Cynics can chuckle that there’s no great harm in condoning this thriving industry built on deceptive advertising. They may even say it’s a tax on gullibility.

But it makes things much harder for those of us whose careers involve trying to steer these osteoarthritis sufferers towards the proven interventions that can reduce their disability and pain.

There aren’t any miracle cures for osteoarthritis but there are evidence-based measures to treat the condition or reduce its severity. These include:

  • peer-led education groups;

  • carefully tailored weight loss;

  • cognitive-behavioural treatment;

  • judicious medication use; and

  • joint replacement.

These measures aren’t glamorous and challenge sufferers' beliefs about their pain and their lifestyle. This type of change is hard for individuals to contemplate, and difficult to resource and implement.

For the average Australian without much scientific background, it’s easy to see the attraction of a simple and compelling story about a miraculous cure.

So what’s the solution?

Well, for a start, health-care professions should do more to educate consumers about dodgy arthritis products and avoid lending our professional credibility to endorsing them.

And the government needs to step in with some ruthless regulation.

Join the conversation

6 Comments sorted by

  1. Doug Cotton

    medical research

    S-adenosylmethionine (SAMe) has been shown effective and I have experienced personal cure using it.

    It increases the number of chondrocytes and proteoglycans, so it apparently reverses the underlying process of osteoarthritis by stimulating cartilage to grow.

    The American Journal of Medicine published a series of articles on the use of SAMe for treating osteoarthritis back in 1987.

    One of several studies in Italy involved more than 20,000 patients. Those taking SAMe improved steadily from the…

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    1. Michael Vagg

      Clinical Senior Lecturer at Deakin University School of Medicine & Pain Specialist at Barwon Health

      In reply to Doug Cotton

      http://www.ncbi.nlm.nih.gov/pubmed/21169345
      http://www.ncbi.nlm.nih.gov/pubmed/19821403
      http://www.ncbi.nlm.nih.gov/pubmed/18246887

      Thanks for the considered response Doug

      The above references give a more recent picture of the consensus regarding SAMe. It remains of unclear benefit due mainly to lack of a plausible mechanism of action, and concerns about methodological quality. Yes, it has some positive studies but they are not yet convincing. Yes, it may stimulate chondrocytes in vitro, but what…

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    2. Doug Cotton

      medical research

      In reply to Michael Vagg

      I'm sorry but I have to differ with you. I find studies with 20,000 patients somewhat more compelling than your reviews. But even so, your first one stated "The present review found consistent evidence that capsaicin gel and S-adenosyl methionine were effective in the management of OA." The second dealt mainly just with knees and the third seemed more concerned about the cost, which, incidently has come down quite a bit in the 15 years or so that I have been taking it.

      There are numerous other proven benefits also, not least of which relates to depression. But, as always, you will find studies that use far too small a dose (often not even specified) in what is usually a blatant attempt to rubbish whatever it might be for the indirect benefit of the pharmaceutical industry.

      Surely I don't have to state the obvious when it comes to research budgets. If you can't patent it, why spend your own money on research?

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    3. Michael Vagg

      Clinical Senior Lecturer at Deakin University School of Medicine & Pain Specialist at Barwon Health

      In reply to Doug Cotton

      Doug, can you post the reference with 20K subjects, as the references you have listed are all small pilot trials. I did find one Italian study by Caruso et al with 734 subjects but that is the biggest I can find.

      If you read to the end of the first abstract I have linked to , you will find the actual conclusion of the reviewers was in fact that 'The major limitation in reviewing the evidence is the paucity of randomized controlled trials in the area: widening the evidence base, particularly for…

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  2. Bwca Brownie

    Sloth

    sudden onset OA 1993 here. reduced weight by 20 kgs, no difference. the celbrx nsaid almost halves the morning stiffness, but that is not enough to eliminate desire to suidice.
    the worst thing about this condition is looking normal (when not ambulatory).
    no, maybe the worst thing is not sleeping through the aches caused by the slightest nocturnal movement. I lasted only 2 years working fulltime after the onset, maybe unemployment is the worst thing. Am very weary of friends suggesting all those costly placebos you describe. green shark crap etc. cabbage leaves over the knees would be as useful.

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