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Arthritis Treatments

Arthritis Treatments

Arthritis is a general term that covers over 100 different conditions that affect the musculoskeletal system.  These joint-related problems cause symptoms such as stiffness, inflammation, pain, and damage to the cartilage and surrounding tissues. This can lead to weakened joints, deformities, and instability that can make basic daily tasks challenging. That is why we need arthritis treatments to help ease these symptoms.

In the UK approximately 10 million people suffer from arthritis, with the most common forms being osteoarthritis and rheumatoid arthritis. There are no cures for these conditions. However, there are ways to manage arthritis to lessen the symptoms and improve the quality of life. Arthritis treatments vary and often include a combination of medications, natural supplements, physical therapy, and lifestyle adjustments.

Classification of Arthritic Conditions

The wide range of arthritis conditions can be classified into three main groups:

Inflammatory Arthritis

Inflammatory arthritis is a term used to describe a group of conditions which affect the immune system. The arthritis is caused by the body’s own defence system attacking its own tissues instead of viruses, germs and other foreign substances.  This causes stiffness, pain and joint damage.

The most common type of inflammatory arthritis is Rheumatoid Arthritis (RA). Other common conditions from within this category include gout, ankylosing spondylitis, and psoriatic arthritis.

Rheumatoid Arthritis Treatments

Rheumatoid Arthritis Treatments

The most common type of inflammatory arthritis rheumatoid arthritis affects approximately 400,000 people in the UK according to the National Health Service (NHS). Adults of any age can be affected by this condition, although it most commonly develops between the ages of 40 and 50.

Women tend to be more prone to rheumatoid arthritis than men, with around three-quarters of diagnosed patients female1.

An auto-immune disease, the immune system attacks the cells around the joints. This causes painful swelling and stiffness. As the disease progresses the affect joint becomes damaged as cartilage and surrounding bone break down.

Treatment Strategies

All experts agree that the earlier rheumatoid arthritis is detected and treatment begins the better the chance of limiting joint damage. Since the majority of joint damage is irreversible, the disability will be greater with persistent damage. The goals of treating rheumatoid arthritis are to try and control the degree of joint degradation, stop disease progression and loss of function, minimize symptoms, and improve quality of life. Most experts encourage aggressive treatment plans as soon as the disease is detected, although there is still some conjecture as to the best treatment strategy2.

Results from a range of clinical studies suggest that early therapy should focus on the use disease-modifying anti-rheumatic drugs (DMARDs)3. This may involve monotherapy with a drug such as methotrexate (MTX) or hydroxychloroquine (HCQ), or a step-up combination therapy where a range of DMARDs are used4,5. Non-steroidal anti-inflammatory drugs (NSAIDs) may also be prescribed. There also evidence to support the use of anti-tumor necrosis factor (anti-TNF) drugs, especially in combination with MTX, in rheumatoid arthritis treatments 6.

Medical practitioners and researchers acknowledge that there isn’t one single strategy that can be applied to treat rheumatoid arthritis. Everyone responds differently to the disease and arthritis treatments must be adapted accordingly. Combining medications with exercise, healthy diet, and supplements is the overarching treatment plan for rheumatoid arthritis. As new advances are made in developing medications, it’s possible that treatment options will be expanded and improved on.

New breakthrough research from the University of Queensland in Australia has developed a vaccine-style treatment for rheumatoid arthritis. This vaccine treats the underlying cause of the disease, rather than the symptoms. This new treatment is in its infancy and needs further testing, but may be a future turning point for sufferers of this disease.

Gout, Ankylosing Spondylitis, and Psoriatic Arthritis Treatments

Gout, Ankylosing Spondylitis, and Psoriatic Arthritis Treatments

Gout

One of the most painful forms of arthritis, gout occurs when there is an abnormal build-up of uric acid in the body that deposits as crystals within the joints. Gout is most commonly associated with the big toe, although it can also affect insteps, ankles, knees, heels, wrists, elbows, and fingers.

Acute gout attacks are treated using non-steroidal anti-inflammatory drugs (NSAIDs), corticosteroids, or colchicine. Medications that block uric acid production may also be prescribed.

Ankylosing Spondylitis

A form of spinal arthritis, ankylosing spondylitis typically affects young men and can eventually lead to new bone formation on the spine. It can cause severe, chronic pain and discomfort. Although the spine is primarily affected, ankylosing spondylitis can also cause inflammation, stiffness, and pain in other areas such as the ribs, hips, shoulders, and smaller joints associated with the feet and hands.

NSAIDs (nonsteroidal anti-inflammatory drugs) are the primary arthritis treatments for ankylosing spondylitis. If these are not effective, disease-modifying anti-rheumatic drugs (DMARDs) may be used. Exercise, good posture, and diet are important in the management of ankylosing spondylitis. In some cases surgery may be required.

Psoriatic Arthritis

There are several forms of psoriatic arthritis, which affects people with the skin condition psoriasis. It causes stiffness, pain, swelling and discomfort of affected joints, reducing movement.

NSAIDs (nonsteroidal anti-inflammatory drugs) or disease-modifying anti-rheumatic drugs (DMARDs) may be recommended for people with psoriatic arthritis. Oral “small molecule” arthritis treatments or biologic drugs given by intravenous infusion or injection are another possible option.

arthritis treatments for painful jointsNon-Inflammatory Arthritis

Non-Inflammatory Arthritis is characterized by natural wear and tear of mostly the weight-bearing joints (back, hip, feet and knee). It can also affect both the smaller joints of the body, including the hands and wrists.

Unlike Rheumatoid Arthritis, this type of arthritis is very common in elderly people.

The most common type of Non-Inflammatory Arthritis is osteoarthritis. Other conditions within this category include scoliosis and torn ligaments.

Osteoarthritis Treatments

Osteoarthritis Treatments

This is the most common type of non-inflammatory arthritis and is the most common form of arthritis in the UK7. Statistics from Arthritis Research reveal that 8.75 million people have sought treatment for osteoarthritis in the UK.

While this disease usually develops in people over the age of 50, it can develop at any age in response to anther joint-related problem or an injury. More than 30 percent of women have some degree of osteoarthritis by age 65.

Osteoarthritis make movement very difficult. In the early stages the disease affects the cartilage lining of the joints, leading to stiffness and pain. As the cartilage thins the joint bones start to rub together, increasing deformation and discomfort.

Initially, osteoarthritis starts with minor pain during activities, but soon the pain can become continuous and even occur while in a state of rest. The joints most commonly affected by osteoarthritis include the hips, knees, hands, and spine.

People with prior joint trauma, obesity, and a sedentary lifestyle are at the highest risk of developing osteoarthritis.

Treatment Strategies

The principal aims of treating osteoarthritis are to adequately control pain, enhance function, and minimize disability. All arthritis treatments should include a combination of therapies focusing on the best strategy for individual circumstances.

The primary treatment for osteoarthritis has been paracetamol for pain relief, although NSAIDs (nonsteroidal anti-inflammatory drugs) are also recommended in the case of moderate or severe pain 8. The types of medications prescribed to help manage osteoarthritis will depend on other underlying health factors. For example, people suffering from osteoarthritis and hypertension should avoid NSAIDs and cyclooxygenase-2 (COX-2) inhibitors because they can increase blood pressure9. Corticosteroids and hyaluronic acid injections may also be a viable short-term treatment option for some patients.

Exercise, TENs and acupuncture10,11, heat or cold packs12, and healthy weight management13 are all important aspects of non-pharmaceutical osteoarthritis management strategies.

Occupational therapy combined with a healthy diet and nutritional supplements can help to lessen the burden on the joints and improve overall joint health.

Scoliosis and Torn Ligament Treatments

Scoliosis and Torn Ligament Treatments

Scoliosis

Lateral curvature of the spine is termed scoliosis. It can be congenital, or develop as a result of abnormal muscles, a traumatic injury, or in some cases there is no known cause.

Braces or surgery may be recommended to correct the spine in children if the condition is severe. Adult scoliosis is rare, although it is sometime caused by a degenerative joint problem.

Torn Ligament

Torn ligaments can occur as a result of a sporting injury, accident, or repetitive strain. It can occur at any joint, although the knee and ankle are especially vulnerable when it comes to sports injuries.

Usually ligaments will naturally heal with careful management. In some severe cases surgery may be required. The affected joint may be more susceptible to arthritis later in life.

Connective Tissue Disease

This category includes Sjogren’s syndrome, lupus, and sclerosis.

Sjogren’s Syndrome, Lupus, and Sclerosis Treatments

Sjogren’s Syndrome, Lupus, and Sclerosis Treatments

Sjogren’s Syndrome

This auto-immune disease typically affects the salivary glands and eyes, although it can also affect other areas of the body. The severity of the disease can vary significantly, and the progression is unpredictable. One of the symptoms of Sjogren’s syndrome is joint swelling and associated pain.

There are a range of medications available that can be used in the treatment of Sjogren’s syndrome. These may include NSAIDs (nonsteroidal anti-inflammatory drugs) to minimize swelling and discomfort of the joints.

 Lupus

This auto-immune disease causes swelling of the tissues. The symptoms will vary depending on what part of the body is affected. There are four main types of lupus, with systemic lupus erythematosus being particularly detrimental to joint health.

Anti-inflammatories, corticosteroids, antimalarials, immuneosuppressives, and anticoagulants, may be among the recommended medications to help treat lupus. Treatment will be determined by the type of lupus and the severity of the condition.

Sclerosis Treatments

Abnormal hardening of the body tissue is called sclerosis. There are many different conditions associated with sclerosis; however one of the symptoms is swelling and inflammation which can affect the joints.

There are a range of arthritis treatments used to treat sclerosis. Physical therapy is also important, along with a healthy diet and stress relief.

 

 

Types of Arthritis Treatments

The treatment of arthritis aims to minimize symptoms so that joint health is improved. Using a range of therapies, patients can reduce inflammation, pain, and swelling to improve mobility and slow the progression of joint degradation.

The best arthritis treatments will include a combination of approaches, varying depending on individual conditions. For example, a psoriatic arthritis treatments may differ from an osteoarthritis treatment plan due to differences in the underlying cause of the joint degradation.

Painkillers and Anti-Inflammatories

Painkillers and Anti-Inflammatories

Painkillers (analgesics) such as paracetamol are often recommended to be taken regularly during a pain flare-up. Many doctors recommend taking analgesics prior to any activity that may aggravate pain to lessen the severity of the discomfort.

NSAIDs (Non Steroidal Anti-Inflammatory Drugs) can be useful in short bursts to reduce inflammation during a flare-up in combination with analgesics if necessary. These anti-inflammatories are available in oral or topical arthritis treatments. NSAIDs are not suitable for long-term use due to their strong side effects on the digestive system.

In the case of inflammatory arthritis or connective tissues diseases, steroid tablets or localised injections of steroids may be used to stop inflammation. In the treatment of osteoarthritis some doctors may recommend steroid injections for the infected joint.

Suitable treatment timeframe: SHORT-TERM

Inflammatory Disease Suppressants

Inflammatory Disease Suppressants

Slow acting Disease-Modifying Anti-Rheumatic Drugs (DMARDs) can be used to suppress inflammation. Usually these medications are taken together with NSAIDs until they start to take effect.

If DMARDs are unsuccessful, biological therapies may be recommended. These are a relatively new class of drugs made to block the messages between inflammation-causing white blood cells and other proteins.

Suitable treatment timeframe: MEDIUM-TERM

Physical Therapy

Physical Therapy

Arthritis treatments may include doctors may recommend physical therapy. Hydrotherapy in a warm water pool is useful for reducing pressure on the joint and muscles while facilitating important exercise.

Physiotherapy exercises especially tailored to individual conditions can help to reduce inflammation and increase mobility, together with other pain relieving arthritis treatments such as massage, or heat and ice packs.

Occupational therapies to help manage everyday tasks are also an important part of arthritis treatment. This helps to educated people to better manage fatigue and protect their joint from further degradation.

Suitable treatment timeframe: LONG-TERM

Surgery

Surgery

In some extreme cases, hip, shoulder, elbow, and knee arthritis treatments may include surgery. This may be recommended if the damage to the joint is so advanced that it makes day-to-day life difficult or other treatments are unsuccessful.

There are three main forms of joint surgery:

Arthroplasty – A joint replacement procedure

Arthodesis – A joint fusion procedure

Osteotomy – A procedure where the bone is cut and then realigned

Modern surgical methods make joint replacements or pain-relieving reconstructions highly successful. However, surgery is usually the last resort and the procedures are not without risks.

Suitable treatment timeframe: SHORT-TERM

Diet

Diet

 

To reduce arthritis symptoms treatments must also include dietary changes. While there isn’t any scientific proof that dietary changes can cure arthritis, certain foods can aggravate or reduce symptoms.

A healthy diet rich in foods that reduce inflammation and limit weight gain is important. This helps to take the pressure off the joints and minimizes discomfort, ultimately improving mobility.

Antioxidant rich fruit and vegetables, whole grains, low fat dairy and meats are recommended. Foods containing saturated and trans fats, sodium/salt, and sugar should be avoided.

Suitable treatment timeframe: LONG-TERM

Food Supplements

Food Supplements

 

There are many different supplements that can be used in the treatment for arthritis. Omega 3 fatty acids, pine bark extract, chondroitin, glucosamine, and MSM (methyl sulfonylmethane), are some of the natural compounds commonly used in supplements as part of arthritis treatment.

These are often formulated with other key vitamins and minerals to help protect joint health.

There is strong scientific evidence that these compounds can help to reduce inflammation, decrease pain, and defend the joints from damaging enzymes. Clinical studies have shown that these common arthritis nutraceutical ingredients can minimise the reliance on painkillers and NAIDs, which is important for long-term health14 15 16 17.

Suitable treatment timeframe: LONG-TERM

The high-street and online market is awash with so-called “joint food” supplements. But be careful, the products differ significantly in quality and value for money.

 

Arthritis Treatment Requires Lifestyle Adjustments

If left untreated conditions such as rheumatoid arthritis and osteoarthritis will significantly worsen as the joint degradation accelerates. In order to preserve quality of life it’s essential to make positive lifestyle adjustments.

This includes maintaining an arthritis-friendly diet, rich in anti-inflammatory foods and antioxidants.

The Importance of Diet and Nutrients

Making smart food choices can significantly improve joint health, reducing inflammation and associated pain to make movement easier. This will lessen joint swelling and stiffness, providing better joint mobility.

Routinely taking appropriate effective joint food supplements can also significantly reduce arthritis symptoms. The high-street and online market is awash with so-called “joint food” supplements.

But be careful, the products differ significantly in quality and value for money. We have taken the guesswork out for you and compared over 20 joint food supplements.

 

Regular participation in low impact sports is also an important aspect of an arthritis treatment plan. Low-impact exercise such as swimming, rowing, cycling, yoga, bowling and golfing will help to maintain joint movement, reduce joint instability and help to minimise pain.

Of course, regular (ideally outdoor) exercise also increases your endorphine levels and helps to keep your body weight in check. This reduces general pressure on your joints keeping you happy and healthy.

References

  1. “Crowson, C. et.al. (2011). The lifetime risk of adult-onset rheumatoid arthritis and other inflammatory autoimmune rheumatic diseases. Arthritis and Rheumatology, Volume 63, Issue 3, (pp. 633-9).”
  2. “Schipper, L. et.al. (2012). A tight control treatment strategy aiming for remission in early rheumatoid arthritis is more effective than usual care treatment in daily clinical practice: a study of two cohorts in the Dutch Rheumatoid Arthritis Monitoring registry. Annuals of Rheumatic Diseases, Volume 71, Issue 6, (pp. 845-50).”
  3. “Demoruelle, M. and Deane, K. (2012). Treatment strategies in early rheumatoid arthritis and prevention of rheumatoid arthritis. Current Rheumatology Reports, Volume 14, Issue 5, (pp. 472–480).”
  4. “Allaart, C. and Huizinga, T. (2011). Treatment strategies in recent onset rheumatoid arthritis. Current Opinions in Rheumatology, Volume 23, Issue 3, (pp. 241-4).”
  5. Schipper, L. and van Riel, P. (2011). Ups and downs in the treatment strategies of rheumatoid arthritis. Rheumatology, Volume 50, Issue 5, (pp. 818-20).”
  6. “Breedveld F. and Combe, C. (2011). Understanding emerging treatment paradigms in rheumatoid arthritis. Arthritis Research & Therapy, Volume 13, Issue 1.”
  7. “VanItallie TB (October 2010). “Gout: epitome of painful arthritis”. Metab. Clin. Exp. 59(Suppl 1): S32–6. doi:10.1016/j.metabol.2010.07.009. PMID 20837191″
  8. “Puttini, P. et.al. (2005). Osteoarthritis: an overview of the disease and its treatment strategies. Seminars in Arthritis and Rheumatiodism, Volume 35, Issue 1, (pp. 1-10).”
  9. “Verdecchia, P. et.al. (2010). Treatment strategies for osteoarthritis patients with pain and hypertension.” Therapeutic Advances in Musculoskeletal Disease, Volume 2, Issue 4, (pp. 229-40).”
  10. “Itoh, K. et.al. (2008). A pilot study on using acupuncture and transcutaneous electrical nerve stimulation (TENS) to treat knee osteoarthritis (OA). Chinese Medicine, Volume 3, Issue 2.”
  11. “Zhang, W. et.al. (2010). OARSI recommendations for the management of hip and knee osteoarthritis: part III: changes in evidence following systematic cumulative update of research published through January 2009. Osteoarthritis and Cartilage, Volume 18, Issue 4, (pp. 476-99).”
  12. “Denegar, C. et.al. (2010). Preferences for heat, cold, or contrast in patients with knee osteoarthritis affect treatment response. Clinical Interventions in Aging, Volume 5, (pp.199-206).”
  13. “Turley, M. et.al. (2006) Non-fatal disease burden associated with excess body mass index and waist circumference in New Zealand adults. Australian and New Zealand Journal of Public Health, Volume 30, Issue 3, (pp. 231-237).”
  14. “Gruenwald et al. (2009). Effect of glucosamine sulfate with or without omega-3 fatty acids in patients with osteoarthritis. Advances in Therapy, Volume 26, Issue 9, (pp.858-71).”
  15. “Henrotin et al. (2010). Chondroitin Sulfate in the Treatment of Osteoarthritis: From in Vitro Studies to Clinical Recommendations. Therapeutic Advances in Musculoskeletal Diseases, Volume 2, Issue 6, (pp. 335-48).
  16. “Beer, A. & Wegener, T. (2011). Vitamin E for gonarthrosis and coxarthrosis – results of a postmarketing surveillance study. MMW Fortschritte der Medizen, Volume 153, Supplement 1, (pp. 14-20).”
  17. “Belcaro, G. et al (2008). Treatment of osteoarthritis with Pycnogenol. The SVOS (San Valentino osteo-arthrosis Study). Evaluation of signs, symptoms, physical performance and vascular aspects. Phytotherapy Research, Volume 22, Issue 4, (pp. 518-23).”
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MSM

MSM is short for methylsulfonylmethane. It is a member of the group of organic sulfur compounds (sulfones). Methylsulfonylmethane can be found in both vegetable products and animal products. Milk and coffee are two examples which both contain relatively high levels of this sulfur compound.

Increasingly often, MSM is consumed in the form of dietary supplements for the treatment of osteoarthritis. As a sulfur compound, it provides the body with the sulfur that it necessarily needs to grow cartilage tissue.

Osteoarthritis: Effect, Side Effects, Dosage, Application Instructions
MSM has a pain-relieving and detoxicating effect. The sulfur contained inmethylsulfonylmethane is an important building block for cartilage tissue. Cartilage tissue should therefore be positively affected by an increased consumption, although such effects are yet to be conclusively proven.

A minimum daily dosage of 100mg is recommended. No side effects have yet been officially reported. MSM is typically consumed in powder format via capsules for easier, tasteless swallowing.

DMSO and MSM

DMSO and MSM

MSM is a so-called “metabolite“, i.e. an intermediate product metabolized by the body. It is closely related to DMSO, an authorized medicinal product. The source of the compound is DMSO (dimethylsulfoxide).

Intensive research has been conducted on DMSO as a pharmaceutical. Since the stomach immediately transforms DMSO intomethylsulfonylmethane, one may act on the assumption that identical results can be achieved with either compound. However, the number of studies conducted on MSM isn’t nearly as large as the number of those conducted on DMSO.

DMSO is often found in lotions and ointments. Since DMSO can easily be absorbed by human skin, it’s active ingredients reach the blood stream much more rapidly. It also has anti-inflammatory and pain-relieving effects.

In contrast, methylsulfonylmethane is absorbed via the digestive system and has to pass through the liver before it is released into the bloodstream.This means the absorbed amount is significantly reduced.

However, DMSO has the disadvantage that, when taken orally, it may lead to unpleasant breath (scent of fish and garlic). People who use DMSO in the form of ointments frequently report skin irritations. Although DMSO has been classified as a pharmaceutical, MSM is actually classified as a dietary supplement, meaning it can be purchased over the counter.

Studies on MSM as a treatment for osteoarthritis

“The Pain-relieving Effect has Been Proven”

MSM for joint painDietary supplements containing methylsulfonylmethane have been used in the United States for quite some time. Nonetheless, there have been no clinical studies researching the effects of this sulfone prior to 2006.

In 2006, scientists conducted the first small-scale study with the intention of revealing whether or not MSM is effective in osteoarthritis patients.1 Fifty men and women between the ages of 40 and 76 took part in the study. Neither the doctors, nor their patients knew whether they were receiving the actual remedy or a simple placebo. For a duration of twelve weeks, the osteoarthritis patients took three grams ofmethylsulfonylmethane or three grams of the placebo, respectively.

After three months, the MSM group reported that their pains were less intense, while their joint function was increased. Consequently, the quality of patients’ every day lives was significantly increased.

Treatment of Osteoarthritis – Meta Study

Another study evaluated all published research regarding the role of MSM in the treatment of osteoarthritis2. This type of systematic assessment of other research results is referred to as a “meta study”.

Generally, meta studies are viewed as extraordinarily significant. All in all, 168 patient results regarding the effect of methylsulfonylmethane on osteoarthritis were taken into consideration.

This study was also able to verify the alleviation of pain, yet the data supporting this could not be backed by statistics. The individual studies often involved variations in methodology, particularly with regards to the best possible dosage or the duration of treatment.

Improvement in Functionality and Reduction of Pain

A new paper from 2011 now confirms the pilot study by Kim and colleagues conducted in 2006: MSM can improve mobility and alleviate pain in osteoarthritis patients.

Using an identical experiment set-up, 49 men and women between the ages of 45 and 90 took part in the 2011 study. The doctors and patients didn’t know whether they were receiving methylsulfonylmethane or a simple placebo. This time the dosage was lower than that used in the preceding study.

Participants received 1,125 mg MSM twice a day, or the Placebo. Patients were questioned with regards to their algesia and subjective mobility of the affected joints. Surveys took place on the first day, after six additional weeks, as well as after twelve weeks (at the end of the study).

An improvement of mobility, as well as a lower burden of pain were reported by those patients treated with MSM. The observed effects were relatively exiguous. Thus, according to the scientists, it remains unclear whether methylsulfonylmethane does indeed display a relevant clinical effect on osteoarthritis.

Animal Experiment Proves MSM’s Efficacy

The reason animal experiments are necessary

The medical field recognizes various types of studies. “In vitro” are studies based on cell cultures. These studies have the advantage that other effects can be shielded. However, a cell culture inside a Petri dish exhibits a different behavior than that of cells within a complete and complex organism. Therefore, studies performed on humans (“in vivo studies”) are most significant.

Yet, if the goal is proving long-term effects, researchers are reluctant to wait over one to five years. Consequently, they like to resort to a trick: they examine the effects via very large dosages, as well as in extreme situations. In order to avoid putting humans at such a risk, animals which are genetically close to humans are used for those types of studies.

MSM in arthritis in mice

One animal experiment study conducted in 2013 may now deliver this proof. A Japanese team of researchers studied the influence of MSM on the degradation of cartilage in arthritic mice. In doing so, they determined that an appropriate intake of MSM may indeed reduce cartilage damage. Nonetheless, caution will be needed in the future, because large dosages of MSM may cause serious atrophies of the organs, as demonstrated by the mouse model. 3.

Additional uses of MSM

Additional Uses of MSM

MSM is also used for:

  • sulfur deficits in general,
  • for reduction of homocysteine levels4
  • for improvement of blood circulation,
  • for improvement of wound healing.

However, far less research has been conducted on these uses, compared to the use for treatment of osteoarthritis and arthritis.

Safety of MSM: Side Effects, Contraindications

In the EU, MSM is classified as a dietary supplement. It is very safe to use and no side effects worth mentioning were observed. Overdosing is difficult to cause, even willfully and with maximum effort.

Overdose

The dosage at which test animals suffered methylsulfonylmethane poisoning amounted to around 20 grams per kilogram body weight. Therefor, a human (75 kg) would have to take about 1.5 kilograms each day. Studies with volunteers involved administration of 1 gram per kg body weight (i.e. about 60 to 90 grams per day) over one month. No negative epiphenomena were detected.5

Recommended Dosage

Based on the studies, the recommended dosage is between 0.5 grams and 4 grams per day. Higher dosages should only be used under medical supervision for general safety reasons.

MSM is also not appropriate for use during pregnancy. However, that’s a general recommendation as scientific knowledge is insufficient.

The dosage information relates to the oral intake (capsules, pills). In rare cases, MSM is also injected under the skin or – like DMSO – added to ointments. Especially in such cases, please consult your physician.

Purchasing MSM capsules

Several good combination preparations for joints also contain MSM. As the health of the joint cartilage depends on many factors, combination preparations are usually superior to individual active ingredients.

Provide your joints with all nutrients they need. Read the overview of the best joint supplements here.

 

 

You may purchase MSM or methylsulfonylmethane from your pharmacy as a dietary supplement. Likewise, numerous recommendable remedies with good customer reviews can be found on Amazon, some of which we have selected here:

 

Sources and Studies on MSM:

  1. Kim et al. 2006. Efficacy of methylsulfonylmethane (MSM) in osteoarthritis pain of the knee: a pilot clinical trial. Osteoarthritis Cartilage 14(3), 286-294
  2. Brien et al. 2008. Systematic review of the nutritional supplements dimethyl sulfoxide (DMSO) and methylsulfonylmethane (MSM) in the treatment of osteoarthritis. Osteoarthritis Cartilage 16(11), 1277-1288
  3. Ezaki et al. 2013. Assessment of safety and efficacy of methylsulfonylmethane on bone and knee joints in osteoarthritis animal model. J Bone Miner Metab 31(1), 16-25; doi: 10.1007/s00774-012-0378-9
  4. Kim LS, Axelrod LJ, Howard P et al; “Efficacy of methylsulfonylmethane (MSM) in osteoarthritis pain of the knee: a pilot clinical trial. “; Osteoarthritis Cartilage 2006;14(3):286-94.
  5. Jacob WS, Appleton J.; “MSM: the definite guide. A comprehensive review of the science and therapeutics of methylsulfonylmethane.”; Topanga, CA. Freedom Press, 2003