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Glucosamine and Carpal Tunnel? 26

Posted by Cliff from the natural-treatment-or-snake-oil dept.
DemonCat asks: "A friend suggested to me that I try a glucosamine supplement to treat carpal tunnel, saying that it had worked for him. According to its proponents, it stimulates the healing and growth of inflamed connective tissue. Wary of herbal, alternative or otherwise little-tested treatments, I was curious what experience other Slashdotters had had with glucosamine." We have done quite a few articles on wrist pain and Carpal Tunnel Syndrome. It's pretty much an on-the-job risk for most of us working in the industry, and lots of folks ask about treatments. It would be nice to hear what folks think of the Glucosamine option. Does it work? Or is this more baloney for the meat grinder?
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Glucosamine and Carpal Tunnel? More

Glucosamine and Carpal Tunnel?

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  • It's probably not going to do any harm anyway, most alternative therapies (except possibly breatherianism) are pretty safe.

    And there's a fairly good chance it will help, big pharmaceutical companies pay a lot of money for people to research 'folk/native' remedies (then of course they patent them, one of them even patented rice [indiaworld.co.in]) and make a fortune, because there are a lot of genuine cures to be found.

    Let us know how it goes, and if by some strange coincidence you swell up to twice your normal size and turn green, well, I never said this.

  • Quasi-medical advice (Score:4)

    by Alik ( 81811 ) on Thursday September 14, 2000 @05:17PM (#778644)
    I am a medical student. Not a doctor. By law, I can't prescribe jack shit and I am no more qualified to give medical advice than an aborginal tribesman.

    I *can*, however, tell you that carpal tunnel as suffered by geeks is usually a stress injury, not a degenerative or autoimmune cartilage disease as found in arthritis. What's the difference? Use good ergonomics and geek carpal tunnel often goes away, never to return. Arthritis can be relieved, but is currently always progressive. Stress injuries can be healed. Degenerative processes generally can't.

    That means that you definitely don't *need* glucosamine; you can heal just fine without it. However, there's still the question of whether or not it'll help you heal. The literature, at least as far as I can see right now, doesn't contain any data on glucosamine for acute injuries like this; the studies are all for arthritis. In arthritis, it does seem to help, though that's not proven. If taken in reasonable doses, it should not harm you.

    It is worth considering the placebo effect, which is really very powerful. If you think glucosamine will help you, you are very likely to experience some improvement. Therefore, if you have the money to spend and you truly believe it might help, it may well be worth your while to try it. (The best part about the placebo effect is that it'll work even if the supplement you end up buying isn't really glucosamine (which is a big problem with most natural medicines, BTW)).

    I have also done you the courtesy of looking up some existing non-surgical therapies for CTS; you may wish to ask a doctor about them. Steroid injections have been indicated to help reduce the inflammation where aspirin and ibuprofen can't, although some studies indicate that this is only temporary relief. At least one clinical trial has shown that certain yoga postures can have a beneficial effect. (The postures are in JAMA, November 11th 1998. The AMA [ama-assn.org] may still have that issue available online.) There is weak anecdotal evidence for vitamin B6 helping; could take that along with the glucosamine. (Again, assuming you don't start taking massive doses and assuming you use good biomechanics, this can't hurt.)

    Executive Summary: Can't hurt, small chance of helping, here's some other stuff to check out, try not to get scammed, and USE BETTER ERGONOMICS!
  • Of course, there are many who would trust the medical advice of an aborginal tribesman. (So maybe your in the wrong field.)
  • While they did not cite any studies, I have had Biochem profs and Human Phys profs scoff at these oral supplements.

    So have I, but OTOH, my rheumatology profs said they looked promising, and there have been RCTs for osteo and rheumatoid arthritis. I'm personally not 100% convinced, but if someone asked me about it for arthritis, I'd tell them to try it if they could afford it.

    I've seen a release done... it's amazing that something so simple actually works and leaves you with good function. I figured that losing a wide, strong ligament would give you tendon bowstringing or something.

  • Excuse me, but as your inflamed tissue is having problems because there isn't enough room for it -- in what way would growing more tissue help? Having more tissue in that small area would make it worse.
  • Oh, yes, there are many products with a long history. Leeches, mercury, heroin, foxglove, nightshade...

    Make sure you keep us informed [quackwatch.com] of what happens to you.

    I prefer the technical cure [mtn.org] for carpal tunnel syndrome.

  • I had a cyst in my wrist, which I was told indicated that I was suceptible to CTS. Sure enough, a few years later, I started to get the symptoms, and I went through a number of things to try to keep it from becoming debilitating. That included things like wearing wrist braces for as long as I could stand them every day. I even considered having surgery at one point.

    I no longer have CTS, and I didn't have to get the CT-release surgery. What changed? Well, I went on a low-carb diet, I started taking glucosamine HCL, and I started lifting weights. I quit taking NSAIDs. My doctor specifically told me that the LC diet and the weight training would make the problem worse, and that glucosamine HCL was no better than a placebo. He told me that the only real help I could get would be from NSAIDs.

    So, what made the problem go away?

    I don't know for sure, but I think it was the low-carb diet. But maybe it was the wrist curls. And maybe the glucosamine HCL helped. Or maybe not. Or maybe all of the above.

    I'm just glad that my wrists and arms don't ache anymore. Oh, and I fired the doctor. Too bad his treatments didn't have a money-back guarantee...
  • Anyone who would say that is clearly infested by demons. Fortunately, although I am not an MD, I am a fully qualified witch doctor. Come see me; you need emergency trepannation.

  • RSI -- it's not only you, it's them. (Score:4)

    by SEWilco ( 27983 ) on Thursday September 14, 2000 @06:47PM (#778652) Journal
    Do not read this. Have your co-workers read this [bbc.co.uk]. Slowly back away...

    (No, I wasn't touching my keyboard when I heard of this -- Festival [ed.ac.uk] was reading the news to me...)

  • Psychological stress is a factor in nearly every illness, and it's particualrly unsurprising in RSI. I'd go further and venture that the people who've suffered the worst RSI from desk clerk and data entry positions are those who feel the least control over their job - they're not just at the scant mercy of their superiors, but of the balky computing machinery they're forced to use. This would explain why people who generally feel more control over the computers they use (programmers and other relatively technosavvy types) tend to be less susceptible to RSI, and why women have generally been worse struck by it (because they're still given the shitty powerless jobs in way disproportionate numbers, and thus their job stress is higher).

    I have long felt that worsening other people's job stress is a form of assault. When you do it en masse, it ought to be prosecuted as a crime. So when Microsoft (convenient example) makes everyone's life more difficult with unreliable software and lousy user interfaces, they are physically as well as psychologically harming them. Class-action assault.
  • My personal experience with wrist pain (and if you read the sore hands site, you'll find that there are may kinds of wrist/joint pain that are not carpal tunnel) is that it can be fixed by:

    1. Good ergonomics, especially keyboard placement.
    2. Better awareness of other stresses in your life. Check out The Mind Body Prescription [amazon.com]. It is a book by a respected, practicing physician who points out how your repressed anger and stress can contribute to (back/wrist/etc.) pain. Literally, psychosomatic illness. I thought it was bullshit until I was desperate enough to try it, and it made things a lot better.
    3. Vitamins: nothing radical. A good multivitamin, a Vitamin B supplement, and SAMe. This is the #1 prescribed anti-arthritic in Germany, and is sold in the US as a nutritional supplement in places like GNC. It also supposedly has anti-depressive properties. A lot of studies show that increasing one of the B vitamins helps in Carpal Tunnel.
    The bottom line is that, about 1.5 years ago, I couldn't work at a keyboard for more than 15 minutes without a lot of pain, numbness, etc. Now, I don't think about it -- working 12 hour days is no issue. I am definitely not a person who immediately goes to alternative therapies. Actually, I was seeing a MD and physical therapist for over a year before trying these three things out of total frustration.

    BTW, I fully admit that #3 may be a placebo. #2 may be also. So what. They worked for me.
  • When I'm not dunking on people, I am also a medical student.

    My anatomy book (Clinically Oriented Anatomy - 4th Ed., 1999) describes carpal tunnel as any lesion (eg: inflammation of the synovial sheaths, swelling of the tendons, etc.) that significantly reduces the size of the carpal tunnel, causing compression of the median nerve. This can be caused by fluid retention, infection, and excessive exercise of the fingers. Carpal tunnel syndrome is NOT a degenerative disorder, per se. Long term, it can become an arthritic condition.

    Short term, you should use ergonomic equipment, as Alik suggested above. There are also surgical procedures such as "carpal tunnel release", which involes a partial or complete division of the flexor retinaculum (fibrous band that holds the tendons of your hand/finger muscles together).

    As far as taking these mineral supplements to alleviate arthritic symptoms, it is true that chondroitin sulfate and glucosamine are components of cartilage. However, there remains to be seen how little, if any, of these compounds are absorbed by the body when taken as a supplement. While they did not cite any studies, I have had Biochem profs and Human Phys profs scoff at these oral supplements.

    Just as Alik pointed out above, this is not medical advice.
  • I work for a major health/nutrition company which has been producing these supplements for a very long time (65+yrs). And many of the posts are in the right direction, esp. the med. student. You have to be careful when you buy herbal supplements from your favorite local retailer, as many of them contain inactive ingredients or are not pharmaceutical grade, as this industry does not have strict controls as prescription drugs do. Glucosamine's primary benefit is that it helps cartilage retain water, thereby staying elastic and acting as a "cushion" between bones. If you want to take it buy it from a company with a "name" and not mr. generico at {INSERT LARGE RETAILER HERE}. so yeah, its not gonna hurt ya and you will probably notice some benefit. but it aint gonna cure anything. anyone who tells you otherwise is trying to sell you something.
  • >Let us know how it goes, and if by some strange coincidence you swell up to twice your normal size and turn green ...

    if that happens I'll just report myself to seti's team slashdot. Hey! while you guys were looking for signals, we got this green guy.. and it's real.. ;)

    //rdj
  • I have fybromyalgia (not all too pleasant), and a co-worker just gave me a thing about OPC-3 (a completely natural product). It's available in Europe, and was released here in the US a few years ago. I haven't started using it yet, but I will soon. It contains some powerful anti-oxidants (the same stuff that allows our bodies to fight things like premature aging, wrinkles, hardening of artieries, stiffening of joints, formation of cataracts, and cancer, just to name a few).

    I don't know if you can pick it up just anywhere, and I'm not too sure what the price is (I'll be finding out shortly, should know by tomorrow). Any interested feel free to drop me an e-mail, I'll hopefully have more specifics soon...
  • Latrell Sprewell wrote:
    "...there remains to be seen how little, if any, of these compounds are absorbed by the body when taken as a supplement. While they did not cite any studies, I have had Biochem profs and Human Phys profs scoff at these oral supplements.
    And who don't cite any studies, either...or if they did would cite selectively. Your profs have a religion to protect. Do your own research. It's fast and easy.

    Database: MEDLINE
    Author(s): Ronca F ; Palmieri L ; Panicucci P ; Ronca G
    Address: Department of Human and Environmental Sciences, University of Pisa, Italy.
    Title: Anti-inflammatory activity of chondroitin sulfate.
    Source: Osteoarthritis Cartilage (OSTEOARTHRITIS AND CARTILAGE) 1998 May; 6 Suppl A: 14-21 Journal Code: CCO
    Additional Info: ENGLAND
    Standard No: ISSN: 1063-4584
    Language: ENGLISH
    Abstract: The pharmacokinetics of chondroitin sulfate (CS, Condrosulf, IBSA, Lugano, Switzerland) were investigated in rats and in healthy volunteers using CS tritiated at the reducing end and CS labeled with 131I or 99mTc respectively. A rapid absorption of orally administered CS is observed in rats and in humans when the drug is dissolved in water. Lower and delayed absorption is observed when CS is administered in gastroresistant capsules. The absolute bio-availability is 15 and 12% for rats and humans respectively. The CS shows a tropism for cartilagineous tissues in rats and for knee tissues in humans as demonstrated by scintigraphic analysis with 99mTc-CS. Monomers, oligo and polysaccharides produced by enzymatic hydrolysis of CS appear in the blood and tissues together with native CS. The effects of partially depolymerized (m.m. 3 to 15 kD) and desulfated fractions on human leukocytes were investigated. CS and its fractions inhibit the directional chemotaxis induced by zymosan-activated serum, are able to decrease the phagocytosis and the release of lysozyme induced by zymosan and to protect the plasma membrane from oxygen reactive species. In rats the oral administration of CS significantly decreases granuloma formation due to sponge implants and cell migration and lysosomal enzyme release in carrageenan pleurisy. Compared with nonsteroidal anti-inflammatory drugs (indomethacin, ibuprofen), CS appears to be more effective on cellular events of inflammation than on edema formation. It is noteworthy that CS is devoid of dangerous effects on the stomach, platelets and kidneys. In synovial fluid of patients requiring joint aspiration, treated orally for 10 days with CS (800 mg/day) the hyaluronate concentration and the intrinsic viscosity significantly increased, while collagenolytic activity, phospholipase A2 and N-acetylglucosaminidase (NAG) decreased. These results give an insight into the mechanism of the anti-inflammatory and chondroprotective actions demonstrated by this drug in a number of clinical trials in patients with osteoarthritis.
  • Sorry about the bad subject line, the correct name is OPC-3.
  • The Life Extension Foundation Forum is a good place to go for science-based discussions of supplements. The main LEF website isn't so helpful. Either go to the main LEF website [lef.org] and click on "Forums" or simply go straight to the forums [lef.org].

    Please register and log in before posting.

    The two best places to purchase supplements (something you shouldn't do until you have done substantial research at the LEF Forum and especially on MEDLINE [nih.gov]) I have found are Beyond-a-Century [beyond-a-century.com] (as in "live and be healthy over 100 years") and iherb [iherb.com].

  • I too changed my diet and started working with weights this year. A lot of aches and pains disappeard along with a 'hereditary' hypertension problem that required two different medications (which only brought my BP to levels 'approaching' acceptable).

    I used to change hand positions whenever the wrist pain manifested and after a short while they'd subside. They used to teach proper hand/wrist position in typing class on those IBM Selectrics. Most of us type with our wrists resting on, oddly enough, a 'wrist rest' or desk top, with our hands cocked backward. This restricts the carpal tunnel and makes for increased friction as the tendons go sawing back and forth around an unnatural bend. Personally (no studies to back this up) I believe that concert pianists can practice for ten hours without RSI symptoms because they are taught proper form, wrists straight or even arched upward slightly. Practicing the piano is more intense than programming (or even correspondence) because the pressure on the keys must vary quite a bit and you get to rest while typing - to gather your thoughts, check what you've just typed, etc - while the pianist generally only rests briefly between numbers.

  • bottom line. Don't self-diagnose, don't self-medicate. In the words of JWZ:

    But one thing is for certain: Do not fuck around. If you are experiencing any kind of pain, get to a doctor and get it diagnosed.

    http://www.jwz.org/gruntle/wrists.html [jwz.org]

  • here's what worked for me. 1) lowering the keyboard. You must have a real computer desk, or something that drops the keyboard down. 2) the movement and change principle. I believe the latest ergonomic theories are getting away from things like "the perfect posture." People used to try to hold the perfect pose. Now they realize that the best thing is to change posture, keep moving around. Slouch a little. Then straighten up. In other words, exactly what you first wanted to do before you heard of ergonomics! Along with this, just break a lot, get up from the desk and walk around for a minute. And look around a lot. And stop typing, maybe massage the hand a bit. In other words, you are not a machine, you are an animal (physically speaking.) Act like one.
  • See the other slashdot stories for details, but there are no easy answers - recovering from RSI is a combination of:

    - reducing your stress levels, and managing them with meditation/relaxation

    - improving ergonomic setup (furniture, keyboard/screen setup, etc)

    - improving posture and body use (try Trager, Alexander technique or Feldenkrais)

    - massage/physio of various types (esp. adverse mechanical tension physiotherapy, trigger point massage)

    - stretching (esp AMT stretches)

    - changing work patterns (taking breaks and not typing during them!)

    There's probably more that I've forgotten, but right at the bottom is vitamin supplements, glucosamine - I tried the former in spades and they made absolutely no difference.
  • I solved my wrist problems (severe) with physical therepy. Most crucial excersises I did - independent finger rotation, manipulation, and stretching. Other - wrist curling - both up and down - you can get machines which specialize in this Also push-ups and other arm/elbow, and shoulder excersises for better overall circulation in extremities. Mail me for more specifics : ben@rmvinc.com
  • Thought there was one, the other 3 I'd heard something about, but couldn't find muchon medical heroin use.

    Anybody have one for mercury?

  • This report says that people who don't feel that they get enough support from their colleagues and superiors are more likely to report pain in their forearms.

    Seems to me that if I don't get that kind of support I'd be more likely to have to resort to extended typing sessions so I think their conclusions are slightly dubios.

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