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March 25th, 2013

Stem Cells and Platelet Rich Plasma May Be the Perfect Cocktail for Tissue Repair

For years, we have been reading and discussing the potential use of a patient's own stem cells to help heal their injuries. However, which type of mesenchymal stem cells (MSC) from either a bone marrow aspirate, or from your own fat (adipose tissue) seem to still need to be answered. In addition, these fragile cells need a nice loving home to survive and grow. Your body's own platelet cells may provide this perfect environment to help keep these cells alive and grow. When the platelets can be taken from your own blood and concentrated into a serum similar to marmalade we call this Platelet Rich Plasma(PRP) Few case reports exist on this combination but one very interesting report was recently published in the Journal of Orthopedics in January of 2013 entitled "Biologically Enhanced Healing of the Human Rotator Cuff: 8-month Postoperative Histological Evaluation." Researchers Nicole Protzman and Dr.'s Gary A. Stopyra and James K. Hoffman from Leigh Valley Health Network in Allentown, PA discuss the biopsies of some tissue taken from a 52 y.o female with a multiply failed rotator cuff tear treated with MSC , PRP and a dermal graft. Although most doctors consider case reports interesting, they are usually not the final word in medical decision making. However, this study is very interesting because they were able to obtain tissue biopsy of not only the rotator cuff with the stem cells and PRP added, but also her other rotator cuff for comparison. This provides us with a very good look at what the body may be doing with this new cocktail. The biopsy of the injured rotator cuff treated with the MSC and PRP seemed to have new blood vessels and normal looking fibrocartilage compared to her other normal shoulder. This is not conclusive evidence, but just another look at a promising treatment allowing us to use our own bodies cells to help heal injuries. Although researchers have searched the globe high and low for the silver bullet pill to heal our ills, we are now finding that the answer may be right in our own back yards. Further research in this exciting area of medicine is coming out every month -- so stay tuned!

-- Dr. Loniewski

September 27th, 2012

The Benefits of Knee Bracing After an Injury

  "Walk it off! It’s nothing!" We’ve all heard this after we suffer a sports mishap, a bad fall, or a twisted knee; but the worst thing you can do is ignore a knee injury. Instead, it’s essential that you get some knee support with a knee brace or knee rehabilitation kit such as the DonJoy FLEX Deluxe Knee Therapy Kit. Whether you have ACL tears, a dislocated kneecap, bursitis, tendonitis, or arthritis, a knee brace will provide comfort to the knee by providing gentle compression, support, and stability. Other benefits include:

• Decreased additional injuries
• Increased protection during stressful activities
• Performance enhancement and confidence during sports and athletics
• Graft protection following ACL reconstruction
• Eliminates improper movement of the knee cap and controls external knee rotation
• Relieves pain and can reduce need for medication

We suggest using a knee brace made of heavy knit cotton vs. neoprene, such as the DonJoy Comfort Knee Brace. Most store-bought knee braces are made of neoprene, which can get very hot and cause allergic reactions. Knit cotton knee braces are not only more breathable, but they are also simply much more comfortable than neoprene.  

-- admin

March 28th, 2012

Cold Therapy Can Shoulder the Pain

[caption id="" align="alignleft" width="225"] This time, shrinkage is a good thing[/caption] If you were recently diagnosed with a shoulder condition such as a rotator cuff tear or biceps tendonitis or even arthritis of the shoulder, you may be considering surgery.  This  may bring up some anxiety about handling the pain after the surgery.  Well, one of the best ways to reduce the pain of shoulder surgery is the use of cryotherapy. You may be asking, "What the heck is cyro whatchamacallit?"   Cyro means cold and therapy refers to the application of this cold for the treatment of a disorder.   Your disorder is P A I N.   Cold helps reduce swelling by inducing vasoconstriction.  Again you may be asking, "What the heck is vaso whatchamacallit?" This is the tightening of  your blood vessels when they are exposed to the cold.  This is what makes your fingers go numb when you go without gloves, and it is the same phenomena George Costanza experienced when he was caught naked after swimming.    Whenever there is injury to your tissues, your body tries to rush blood supply to this area by vasodialation.   This helps initiate the process of inflammation and the resulting swelling to the area.  We can safely  reduce this response by inducing vasoconstriction.  Cryotherapy is the safest and most effective method to induce this phenomena. At JointHealing.com, we have researched the different methods of cryotherapy and have picked out some of the most effective and efficient Cold Therapy Units anywhere.  One such is the Don Joy Iceman Cold Therapy Unit.   This is one of the most popular cyrotherapy devices used in major hospitals and clinics.  It is completely sealed and powered to pump cool water continuously around your injured shoulder.   The Iceman Cold Therapy Unit has a patented pad allowing the cool water to continually flow in multiple directions around your shoulder.  This creates the best method to cool the area without causing any damage to your tissue.   One of the concerns of using cyrotherapy is the potential damage from making the area too cold otherwise known as frostbite. This constant flow in multiple directions helps significantly reduce over cooling of the area.   The sealed electric motor allows the fluid to flow through the extended hose and pad quietly.  The sealed ice chest allows the ice to be kept at an optimal temperature without having to change the ice throughout the night. Cold therapy units for the shoulder can be a big decision, but we have already done the the work for you and picked out some of the best cold therapy units that work well for our patients.   So you don't have to worry about what is the best device to use for your upcoming shoulder surgery.  You should talk with your doctor about ordering a cryotherapy unit for you or if they have any recommendations about their favorite shoulder cold therapy unit.  Your surgeon can discuss the risks and benefits of cryotherapy and determine if you would benefit from such a device.

-- Dr. Loniewski

March 26th, 2012

Why are DonJoy products the top of the line

Since Jointhealing.com is run by orthopedic surgeons we only approve top of the line knee support and rehabilitation products. Dr. Farjo and Dr. Loniewski have trusted the Don Joy brand because of the company’s long lasting reputation of over 30 years in professional performance for functional knee bracing. DonJoy products have pioneered the concept of knee bracing through studies and research of the body; muscles, ligaments and joints.  By using medical knowledge and technology as well as learning from extensive research amongst athletes and physicians DonJoy has been able to create products that not only push the envelope, but provide the best results in performance and rehabilitation. Through the creation of these heavy duty knee brace and knee support products DonJoy braces are the “standard equipment for competitors in over 44 countries” according to their website. DonJoy products are made with the human body in mind.  Whether an athlete or just an individual recovering from orthopedic surgery, DonJoy has the products to get you back in motion. The reason DonJoy products are so exceptional is due to their high performance construction. Some of the common features of a DonJoy knee brace, such as the Don Joy Extreme are made with the following:

• Patented 4-point leverage dynamic system: DonJoy’s exclusive design to control knee stability
• Moldable Framing and cuffs for custom fitting
• Standard anti-migration Supracondyle padding to prevent the knee brace from shifting during use
• A variety of sizing for the perfect fit
• 6062 T6 Aircraft Aluminum frame construction providing lightweight but ultimate strength
• Flex-extension control
• One year warranty

The DonJoy Knee brace is made of high quality materials that provide support and comfort and products like the DonJoy Extreme have been worn, tested and inspected to provide custom knee support and stability for the user.  These are just some of the features that make DonJoy products top of the line. Many of the DonJoy braces cater to extreme sports athletes and enthusiasts such as motocross races, skiers, and football players. The DonJoy brand’s mission is built on the need “to enable people to regain the joy and comfort of natural motion.” This mission integrates Jointhealing.com’s quest for patient preferred and physician approved joint products to improve everyone’s quality of life and mobility.

-- admin

March 2nd, 2012

Joint Replacement- Replace Your Physical Therapy Costs with Home Rehab

Are you considering a Joint Replacement?  Well, you are not alone, over 600,000 fellow Americans will join you in this choice this year alone.   Joint Replacement Surgery  is my sub-specialty, and over the past 20 years, I have either assisted or performed well over 4,000 of these procedures.   With this experience I have seen patients succeed and others struggle.  Most of the patients who succeeded in their recovery were highly motivated to participate in their therapy.    They performed some of the exercises prior to their surgery and also kept performing them day after day until they succeeded.  Their  success was not  the type of replacement; the nursing staff; the physical therapist or even the surgeon, it was their determination to succeed and perform the exercises day after day.   Thus determination and the perspiration is more important to the success of a surgery than almost any other factor.  I also noticed that a common factor in success was the fact that these patients did their exercises religiously even after their insurance benefits expired.  So, if you are considering a hip joint replacement, knee joint replacement, ankle joint replacement or shoulder joint replacement, you should also consider performing some of the exercises required after the surgery now.   An easy way to do this is though our home rehabilitation exercise kits.  They are great for the quick work out in a safe and convenient fashion.    You can perform the exercises to build your muscles around the joint and start your road to recovery even before your surgery begins.  The best part is that you do these exercises in your own home, without having to travel miles to therapy and you save hundreds to thousands of dollars in co-pays.

-- Dr. Loniewski

February 22nd, 2012

Stretch and Strengthen Problem Areas with our Rehabilitation Kits

You may not know this, but JointHealing.com was founded by two subspecialty-trained orthopedic surgeons. Dr. Farjo and Dr. Loniewski are both currently orthopedic surgeons in Southeast Michigan with busy clinical and surgical practices, so they know what they’re talking about when it comes to injured joints. They have over 30 years of clinical experience treating patients with common orthopedic problems such as ACL tears, rotator cuff tears, arthritis, joint replacement and fracture care. It was during this vast clinical experience that both Dr. Farjo and Loniewski realized that patients needed continued rehabilitation that was not covered by their insurance policies. Thus, they searched for a solution, and found one in a set of home rehabilitation kits. If you have a weak joint or are recovering from joint surgery, our rehabilitation kits are great for strengthening and stretching these areas. For instance, our deluxe knee therapy kit is useful for knee rehabilitation for virtually every knee problem that requires stretching and strengthening (that's just about all of them!). In addition to knee support, we also have great rehab kits for shoulder therapy and ankle therapy. Each kit comes with everything you need to strengthen and stretch your particular problem area. Our rehabilitation kits are ideal for ankle sprains, rotator cuff tears, rotator cuff tendonitis, shoulder arthritis, and recovery from ankle, shoulder, or knee surgery. Our rehab kits don’t just help you recover; they strengthen your joints, tendons, muscles and bones to help prevent the injury from happening again. The best aspect of these kits is that you can use them for the rest of your life without another insurance co-pay. These will literally save you hundreds and more than likely thousands of dollars. So if you have knee, ankle, or shoulder problems, but you don’t have thousands of dollars to spend on gym memberships or physical therapy appointments, check out our rehabilitation kits – they’re doctor recommended; patient approved and insurance co-pay proof!

-- admin

February 15th, 2012

Unloader Braces for the Knee – Fixing the Crooked Pump

When your knee starts to look like you just got off your horse or like a knock kneed teenage cartoon character, it is time to look into a way to correct this problem.    As I mentioned in our previous blog, the function of your knee is very similar to how a water pump works.   When the pump starts to go on the fritz....so does your knee.   Thus, the orthopedic surgeon's job is to fix this pump, so fluid can flow freely throughout your knee restoring the normal function. As your knee ages, the cartilage starts to wear.  Usually, the wear is not symmetric and either the inside (called the medial) or outside (called the lateral) part of the knee wears faster.  When this happens, you start to shift the center of the weight to either the inside (medial ) or outside (lateral) part of your knee.   This shift in what is known as  the mechanical axis leads to further pressure on the already damaged cartilage leading to further wear and a resultant deformity.   A majority of people wear more on the medial (inside) portion of the knee.   This results in the knee becoming bow legged otherwise known as a varus deformity.   Over 80% of people with arthritis of the knee will have more wear on the medial side of their knee.   If you have more wear on the lateral (outside) part of your knee, this will result in the knee becoming knock-kneed otherwise known as a valgus deformity. When the knee becomes deformed, it will lead to a restricted flow of fluid within the joint, resulting in decreased nutrition to the cartilage cells and further progression of the disease.   In addition, this extra pressure on the already damaged cells causes inflammation and pain resulting in a vicious cycle of pressure, pain and further deformity. However, we can help break this cycle and help your body heal itself. A simple unloader brace can help shift the axis towards the natural or normal mechanical axis of your knee.     An unloader brace is different than a standard wrap around neoprene brace.  The unloader brace is designed to actually "un-load" the part of your knee that is over loaded.   Through a patented hinge design the brace can shift the deformity of your knee to a more neutral position.   In addition, a simple heel wedge placed into your shoe, can also help shift the axis of mechanical pressure in your knee.   These braces have been proven to work, and previous studies evaluating the efficacy of these braces have been positive.  The Osteoarthritis Research Society International found that 76% of the participants reported  improvements in the reduction of pain, improvement of stability,  and also the reduction of falls ( 95% confidence interval 69-83%). When picking out an un-loader brace,  you should have an evaluation by a physician or orthopedic surgeon.  X-rays should be taken while your are standing and loading your knee.  This helps determine the degree and direction of the deformity.    If your physician suggests an unloader brace, check out the selection we have available at jointhealing.com I recommend the OA Everyday brace all the time to my patients.  This is the ONLY brace recommended by the Arthritis Foundation and is comfortable, breathable, adjustable, and easy to apply.   I have found that patients tend to prefer this brace over other types.   Correcting the deformity of your knee is again only one part of a comprehensive program to fix the pump and get you moving again because life is motion and motion is life.

-- Dr. Loniewski

February 9th, 2012

Knee Rehabilitation- Getting the Pump Moving Again

A modern  concept of knee osteoarthritis pathophysiology focuses around a simple water pump.   Cartilage is a unique tissue of the body which does not function nor repair itself like other tissues.  However, it does share the common concept of homeostasis with other tissues.  Homeostasis is the body's ability to  balance damage and repair.  Everyday, we loose cartilage cells and everyday we make more cartilage cells.  With osteoarthritis, we just loose more cells than we make and the net result is the wearing down of the soft, shock absorbing cartilage at the end of our bones.    The reason why we loose more cells than what we make is related to a pump that has gone awry.   Human cartilage has no blood supply feeding into or exiting this vital tissue.  Most other human tissue is reliant upon blood flow into and out of the tissue to carry nutrients and help eliminate waste.  Cartilage cells still have an inflow and outflow of a fluid, but this fluid is not blood but rather synovial fluid.  This fluid circulates around the cartilage to help with nutrition and also elimination of waste just like arteries and veins.  The fluid moves though the cartilage cells not through a pump of the heart, but rather through the gentle motion of the normal joint.   Cessation of this motion leads to a literal heart attack to the knee.  Scientists studying arthritis can artificially cause arthritis in most lab animals such as rabbits or mice by just causing a simple injury to the joint and splinting it to prevent this natural function of the joint.  A joint was meant to move as it's primary function.  Halt the primary function of an organ and it will stop functioning. Thus, orthopedic surgeons have a commonly repeated battle cry in restoring function to an injured limb.  We recite this battle cry every day as we stamp out the diseases of your joints.    We recite "Life is Motion and Motion is Life."  The goal of many orthopedic interventions is to restore the normal motion of the human body and life restores to normal function. At JointHealing.com  we also follow this basic philosophy and this is why we emphasize the importance of knee rehabilitation.    Knee Rehabilitation Exercises will help restore the normal fluid motion of your self installed water pump.   One simple knee rehabilitation exercise is the common heel slide.  This can be done in almost any position and it is designed to help off-load your joint while promoting the return of normal function.  Just rest your heel on the ground and slide this back towards your rear end (or Gluteus Maximus if you only speak Latin or are a very old Catholic).  We sell a variety of rehabilitation products, but one of our best selling is our knee rehabilitation kits.   These kits include not only all the simple equipment you may require to set up your home as a virtual physical therapy department, but it also includes a complete set of exercises easily outlined in each kit. We will review some more basic concepts of this pump theory in future blogs, but if you have an injured knee and you have not yet restored the motion to this joint, please consider following our first step in your journey to joint healing.  Get the fluid flowing and let the healing begin!

-- Dr. Loniewski

January 25th, 2012

J Brace for Knee Cap Pain As easy as one…two…three.

Pain around your knee cap can be related to a few known conditions of the lower extremity but the most common cause we see is lateral tracking of the patellar-femoral joint. In plain English this means that the patella or knee cap is traveling slightly out of alignment towards the outside portion of the groove in femur (called the lateral side). Luckily, there is a simple three step plan we normally use to help treat this common disorder. The first step is called 'avoidance- activity." Now, this may seem like a contradiction of terms. However, it simply means that you avoid activity that makes the pain worse. Squatting, kneeling, stair climbing and sitting with the knee flexed are just a few that patients identify as activities that make the pain worse. Avoiding these activities will give the overloaded cartilage to rest and break the cycle of pain and inflammation. I would suggest you actually purchase a small notebook and write down what makes it worse throughout the day. Type up this list on your computer or your smart phone and keep reminding yourself not to do these things. The second step is to perform a set of exercises that build up the Vastus Medialis Obliquus muscles (known as the VMO) and also stretches to relax the lateral retinaculum help realign the knee cap. You can read more about this by going to our site at: http://www.jointhealing.com/pages/knee/chondromalacia.html The third step is to help off-load the knee cap with a knee j brace that holds the knee cap in place and reduce the pressure off the overloaded cartilage of your knee cap. The lateral j brace is one of the best braces for this condition. The "J " portion of this brace is exactly what it sounds like. It is a soft, durable piece of shock absorbing foam resembling the letter " J ." Hence the name. This brace helps cuddle the knee cap back into the proper position on the femur. By doing this,, the swelling and pain is reduced. The j brace for the knee is sometimes used for other conditions such as dislocations of the knee cap or after a surgery that helps realign the knee cap. The j brace for the knee is a great brace to help retrain the knee cap to stay on course and prevent it from straying too far from home. The breathable, stretchable drytex material makes this brace comfortable to wear. So treating your knee cap pain can be as easy as ....one...two...three!

-- Dr. Loniewski

January 18th, 2012

Short Term Efficacy of Physical Therapy Interventions for Osteoarthritis of the Knee

I know this title is a bit daunting and intimidating. However, this is a very interesting study looking at nonsurgical treatments for arthritis.  Jan M. Bjordal and colleagues at the Health and Social Sciences Institute of Physiotherapy in Bergen Norway published a very nice article with the above title in  Musculoskeletal Disorders, 2007.  They performed a systematic review meta-analysis of randomized placebo-controlled trials of all the accepted nonsurgical physical therapy interventions such as  acupuncture, electro-acupuncture, ultrasound, static magnets , pulsed electromagnetic fields (PEMF), electrical stimulation using surface electrodes (TENS) , and Low Level Laser Therapy (LLLT).   They had very strict criteria of how to include studies to be considered for review. Eventually, they found 36 studies which were reviewed for short term relief of osteoarthritis of the knee.   The researchers set up a theoretical threshold of pain improvement.  Each of the results were standardized and compared to this threshold of pain relief.    The researchers wanted to see pain relief start at least  4 weeks after treatment to be termed "effective."  Of all the accepted therapies, the researchers found that electro-acupuncture, TENS, and low level laser treatments were "effective" compared to a placebo in relieving osteoarthritis of the knee if administered as an intensive treatment over a 2-4 week period.  PEMF did provide pain relief but not in the 4 week period. What does this mean for you?    If you are searching for safe, effective and RAPID pain relief of arthritis pain of your knee, look for TENS, electro-acupuncture (OUCH!) or low level laser treatments.  Of the three, low level laser treatments may be the easiest to administer (10 minute treatments 3 times a week) with the most promising relief of pain.  

-- Dr. Loniewski

January 12th, 2012

Taking Skiing and Motocross to the eXtreme

One of the most popular braces requested by our patients who consider themselves extreme sports enthusiasts is the DonJoy eXtreme Armor Action Knee Brace.  This is also one of our most reliable and stable braces sold anywhere in the world.   The DonJoy Armor eXtreme Knee Brace uses a patented 4 point leverage dynamic system to lock your knee into a stable, yet functional position.  The brace is a a fortress of stability made from 6061 T6 Aircraft Aluminum with a swooped design to hug the knee and thigh along your natural curve along the medial (inside) portion of your leg.   The unique swivel posts hold the straps in place allowing for a custom fit while still providing optimal support.   The short calf design allows anyone to wear ski boots or motocross boots without impingement or pinching.  You can add-on some great additional protection such as the state of the art shin impact guards or knee cups so you can go full force at high speeds and feel confident that you are fully protected. We have sold this brace to professional and amateur athletes alike and have not had any complaints about it's performance.   I feel that this is our top of the line and most stable brace we sell.  The US  Olympic Ski Team also agreed with me and made this their brace of choice.   So, if you are an avid skier, snowboarder,  or motocross nut, you will not find a better built and designed brace.  The DonJoy Armor eXtreme is one of the braces I can recommend without reservation.

-- Dr. Loniewski

January 4th, 2012

Importance of Knee Bracing for Rehabilitation Purposes

If you have recently sustained an injury to your knee and are in the rehabilitation process, it is vital that you practice wearing a knee brace of some kind. Progress with healing and rehabilitating the joint can be set back unnecessarily if you neglect this important step. Knee injuries can be incredibly frustrating and difficult to remediate. However, rehabilitation can have incredibly positive effects on the healing process. Whether your injury is minor and you are following a self-regulated rehab schedule, or you are receiving medical services from a physical therapy practitioner, protecting your knee from further injury in its vulnerable state is of utmost importance. A properly fitted knee support can help add stability and reduce the pressure around a specific area. Knee braces will not heal your injury on their own, it is important to follow a rehabilitation plan unique to your situation. Upon resuming your sport, one can nearly always benefit from keeping a form of knee support on your joint. For example, competitive basketball players are required to make frequent abrupt changes in direction and cuts on the court. Wearing a hinged knee brace for support is a common practice for those players who have suffered ACL or MCL tears. Part of your knee rehabilitation will involve regaining strength and mobility of the joint through knee rehabilitation exercises. These can vary widely depending on the nature and severity of your injury, but will involve a mixture of static and dynamic movements, as your knee recovery progresses. Adding weight, resistance and different movements to the repertoire will come as you progress. Due to the exercises for knee rehabilitation, you will probably find your joint to be quite fatigued. Even if you cannot physically feel it, the rehabilitation process can be tiring on the sensitive joint and muscles. Diligently wearing a knee support brace or band while not participating in rehab activities will help insure you do not accidently or unnecessarily aggravate the area. The rehabilitation process is frustrating enough without adding any additional setbacks. So, be wise in this process and protect your joint with a knee support. Getting back in action can be simple, why complicate things by neglecting the well-being of your healing knee? Wearing a support band or knee brace can keep you on track. Are you wearing the best knee support for a quick and full recovery?

-- admin

January 3rd, 2012

Ankle Supports For Returning To Sports!

If you are considering getting back into sports but you are concerned about weak ankles or have suffered a past ankle injury, there may be a good solution for you. Ankle supports such as our Don Joy Velocity Ankle Brace or our Ascend Ankle Stabilizer can be a great solution to allow you to get back to living and moving. I have personally used both braces, and feel they are the best on the market for anyone getting back to sports. If you are looking for an ankle support for running, I would suggest the Ascend Ankle Stabilizer brace since this is a simple wrap around design that allows for proper planting of your foot during running and on changing terrains. If you are looking for a basketball ankle support, the best ankle support is the Don Joy Velocity Ankle Brace which is one of the most reliable and stable braces for stop and go sports. The slimline design allows this brace to fit into any shoe, but the uniquely designed swivel heel cup allows for surprisingly stable support in side to side and cutting movements. Although, it provides great support, it is very lightweight and easy to apply. In fact, I was able to put this on and play in under 30 seconds. It is also hand washable so it doesn't end up smelling like your locker. If you love sports such as running or basketball, consider one of these braces. We have sold thousands of these over the past 12 years in business, and our customers love them. We have a saying in orthopedics....life is motion and motion is life. Stop one and the other follows. These braces allow you to keep moving so you can keep living.

-- Dr. Loniewski

December 1st, 2011

Glucosamine Sulfate- Does it really work?

Numerous patients with arthritis always seem to ask this question.  For some reason, patients have no problem believing that standard medications such as Celebrex, Aleve, and even Vicodin help relieve pain for arthritic joints.  However, when it comes to a supplement that actually treats the underlying causes of arthritis, they seem to have a tough time believing that it would be effective.  If we look at the volume of evidence for effective treatments of arthritis, Glucosamine Sulfate is the hands down winner.   In fact, Deal and colleagues in their meta-analysis of 13 randomized controlled and double blinded studies in the journal of  Rheumatology Disease and Clinics of North America found that all of the 13 studies they reviewed provided statistically significant (p<.05) improvement of symptomatic arthritis when compared to either placebo or even non-steroidal anti-inflammatory medications such as Celebrex or Aleve.   However, the key point here is the that they evaluated Glucosamine Sulfate and NOT other forms of glucosamine such as Glucosamine HCL or Glucosamine NAS.  The sulfate form allows the donation of a sulfur molecule.  This is the organic element sulfur and not sulfa normally found in sulfa drugs.    Sulfate and sulfa are NOT chemically related and patients allergic to sulfa drugs CAN take glucosamine sulfate safely.   The donation of the sulfur molecule allows the reduction of pain and inflammation.   This may bring up the concern about Glucosamine Sulfate Side Effects.  Although , there was some concern about Glucosamine Sulfate causing elevated blood sugars in brittle diabetics, more recent studies that were better designed failed to show that glucosamine caused any rise in blood sugars.   There was also one case of an asthma attack associated with the use of glucosamine.  However, no other case reports were found.   Patients taking Glucosamine especially with the Chondrotin combnination  may be at higher risk for bleeding since chondrotin is chemically similar to another blood thinner called heparin. However, there has not been any bleeding problems  reported with patients taking this combination.  Other minor side effects such as nausea, constipation and diarrhea have also been reported and are usually temporary.  If you are allergic to shellfish, you may want to first talk with your doctor before starting Glucosamine but there has not been any reported cases or shellfish allergies and the use of Glucosamine Sulfate. Patients also want to know if they should take the glucosamine sulfate and chondrotin mixture or just pure glucosamine sulfate.  The theoretical advantage is the fact that chondrotin acts as a hydrophylic agent bringing in more moisture into the central GAG portion of cartilage cells.   Although the combination seems very compelling to a biochemist, in reality, the single formula Glucosamine Sulfate has more clinical evidence that it is effective in reducing pain in patients with arthritis. In summary, Glucosamine Sulfate is a safe and effective treatment for joints affected with osteoarthritis.  It is very important to use the Sulfate form and to also take this medication for at least 2 months prior to making any decisions if this is helpful or not.  It is also very important to combine the use of Glucosamine Sulfate with other proven treatments for arthritis such as weight control, exercise, proper shoe wear, diets high in fruits, vegetables and antioxidants.   If you have concerns about taking Glucosamine Sulfate, please discuss this with your personal physician prior to taking this supplement.

-- Dr. Loniewski

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