How to maintain joint health: list of medications

Author: Sergey Yezhov - sports medicine physician.
2017-03-06

In modern sports medicine, one of the most pressing problems remains joint pain among training individuals. Of course, the main role in this pathology is played by constant injuries and overloads faced by professional athletes.

Biomechanically, any joint in our body acts as a sort of block between the limbs and the torso, making it particularly vulnerable under heavy loads.

In this regard, I recommend that athletes regularly observe preventive measures in the form of taking supplements that nourish joint cartilage (chondroprotectors). Even without joint pain, usually, two courses of preventive therapy per year are necessary. Do not neglect this advice. The appearance of pain in the joint means that the pathological process has already begun, and stopping it will be much more challenging.

Let's consider the main groups of medications used in this field.

1. Injectable chondroprotectors.

• Chondroitin sulfate. The most commonly used medications in this group are: Chondrolone, Chondrogard, Chondroxide. I don't see any significant differences between them. They are usually prescribed as follows: the first 3 doses of 1 ml once a day every other day. With good tolerance – 2 ml once a day every other day, for a total of 10-15 injections.
• Medications derived from animal tissues. Rumalon – cartilage tissue from calves, Alflutop – an extract from the cartilages of marine fish. These medications have proven to be quite effective. They are administered intramuscularly at 1 ml once a day for 20 days. Alflutop is also used for injection into the joint cavity.
• Synovial fluid substitutes (Synocrome, Fermatron, Hyalgan, Noltrex, etc.). These are used for injection into the joint cavity. They create a sort of mechanical cushion inside the joint, reducing the load on the joint surfaces and mechanical friction. These must be administered only by qualified surgeons or trauma specialists.

2. Tablet chondroprotectors. There is a huge variety on the market today, so I will discuss them in a separate review.

3. Ointment forms of chondroprotectors: Chondroxide gel. Due to the low bioavailability of the active substance (only 3%), I find the use of these forms to be ineffective for athletes.

4. Medications that improve microcirculation in the joint. The most commonly used are Trental or Pentoxifylline. For home use, I prescribe tablet forms. The usual regimen for an athlete is 1 tablet 3 times a day for 1 month. Nicotinic acid may also be used: 1 ml intramuscularly once a day for 10 days.

5. Neurovitamins: Combilipen, Milgamma. They enhance the work of peripheral nerves, thereby improving the nutrition of the joint. Administered at 2 ml once a day for 10 days.

6. Calcium and vitamin D supplements (Calcimine Advance, Calcium D3 Nicomed, Osteogenon). They also have a proven effect in treating osteoarthritis. By enhancing osteogenesis, they strengthen subchondral bone tissue, thereby preserving the nutrition of joint cartilage. Taken as 1 tablet 3 times a day for 30 days.

7. Omega 3, 6, 9 fatty acids. They enhance the synthesis of synovial fluid in the joint.

8. Collagen. It is one of the structural components of cartilage tissue. Today, there are dozens of supplements on the pharmaceutical market containing this substance. I recommend a simple scheme for my patients: take regular food gelatin (available at any grocery store). Dissolve and consume 1 packet (15 grams) three times a week for a course of 6-8 weeks.

9. SARM preparation Ostarine. Its mechanism of action is unproven. However, clinical trials have noted a reduction in joint pain in athletes taking this drug.

10. Methylsulfonylmethane (MSM) – it inhibits the synthesis of prostaglandins, thereby reducing inflammation in the joint and improving cartilage metabolism. It is typically included in complex supplements.