April 25, 2007

By Frank Long

Chondroitin, once the darling of supplement treatments for osteoarthritis pain, has been roundly criticized by academic research that suggests its effectiveness as a pain reliever may be on par with snake oil.

The ignominious turn of events may renew interest in physical therapist (PT) interventions as a preferred source of arthritis-related pain relief.

With bills before Congress that could drop the doctor-referral barrier (H.R. 1552) and lift the Medicare cap on PT treatment (H.R. 748), the demand for therapist-driven pain treatment may experience a surge. And if the Arthritis Foundation’s projection that one in four Americans will be affected by arthritis by 2030 becomes reality the demand for therapy may become unprecendented.

"The physical therapist, in collaboration with the patient and the patient’s physician, can help the patient manage his or her health over the long term," explained American Physical Therapy Association President R. Scott Ward, PT, PhD, in an APTA news release.

Ward’s position is fortified by a study conducted at the University of Bern in Switzerland and published in  “Annals of Internal Medicine.”

The study revealed pain associated with certain degenerative diseases such as osteoarthritis can be reduced with physical therapist intervention. The data also found therapist intervention such as exercises for strength, flexibility and range of motion can help alleviate pain.

Orthotics and other devices common to physical therapy practices that rest impacted joints can also provide effective pain relief, according to the study’s results.

Exercise and educating the patient about joint conservation techniques are already used in pain treatment at Good Shepherd Rehabilitation Network in Allentown, Pa, according to Cynthian Bauer, PT, DPT, OCS, Director of Musculoskeletal Outpatient Services at Good Shepherd.

“Patients can get on a weight reduction program, a joint strengthening program and get a better understanding of what exercises they’re doing so they don’t make their condition worse,” Bauer said. “PTs are educated to know if a person is appropriate for an intervention."

Exercise and joint-strengthening techniques are gaining ground as preventive measures and pain management strategies. In some cases these methods are augmented by pharmacological solutions or surgical interventions in cases of more severe pain.

As therapy treaments continue to attract attention for the time being the efficacy of supplements, it appears, will remain in dispute.

“Ingesting chondroitin is a waste of money,” said Nortin Hadler in an April 17 interview with ABC television. Hadler, attending rheumatologist at the University of North Carolina Hospital, added, “I’ve long said that and told my patients.

“Some have money to waste,” Hadler adds, “so be it.”

Contact the author of this story: flong@ascendmedia.com