Celebrex, Glucosamine, Imagery, and Pain relief
A recent study of glucosamine for osteoarthritis was reported in news media as being both effective and not effective, which illustrates that we really need to look at studies with some depth in order to tell what they really show. The study showed that glucosamine was no better than placebo for relieving knee pain from osteoarthritis, and not as good as Celebrex, and that's what some news agencies including the NY Times reported.(http://www.nytimes.com/2006/02/23/health/23arthritis.html?pagewanted=2&ei=5070&en=38b9b1393d32311e&ex=1149998400)
But the study also showed that for the 30% or so of patients with the most severe pain levels, the glucosamine along with chondroitin DID relieve pain better than placebo, and about as well as Celebrex, so some other sources focused on this finding of effectiveness. (http://www.medpagetoday.com/Rheumatology/Arthritis/tb/2728?pfc=101&spc=230)
So we need to consider our sources when we evaluate medical studies. But what is even MORE interesting is that while 70% of the people taking Celebrex and 64% of those taking glucosamine got good pain relief, 60% of the people taking a placebo (with no active ingredients) also got good pain relief. In other words, THINKING that you are taking something for your arthritis accounts for over 85% of the effectiveness of actually taking a powerful and somewhat risky medicine!
What this study actually showed is that there is a very small statistical advantage to taking Celebrex over either glucosamine or placebo in terms of effectiveness, but glucosamine and placebo have minimal if any adverse effects (yes, there can be negative effects of placebo, too). Please understand that I am not anti-medicine, and actually think Celebrex is probably a pretty good medicine in certain situations, but we shouldn't ignore that Celebrex can cause ...well, see below for a warning about potential side effects from a Celebrex advertisement.
"Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Celebrex. More common side effects may include: Abdominal pain, diarrhea, headache, indigestion, nausea, respiratory infection, sinus inflammation
Less common side effects may include: Back pain, dizziness, gas, insomnia, rash, runny nose, sore throat, swelling Rare side effects may include: Allergic reactions, anxiety, belching, blisters in mouth and eyes, blood disorders, blood infections, blurred vision, bone disorders, breast pain, breast problems, bronchitis, cataracts, chest pain, colitis, conjunctivitis (pinkeye), constipation, coughing, cysts, dark-tarry stools, deafness, depression, dermatitis, diabetes, difficult urination, difficulty breathing, difficulty swallowing, drowsiness, dry mouth, dry skin, earache, ear infection, ear ringing, esophageal perforation, eye infection, eye pain, fainting, fatigue, fever, flu symptoms, fungal infection, gallstones, gangrene, general swelling, glaucoma (pressure in the eye), hair loss, heart failure, heart irregularities, hemorrhoids, hepatitis, hernia of the stomach, herpes infection, hives, hot flashes, increased appetite, increased blood pressure, increased heart rate, increased muscle tone, increased urination, infection, inflammation of the digestive tract, inflammation of the bladder, inflammation of the blood vessels, intestinal bleeding, intestinal obstruction or perforation, itching, jaundice, joint pain or inflammation, kidney problems, laryngitis, leg cramps, liver problems, loss of appetite, loss of balance, low blood sugar, menstrual disorders, migraine headache, mouth ulcers, muscle ache, nail disorders, neck stiffness, nerve pain, nervousness, nosebleeds, pain, painful urination, pancreatitis, phlebitis, pneumonia, poor coordination, prostate problems, severe diarrhea, severe skin rash and peeling, skin reaction due to sunlight, skin sensitivity, skin tingling, stroke, suicide, sweating, swollen face and throat, taste disturbances, tendonitis, tiredness, tooth disorders, urinary incontinence, urinary tract infections, vaginal problems, vomiting, weakness, weight gain"
I underlined some the rare reactions just so we notice that some of these rare reactions are quite serious, even fatal. There are no fatalities that have ever been attributed to glucosamine or placebo.
Celebrex costs about $1-2 a day, glucosamine costs about 35-50 cents a day, and placebo costs...nothing.
"Placebo effect" is a much misunderstood phenomenon in medicine. It's a real effect, accounts for a huge amount of positive responses to all treatments, and actually, is the only reason we do extraordinarily expensive, double-blind, randomized, placebo-controlled studies - because it's THAT difficult to eliminate the effects of positive expectation from the healing equation. Researchers want to eliminate the placebo effect, but as patients and health professionals, we want to maximize its effects.
After all, if we can be "tricked" into healing, why can't we learn to turn it on ourselves?
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