Can MSM relieve osteoarthritis?
BACKGROUND
MSM stands for methylsulfonylmethane, which is found in many plants, fruits and vegetables. It is chemically similar to dimethylsulfoxide (DMSO) in being an organic form of sulphur. Consumption of MSM is one way to supplement the body’s intake of sulphur. Many proteins require sulphur to function properly, including those used to make hair, muscles, bone, teeth and cartilage.
Because sulphur plays a number of important roles in the body, MSM has been suggested as an alternative therapy for many conditions, including arthritis and osteoarthritis which it is most commonly said to relieve. Osteoarthritis affects about one in 10 adults over 35 years of age. Although the intensity of the symptoms vary, it can be a significant source of pain and disability.
Analgesic medication, exercise and surgery can bring some relief for those with osteoarthritis. At the same time, a number of herbal remedies and food supplements are said to bring relief without adverse effects. MSM is said reduce both pain and inflammation, and counteract the degenerative changes that occur in osteoarthritis.
EVIDENCE FROM STUDIES
An early trial of 2.25g MSM per day produced some improvement in arthritic pain, but the study involved only 16 people and its details have never been published.
A second double-blind study involved four groups of people with mild to moderate osteoarthritis in various joints. More than 100 patients were randomly assigned to receive either glucosamine or MSM alone (1.5g per day), a combination of both, or a placebo. After 12 weeks, pain and swelling were significantly reduced by glucosamine and MSM compared with placebo. The group that took both supplements together had even better results. Joint mobility was also improved, although MSM did not bring as much improvement as glucosamine or the combination.
However, this study has been criticised because many important details were missing from the article. Reviewers have attempted to contact the researchers to obtain the missing data, but have never received replies.
A more recent randomised controlled trial enrolled 50 patients with knee osteoarthritis. Patients were given 3g MSM twice daily or placebo for 12 weeks. Those taking MSM reported significantly better pain relief and physical functioning. However, stiffness and an overall score of all symptoms did not differ between MSM and placebo. Strangely, the pain reduction in this study was less than that in the earlier one even though the dose here was four times higher.
Symptoms gradually decreased in both the MSM and placebo groups, and were continuing to decrease when the trial ended. This suggested that the study may not have been long enough to see the final result and whether MSM would have continued to be more beneficial after longer use.
PROBLEMATIC ASPECTS
Adverse effects have been relatively minor in clinical trials. These include cases of gastrointestinal upset, allergic reactions and skin rashes. Animal studies have given rats large single doses and found no adverse effects.
RECOMMENDATIONS
The evidence for the use of MSM for osteoarthritis is relatively sparse. The three controlled trials are relatively small and short, with many details missing from two of them. However, the three studies do suggest that MSM may provide some benefits. Much further research is needed to confirm these preliminary findings, especially for long-term use. Given its lack of adverse effects, and the problems that some people have with conventional medications, a trial period with MSM may be warranted. Anecdotal reports claim that MSM can take up to three months to produce its benefits.
Would you like to see a particular herb or supplement reviewed here? If so, send your suggestions to healthsupplement@irishtimes.com
Dónal O’Mathúna has a PhD in pharmacy, researching herbal remedies, and an MA in bioethics, and is a senior lecturer in the School of Nursing, Dublin City University
