msm
Place in Therapy
MSM is a form of organic sulfur that has been associated with improvements in many conditions, including osteoarthritis. Although the Arthritis Foundation reports MSM as an option for pain and inflammation, it is not recommended due to a lack of evidence supporting its efficacy. MSM appears to be likely safe and tolerable when used orally in recommended doses of 1500 mg daily to 3g twice daily for up to 12 weeks. However, the limited amount of trials, small sample sizes, flawed methodology, and lack of long term safety and efficacy analysis has led to an unclear conclusion. Furthermore, trials have shown modest improvement in symptoms such as pain and physical function compared to placebo, both of which have shown improvement to a greater degree with current available treatments with much more thorough and valid evidence (such as Tylenol and NSAIDs). With respect to safety, clinical trials showed similar adverse effects in both the placebo and treatment groups in the short term, with mild side effects such as bloating, diarrhea, gastrointestinal discomfort, constipation, fatigue, insomnia, headache and lack of concentration. Significant toxicity may be lacking, but reports assessing long-term use are also absent. There are no studies in children, pregnancy or lactation, and many patients which are most likely to suffer from osteoarthritis (due to increasing age) were excluded from the trials (ex: those with renal or hepatic disease, severe arthritis, diabetes etc.). In addition, trials focused on knee arthritis specifically, which may narrow the targeted patient population of this product. Taking into account all these reasons, MSM is a practical option for those wishing to try a natural health product for mild symptoms of knee osteoarthritis. Its proposed modest benefit may be appropriate in those who have contraindications to other available treatments, preference for natural health products, for those who do not meet the exclusion criteria of the trials, and who do not have gastrointestinal, circulation or nervous system disorders. Benefits and harm appear small, and further studies are warranted.
References:
1. MSM (methylsulfonylmethane) Natural Standard Professional Monograph, Copyright © 2013 (www.naturalstandard.com). Accessed March 1st, 2014.
2. Lexicomp Online, Methylsulfonylmethane (Natural Products Database), Hudson, Ohio: Lexi-Comp, Inc.; 2013. Accessed March 1st, 2014.
References:
1. MSM (methylsulfonylmethane) Natural Standard Professional Monograph, Copyright © 2013 (www.naturalstandard.com). Accessed March 1st, 2014.
2. Lexicomp Online, Methylsulfonylmethane (Natural Products Database), Hudson, Ohio: Lexi-Comp, Inc.; 2013. Accessed March 1st, 2014.