Feeling a bit creaky, achy, or stiff in the joints? You probably are among the 18 million Americans and Canadians who suffer from rheumatism, bursitis, or tendinitis, which are often mistaken for arthritis. Another 16 million suffer from osteoarthritis. While new drugs such as COX-2 inhibitors are giving arthritis sufferers hope for pain relief, natural supplements show dramatic results in relieving the symptoms--and possibly slowing the cartilage disintegration--at the root of this ailment.

Here's a rundown of the leading supplement recommendations for osteoarthritis. Most cause far less stomach irritation than aspirin, ibuprofen, or naproxen, the NSAIDs doctors typically prescribe for osteoarthritis.

Start with glucosamine. To enhance it, take it with one of the other oral supplements listed, experimenting until you find the combination that works best.

Allow at least a month to see results. These supplements can be used long-term and with conventional pain relievers.

This cartilage-building sugar compound is one of the most helpful remedies for relieving arthritis pain. It appears to slow joint damage over time, although whether it can actually reverse the disease is unknown. One recent study showed that glucosamine may be particularly useful against arthritis of the knee. And two earlier studies found that glucosamine was as effective as or more effective than ibuprofen for relief of arthritis symptoms.

Suggested dose: 500 mg 3 times a day. May be more effective on an empty stomach; take with food if irritation occurs. Appears to have none of the serious side effects common to aspirin and other NSAIDs.

The jury is out on whether chondroitin sulfate, a cartilage-building compound, works as well as glucosamine, because it may be poorly absorbed by the body. However, the combination of glucosamine and chondroitin has become extremely popular, and rigorous studies to prove its effectiveness are now being conducted.

Suggested dose: 400 mg 3 times a day. Take with food to minimize digestive upset.

Methylsulfonylmethane is a newly popular sulfur compound that appears to inhibit pain impulses along nerve fibers, acting as an analgesic and anti-inflammatory. Although few controlled studies have been done in humans, MSM has eased the pain associated with osteoarthritis in many people who use it regularly.

Is MSM safe? Few studies on the supplement have been done. We asked Ronald M. Laurence, M.D., Ph.D., assistant clinical professor at UCLA School of Medicine and author of a book on MSM (The Miracle of MSM, Putnam's, 1999)."In the thousands of patients I have treated who took 2,000 mg and more of MSM daily for many months and years, I haven't heard of any serious complaints to date," Dr. Laurence says. "In fact, I feel comfortable telling people that MSM is safer than water. Remember, though, MSM is a biologically active substance and can sometimes produce side effects, such as skin rash or minor gastrointestinal upset, in some people. If you're on anticoagulants, you should check with your doctor before taking MSM, because it can occasionally have a blood-thinning effect."

Are some forms of MSM more effective than others? Dr. Laurence replies: "Many of my arthritic patients have found that they experienced less pain when they took MSM in combination with glucosamine, and a number of companies are now adding MSM to their glucosamine formulations. I recommend taking a combination of 500 mg of MSM and 500 mg of glucosamine three times a day. Using MSM cream in addition to the oral supplement also works well for some people. Rub MSM cream on the arthritic area four or five times a day for best results. I suggest adding 1 teaspoon of MSM powder to the cream to make it even more potent."

Suggested dose: 750 mg 3 times a day, Take with food to minimize digestive upset. If using it with glucosamine, look for a combination MSM/glucosamine product containing 500 mg of each.

Supplementspot's Formulas combine the recommended dosage in easy to take capsules

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