Alternative options for bone & joint pain: while nonsteroidal pain relievers (Ibuprofen [Motrin], among others) and acetaminophen (Tylenol) can definitely help with the pain of osteoarthritis, they each carry significant side effects: gastrointestinal bleeding and possible cardiovascular problems with nonsteroidal anti-inflammatories and liver toxicity with acetaminophen.

So millions of people turn to alternatives to relieve the pain of arthritis and restore function to aching knees and hips. Among the options with some evidence behind them:

Glucosamine/chondroitin.

Glucosamine and chondroitin are substances found in and around cartilage cells. The evidence on their use as dietary supplements for osteoarthritis is mixed. A large government study called GAIT (Glucosamine/chondroitin Arthritis Intervention Trial) compared the supplements alone or together to celecoxib (Celebrex) in 1,229 participants with mild pain from knee arthritis and 354 with more severe pain. The trial found that while 1,500 grams a day of glucosamine and 1,200 mg a day of chondroitin alone or together did not improve pain in the group at large any better than a placebo, it did have a significant benefit in people whose pain was more severe. (17) Meanwhile, a review of studies found a much greater benefit from the Dona brand of glucosamine than any other. (18)

Methylsulfonylmethane (MSM).

One study found that 500 mg three times a day of this dietary supplement significantly reduced pain and improved function in people with osteoarthritis. (19) In another study, three grams of MSM twice a day worked better than placebo in reducing pain and improving function. (20)

S-Adenosyl methandienone

(SAMe). A review of 11 studies involving 1,442 people with osteoarthritis found that SAMe, a synthetic form of an amino acid and energy-producing compound in your body, worked just as well as nonsteroidal anti-inflammatories at reducing pain with fewer side effects. (21)

Acupuncture. A review of five well-designed, randomized clinical trials involving 1,334 people with pain from osteoarthritis found that real acupuncture was significantly better than "sham" acupuncture in improving objective measurements of pain and function. (22)

Tai Chi. Several studies find that this ancient Oriental meditative exercise can help reduce pain and improve function in people with osteoarthritis, sometimes even better than typical treatment. (23) As always, tell your health care professional about any supplements you take or want to try and about any new exercise regimens you begin.

RELATED ARTICLE: What About Back Pain?

Lower back pain is one of the most common reasons people visit their health care professionals. While anti-inflammatories and pain relievers can help some, nonmedical options abound. One of the most commonly used is massage-for good reason. Eight studies comparing massage to other treatments for low back pain such as exercise, bracing, relaxation therapg, physical therapy, acupuncture and self-care showed that massage definitely has benefits for low back pain, particularly when combined with exercise and education about preventing further back injuries. Acupressure massage and Thai massage, two special types, were most effective. (24)

Meanwhile, a review by the American Pain Society and the American College of Physicians found "good evidence" that cognitive-behavioral therapy, exercise, spinal manipulation (chiropractic) and interdisciplinary rehabilitation involving aspects of several approaches were all moderately effective for back pain that has lasted more than four weeks. They also found "fair evidence" that acupuncture, massage, yoga and a form of physical therapy called "functional restoration" also worked. Meanwhile, heat applied to the painful area and spinal manipulation were effective for acute back pain, or pain lasting less than four weeks. (25)