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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. | 
