Patient case (clinical description): A 66-year-old woman comes to the office due to joint pain in the hands and periodic morning stiffness that lasts less than 15 minutes.  The pain is moderately severe and worsens with daily activity. The patient used Tylenol with minimal relief.  Past medical history is notable for hypertension and hypercholesteremia.  Physical examination shows firm nodules over the distal interphalangeal joints, bilaterally. The patient has pain in her knees as well. The knees are stiff in the morning for less than 30 minutes and become worse with climbing stairs. She has some sensation of bone friction during activity. X-ray shows narrowing of the joint space, subchondral bone sclerosis and osteophyte formation along the joints.

Patient's own account: I'm a 66-year-old woman and I went to my doctor's office because of a bloody joint pain in my hands that has been lasting for a while. The pain comes and go in the morning usually. I feel like a stiffness that last less than 15 minutes. The pain is moderately severe but it gets worse when I'm using my hands. I used Tylenol which helped a little. Apart from that, I suffer from hypertension and high cholesterol. The doctor made me notice that I have bumps around both of my hand joints. I also suffer from my knees and they are also stiff in the morning for around 30 min. It's even worse when I climb up the stairs! I also feel like my bones are rubbing against each other when I'm moving. The X-ray showed that I have narrow joint space, I have sclerosis, and abnormal growths of bone along my joints.

Clinical trial: Instaflex and Joint Pain in Community Adults

Eligibility criteria:
Inclusion Criteria:

          -  Male or female

          -  ages 50-75 years

          -  history (>3 months) joint pain, knees, hip, ankles, shoulders, or hands

          -  willingness to avoid NSAIDs use during the 8-week study

          -  willingness to avoid other anti-inflammatory medications

          -  agree to stay weight stable during the 8-week study

          -  willing to follow all study procedures, including randomization to one of two groups

          -  able to walk for at least 6 min at a moderate-to-brisk pace

        Exclusion Criteria:

          -  history of regular NSAID use during the previous two weeks

          -  use of other medications (e.g., analgesic gels, arthritis medications, other
             anti-inflammatory drugs) or supplements (in particular, glucosamine and chondroitin)
             for joint pain for the previous two weeks

          -  serious medical problems (current cancer case, severe rheumatoid arthritis, recent
             heart attack, recent stroke, congestive heart failure, ulcers, kidney disease, or
             other disease that will interfere with study participation).

          -  psychiatric disorder or other condition that might interfere with self-assessment
             ability.

          -  history of allergic reactions to shellfish products.

          -  history of allergic reactions to products containing aspirin.
No condition on gender to be admitted to the trial.
Accepts Healthy Volunteers
Subject must be at least 50 Years old.
Subject must be at most 75 Years

Eligibility (NLI label): Entailment