I just wanted to thank the people that got back to me on this, as I have started taking 250mg timed released B3 last week and my hands are 50% improved, I can't believe this myself but it is the only change I have made, I am also starting to take Tumeric and boron today. Just one more question about the B3 do you think I should increase the dose or stay where I am. Thanks to this wonderful place, I can't believe how much better I am feeling. I still take pain pills but not as often. Any reply would be appreciated.