Glucosamine No Better Than Placebo for Lower Back Pain Caused by Arthritis
Glucosamine is a natural compound found in healthy cartilage. Dietary supplements containing glucosamine are often used by osteoarthritis sufferers to relieve symptoms such as inflammation and pain. However, studies on the supplement’s ability to treat arthritis symptoms have been mixed. The latest has found that taking glucosamine for six months was no better than a placebo for lower back pain caused by degenerative arthritis.
A team led by Philip Wilkens, research fellow in the orthopedic department at the University of Oslo in Norway conducted a randomized clinical trial in 250 people over 25 with chronic lower back pain and degenerative lumbar osteoarthritis. Half of the subjects took 1500 milligrams of glucosamine daily for six months while the other half took a placebo. At six weeks, 3 months, 6 months, and one year, the team assessed the participants’ pain using the Roland Morris Disability Questionnaire. The patients also self-reported on their quality of life.
Glucosamine is thought to work in the synovial fluid by strengthening cartilage and aiding glycosaminoglycan synthesis. The compound is often combined with chondroitin, a glycosaminoglycan derived from articular cartilage. Previous studies on the effects of glucosamine have not been well designed, according to the US National Institutes of Health.
At the start of the trial, patients taking glucosamine scored 9.2 on the pain scale. After six months of supplement use, their pain score reduced to 4.8. However, those not taking glucosamine scored 9.7 in the beginning, and found their pain also reduced to a score of 5.5.
"Based on our results, it seems unwise to recommend glucosamine to all patients with chronic lumbar pain and degenerative lumbar osteoarthritis," Wilkens and colleagues wrote in the Journal of the American Medical Association.
The bottom line, according to Wilkens: "People with chronic low back pain and degenerative osteoarthritis will not benefit more from glucosamine than placebo for treating their back problem."
On the positive side, glucosamine supplementation appears to be safe with few side effects and is inexpensive. Some studies have found glucosamine sulfate to provide benefits to those who suffer from mild-to-moderate knee osteoarthritis.
Osteoarthritis affects more than 20 million Americans and lower back pain is the second-most common concern expressed by patients to their primary care doctors. About 80% of the US population will have back pain in their lifetimes. The US spends about $16 million a year to treat the conditions.
The best treatments found so far for chronic back pain are exercise, physical therapy, manipulation, and cognitive therapy combined, according to Wilkens.
For those who wish to give glucosamine a try for themselves, the daily dose of 1500 mg of glucosamine was "appropriate," according to Wilkens. Studies have shown that doses below this amount do not enter the bloodstream at sufficient levels, and any amount over this dose is not absorbed, he said.
Wilkens P, et al "Effect of glucosamine on pain-related disability in patients with chronic low back pain and degenerative lumbar osteoarthritis: A randomized controlled trial" JAMA2010; 304(1): 45-52.