Do glucosamine chondroitin supplements actually work for osteoarthritis pain, or are their “effects” really just wishful thinking by people desperate to find some relief?
Over 20 million Americans suffer from osteoarthritis -- which means that 20 million Americans are looking for relief from osteoarthritis pain. That’s no small task, especially after the recall of the two COX-2 inhibitors, Vioxx and Bextra.
One popular treatment for osteoarthritis is the supplement glucosamine. Glucosamine, usually made from crustacean shells, contains an amino sugar compound found in cartilage. Supplement manufacturers claim that taking glucosamine supplements will help preserve and repair cartilage in arthritic joints, although it is unknown exactly how the body processes this extra glucosamine -- or even whether it is delivered to the joints. Some glucosamine supplements also contain chondroitin, another natural component of cartilage. Chondroitin is believed to promote cartilage elasticity and prevent cartilage breakdown, but again it’s unknown how or if the chondroitin reaches the joint tissue.
How effective are glucosamine chondroitin supplements? A large-scale study conducted by the National Institutes of Health hopes to answer this question. While the full verdict isn’t in yet, preliminary results suggest that glucosamine chondroitin supplements may not live up to manufacturers’ claims.
The Glucosamine Chondroitin Arthritis Intervention Trial (GAIT) involved almost 1,600 patients with knee osteoarthritis. Participants were assigned to six months of treatment with one of five regimens: 1,500 mg of glucosamine hydrochloride daily, 1,200 mg of chondroitin sulfate daily, a full-dosage combination of both glucosamine and chondroitin sulfate daily, 200 mg of celecoxib daily, or placebo. All study participants were allowed up to 4,000 mg of acetaminophen per day if needed for pain relief, though on average they took less than 1,000 mg per day. Patients reported the intensity of their pain symptoms on a scale from 1 to 5. Effective treatment was defined as a 20% improvement in pain.
Overall, glucosamine and chondroitin supplements were no more effective than placebo: Both groups reported similar improvements. As was expected, people taking celecoxib had the greatest improvement. Glucosamine chondroitin supplements did appear to work better for participants suffering from moderate to-severe pain: 79% of the glucosamine chondroitin supplement group reported an effective reduction in pain, compared with just 54% of the placebo group.
So are glucosamine chondroitin supplements worth the expense? Clifton O. Bingham III, M.D., assistant Professor of Medicine at Johns Hopkins in the Arthritis Center says, “If people are not having any improvement after taking a supplement for some time, our data would suggest that there is little point in continuing.” In the end, proven painkillers— such as acetaminophen, NSAIDs, and celecoxib—will get you the most pain relief for your money. However, Dr. Bingham stresses that pain relievers are only one component of effective osteoarthritis management. "Though most people want a magic bullet, the fact remains that the best responses are seen in people who are willing to engage in regular activity and lose weight.” He also stresses that when discussing treatment options with your doctor, it’s important to mention any medications and supplements you use.
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