Effect of Glucosamine on Back Pain: Unfulfilled Hope
Tuesday, March 15, 2011 at 10:38PMThe glucosamine supplement industry has grown into a billion dollar industry. For years the public and scientists alike have touted the ability of glucosamine and chrondroitin suppments to reduce symptoms of arthritis, especially with knee osteoarthritis. Unfortunately, a lot of these studies drew conclusions based on studies involving small numbers of patients and patient questionnaires.
However, a number of recent well designed double-blind placebo controlled studies have begun to call into question the benefit of glucosamine in patient with osteoarthritis pain.[i] A large meta-analysis from the Annals of Internal Medicine, in fact, sugges that “Large-scale, methodologically sound trials indicate that the symptomatic benefit of chondroitin is minimal or nonexistent. Use of chondroitin in routine clinical practice should therefore be discouraged.” [ii]
Those are harsh words for a glucosamine supplement industry that already has a lot of steam behind it.
I have a lot of people who maybe have used glucosamine for knee arthritis and wonder if it will be helpful for back pain. My stock answer had always been, if it helps for knee or other joint arthritis, it could be helpful with joint-related pain in the back.
Wrong answer.
A body of evidence is emerging to suggest that people with chronic low back pain and degenerative arthritis in the spine may not get a lot of benefit from glucosamine.[iii]
A study in The Journal of the American Medical Association from 2010 looked specifically at this issue. A randomized, double-blind, placebo controlled study with chronic low back pain and degenerative lumbar OA found that “6-month treatment with oral glucosamine compared with placebo did not result in reduced pain-related disability after the 6-month intervention and after 1-year follow-up.” [iv]
That is strong medicine. Now I have talked to a lot of people that swear by glucosamine supplements. I am sure that traditional Western medicine has offered lots of less appealing options for back pain. But maybe glucosamine is not the best treatment choice for back pain, at least not based on the data now available.
[i] Ann Intern Med. 2007 Apr 17;146(8):580-90.
[ii] Ann Intern Med. 2007 Apr 17;146(8):580-90.
[iii] JAMA. 2010 Jul 7;304(1):45-52.
[iv] JAMA. 2010 Jul 7;304(1):45-52.
Reader Comments (2)
Very interesting article! I was really sure that glucosamine helps pacients.
One problem with so many studies is that they (deliberately ? ) use a dose that is too small. Also glucosamine is only one of the supplements a patient needs. There is no magic bullet.