Do Glucosamine Supplements Really Help Reduce Joint Pain? What Does the Science Say?

Glucosamine is currently one of the most commonly used dietary supplements in the US.  With major increases in the rate of obesity and the osteoarthritis that often stems from it, many people are eager to find a solution to their joint pain (particularly in the knees and hips) that does not also cause significant side effects.  However, there is still a significant amount of controversy surrounding its efficacy.

An essential element that helps keep joint cartilage healthy, glucosamine levels naturally drop as we age, which can lead to deterioration of the joints.  Cartilage is made up of water, collagen, and little fibers called proteoglycans.  Proteoglycans hold many times their weight in water and are arranged like a net that is the supporting structure for collagen and that keeps it lubricated. If the proteoglycans weaken, they can break and form “holes” in the net, allowing the collagen to leak out, weaken the structure of the cartilage, and reduce the amount of cushioning and lubricating synovial fluid in the joint.

Glucosamine is a major building block of proteoglycan synthesis and stimulates cells to produce more of them.  This means that a drop in glucosamine leads to an eventual deterioration of the cartilage.  However, the question now is whether glucosamine supplementation makes any difference in the amount of glucosamine in the joints, and if so, whether there is any benefit.l

In 2010, the research journal BMJ examined 10 trials consisting of a total of almost 4,000 people and found that glucosamine, chondroitin, and the combination of the two did not alleviate joint pain or have any impact on the reduction of joint space, when compared with placebo. However, it is important to note that glucosamine comes in different forms (the two primary ones being glucosamine sulfate and glucosamine hydrochloride), and can be derived from different sources.  The research included trials using both forms.  As a result, the analysis did not necessarily compare like with like.

Unsurprisingly, the researchers found that industry-funded studies were more likely to report that glucosamine reduced joint pain than independently funded studies.  However, a 2005 analysis of randomized controlled trials evaluating the effect of glucosamine included 25 studies with nearly 5000 participants.  When investigators discarded the low-quality and older studies, they concluded that glucosamine alone did not have any effect on joint pain that was superior to placebo.  When glucosamine was combined with chondroitin, however, results were promising.

BMJ researchers said that many patients believed that glucosamine was beneficial for their joint pain, whether or not it was due to the placebo effect.  They also noted, “We are confident that neither of the preparations is dangerous.  Therefore, we see no harm in having patients continue these preparations as long as they perceive a benefit and cover the costs of treatment themselves.”

Further high-quality studies of the various types of glucosamine are necessary to sort out the benefits (or lack of benefits).  For now, the bottom line on the science is that glucosamine may or may not help relieve your joint pain.  That said, the consensus of researchers is that trying it will do no harm.

So, what’s my take on it?  First of all, know that simply taking a supplement is NOT going to solve all your pain.  Arthritic joints become that way over decades of wear and tear, and a couple glucosamine tablets a day aren’t likely to be a miracle cure.  The best way to manage your pain is through a healthy, anti-inflammatory diet (come to one of my talks at the library for more information!) and exercises.   Joints that are moving and being used are happier than joints that are sedentary.

Next, I suggest using glucosamine and chondroitin together.  Studies have shown the best results occur when the glucosamine is shellfish-derived, and the chondroitin is from bovine sources.  The label on the bottle will tell you where the stuff comes from, so check it! 

Finally, commit to using it.  I have found it sometimes takes at least a month for people to start feeling a significant difference.  Yes, there is often a placebo effect that happens right away, but long-term improvement comes from a commitment to daily supplementation.

We are all going to get some aches and pains as we age…even me, the chiropractor!  We do have a say, however, in how mobile we keep our joints and how active we stay as we age.  And remember, the key to quality of life is independence, which comes from the ability to move around and stay active into the golden years. 

As always, if you have any questions at all, feel free to contact me at the office, 894-2399.