Joint Pain And Glucosamine Supplements
If youre looking for joint pain relief then youll be glad to know that it’s available in many forms, from glucosamine tablets to exercise supports and gels. Finding the best relief for you can be a bit of a minefield. Thats why were taking you through the options available and what might work best to ease your joint pain.
If Your Joints Ache Can Glucosamine Help Ease The Pain
Joint pain makes almost everything you do more difficult. The stiffness, swelling and aching can start when you get out of bed, worsen as you walk or climb stairs, and even flare up with changes in the weather.
Youve probably heard people recommend glucosamine as a supplement that can help ease your joint pain. But does it work? Or is it just a waste of your money?
Where Do Glucosamine Supplements Come From
Commercially available glucosamine supplements are usually sourced from animals, including shellfish, lobster, or crabs.
For vegetarians, plant-based glucosamine supplements are derived from soybeans and other vegetables. These can be also taken by those who are allergic to shellfish.
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Effectiveness Of Glucosamine And Chondroitin Sulfate For Osteoarthritis
Conventional medicine does not yet have a proven treatment to stop or slow the progression of osteoarthritis.
The nutritional supplements glucosamine and chondroitin sulfate have emerged as a treatment alternative for some patients suffering from osteoarthritis pain.
Perhaps the most important aspect of glucosamine and chondroitin sulfate supplements is that they are thought to help slow or prevent the degeneration of joint cartilage, the underlying cause of osteoarthritis pain. Glucosamine and chondroitin sulfate dietary supplements may also help alleviate existing joint pain. Presently, it is thought that unlike many medications available to treat arthritis pain and inflammation, glucosamine and chondroitin sulfate supplements have very few side effects.
However, glucosamine and chondroitin sulfate nutritional supplements do not offer the desired pain relief for all osteoarthritis patients. At the time of this article, the benefits and risks of taking glucosamine and chondroitin sulfate have not been definitively proven, and long term studies are needed to better understand their effects.
Are The Claims Reasonable
Chondroitin and glucosamine are both found naturally in the bodys cartilage and synovial fluid . Chondroitin lubricates joints, supporting the natural elasticity of your cartilage whilst glucosamine helps the body repair and maintain cartilage . The issue is not whether both occur naturally, but whether taking them in supplement form does any good.
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What To Avoid At The Orthopedist’s Office
In all, 60 percent of patients taking the sugar pill said their pain was reduced by about 20 percent, while 66 percent of those taking the supplements reported similar pain reduction. The results were published in 2006 in the New England Journal of Medicine.
But for a small subset of patients, those with moderate to severe arthritis pain in a knee, there was some benefit.
“About 79 percent had a 20 percent or greater reduction in pain, compared to about 54 percent for placebo,” says Dr. Allen Sawitzke, a rheumatologist at the University of Utah Hospital and Clinics and co-leader of the GAIT study. “So some patients who have severe pain may get more benefit than somebody who’s got a mild case.”
Because the number of patients in that group was so small, Sawitzke cautions that finding is only preliminary and needs to be confirmed by further study.
Two large studies currently underway, one in Europe and one in Australia, may help answer that question. They’re expected to wrap up within one year, which Sawitzke says “will either reopen the debate or put an end to it, depending on the results.”
On the other hand, Felson says he doesn’t disabuse patients of the notion that the supplements are helping if patients truly believe they are, even though a month’s supply can cost $30 to $50. “Far be it from me to take away either the placebo effect or an idiosyncratic reaction that might be of benefit,” he says.
How Do Glucosamine And Chondroitin Work
Chondroitin and glucosamine are thought to be chondroprotective . In addition to glucosamine, chondroitin helps pull water and nutrients into the cartilage, maintaining its elasticity.
- Glucosamine and chondroitin have been shown to inhibit cartilage breakdown, reducing joint discomfort and promoting healthy joints in studies.
- They also help maintain cartilage structure, since glucosamine and chondroitin contain anti-inflammatory qualities that can help minimize cartilage degeneration and pain in the joints.
To summarize, when these supplements are taken together, they do the following:
- Maintain and promote joint health
- Assist in the relief of mild to moderate joint pain
- Assist in the growth and production of healthy joint cartilage
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What Are Glucosamine And Chondroitin
Glucosamine and chondroitin are structural components of cartilage, the tissue that cushions the joints. Both are produced naturally in the body. They are also available as dietary supplements. Researchers have studied the effects of these supplements, individually or in combination, on osteoarthritis, a common type of arthritis that destroys cartilage in the joints.
Cartilage is the connective tissue that cushions the ends of bones within the joints. In osteoarthritis, the surface layer of cartilage between the bones of a joint wears down. This allows the bones to rub together, which can cause pain and swelling and make it difficult to move the joint. The knees, hips, spine, and hands are the parts of the body most likely to be affected by osteoarthritis.
For more information about osteoarthritis, visit the National Institute of Arthritis and Musculoskeletal and Skin Diseases Web site at www.niams.nih.gov. For more information on complementary health approaches for osteoarthritis, see the National Center for Complementary and Integrative Health fact sheet Osteoarthritis and Complementary Health Approaches.
Glucosamine And Chondroitin For Osteoarthritis Pain
Research is mixed on whether these supplements help with OA pain and stiffness, but they are safe to try.
Glucosamine and chondroitin are popular supplements used to treat osteoarthritis . According to one estimate from the National Institutes of Health, 6.5 million adults, or 2.6% of the population, has used one or both of these products. Although studies on glucosamine and chondroitin have been mixed, some evidence suggests they may help relieve OA joint pain and stiffness.
What Are Glucosamine and Chondroitin?
Glucosamine and chondroitin are natural compounds found in healthy cartilage the connective tissue that cushions joints. Supplements are manufactured from the cartilage of animals such as cows, pigs or shellfish, or are made in a lab. Glucosamine is sold in different forms, including glucosamine sulfate and glucosamine hydrochloride. You can buy glucosamine and chondroitin individually, but most often theyre sold together in a single supplement.
In many European countries, these supplements are a prescribed treatment for OA. In the U.S., the recommendations on glucosamine and chondroitin are more moderate, due to the mixed results of studies.
How Do They Work?
Glucosamine and chondroitin protect cells called chondrocytes, which help maintain cartilage structure. In theory, these supplements have the potential to slow cartilage deterioration in the joints, and to reduce pain in the process.
Which Form Is Best?
Are They Safe?
The Bottom Line
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Are There Any Safety Concerns
Although glucosamine sulfate is safe for almost everyone to use, you should exercise caution and talk with your doctor before starting any new nutritional or fitness programs.
Specifically, you should consult with your physician because:
What Vitamins Are Good For Your Joints
If you eat a healthy balanced diet you should be able to get all of the vitamins your body needs to function. However if you experience joint pain you might want to consider taking extra vitamins and minerals to help support your joints.
These vitamins for bones and joints include:
- Omega-3 fatty acids are found in naturally oily fish such as mackerel and salmon, these can be helpful for those with inflammatory arthritis
- Vitamin D helps to maintain strong bones and healthy muscles. Not getting enough vitamin D can lead to a condition called osteoporosis, which is a weakening of the bones.
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Yet Another Study Finds The Popular Supplement Doesn’t Help See What Really Does
Consider it another nail in the glucosamine coffin: A new study published today in the journal Arthritis and Rheumatology found that the popular supplement neither decreased pain nor prevented the deterioration of cartilage in people with knee pain due to osteoarthritis. Americans spent $813 million in 2012 on glucosamine and the related ingredient chondroitin sulfate. The ingredients are thought to help relieve arthritis pain since they’re both building blocks of cartilagethe tough and flexible tissue that cushions the ends of knees and other joints, and which deteriorates in people with osteoarthritis.
In the trial, researchers at the University of Arizona randomly assigned 201 people with chronic knee pain to get either 1,500 milligrams a day of glucosamine dissolved in a bottle of lemonade or an identical-tasting placebo drink. After 24 weeks, the group that took glucosamine had no decrease in cartilage damage and reported no improvement in pain compared with the placebo group.
The researchers also examined whether the participants had any change in bone marrow lesions, more commonly called “bone bruises,” which are thought to contribute to osteoarthritis pain. The control group actually had greater improvement in bone marrow lesions compared with the participants who took glucosamine.
Recommended Dietary Intake Of Glucosamine Chondroitin
The normal recommended dosage of glucosamine chondroitin for knee pain is:
- 1500 mg of either glucosamine hydrochloride or sulfate, and
- 1200 mg of chondroitin sulfate.
This should be taken daily, either as a single dose or divided into 2 or 3 smaller doses per day.
So, you can choose to take a single 1500 mg pill of glucosamine once per day or 3 divided doses of 500 mg pill per day.
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The Forms Of Glucosamine And Their Effects On Knee Pain
Three forms of glucosamine can be effective for treating osteoarthritis: glucosamine sulfate, glucosamine hydrochloride, and N-acetyl-glucosamine.
All of them have the same active ingredient glucosamine -, responsible for the beneficial effects of these supplements on joints.
And while all of them provide similar results, they have slight differences in their chemical compositions. This can make some forms more adequate than others for certain people.
The main forms of glucosamine are:
Do Glucosamine And Chondroitin Work
There is lots of research about this. The US-based Arthritis Foundation points to numerous studies that have shown positive effects, but ultimately its summary is that trial results are mixed. In the UK, opinion is far less ambivalent.
Versus Arthritis puts its finger on the issue with its assessment that, Evidence is inconsistent but many show that it has significant clinical benefits in reducing pain and painkiller use. Higher quality trials were less likely to show benefit.
There are lots of trials that show some benefit, sometimes even quite considerable benefit, but not all studies are equal. When subjected to good science that is, large scale, peer-reviewed, randomised and controlled studies the evidence falls away.
The NHS points to one such Swiss study, the results of which led The Independent and other members of the UK press to declare that arthritis supplements do not work.
NICE, the National Institute for Healthcare and Excellence, the body with the effective last word on whether the clinical evidence stacks up, is unequivocal. Do not offer glucosamine or chondroitin products for the management of osteoarthritis, is its recommendation to knee surgeons and other health professionals.
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How Are Glucosamine Supplements Beneficial For Knee Pain
Healthy people can regenerate their joint cartilage after the degradation from daily wear and tear. Their bodies can do that by taking glucose from their diet and transforming it into glucosamine.
But with increasing age, the body may lose its ability to do this. This causes an imbalance between the regeneration and degradation rate in the joints. In the long term, this can cause joint pain.
Got Arthritis Exercise Can Help
And if taking supplements or a placebo pill make it more likely that people will be active and lose weight, that’s a good thing, according to Dr. Patience White, a rheumatologist and spokesperson for The Arthritis Foundation. “My goal as a practicing physician is to decrease pain so patients will actually do the things that really make a difference in terms of changing the natural history of osteoarthritis, which is weight reduction and physical activity,” she notes. People have a hard time exercising and losing weight if they hurt.
There’s abundant evidence that losing weight and regular exercise are the most effective treatments available for osteoarthritis pain, White adds. “It’s quite striking,” she says. “If you lose only five pounds, you’re talking about the equivalent of 20 pounds across those knees, so you can imagine it would make quite a difference.”
Pretty much any type of exercise seems to reduce pain and increase flexibility, according to Felson. “There have been a variety of different exercise studies which have tried everything from water aerobics to walking to muscle strengthening, and they all seem to work.”
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Selection Process Of Articles
First, we identified 531 articles from the MeSH database that were related to the effect of oral supplements for OA. In addition, we found four systematic reviews . After title and abstract review, we obtained 29 articles related to glucosamine intervention. Further, we included additional 8 articles identified via manual search and obtained 37 articles for the second screening. After a thorough full-text reading process by experts, 19 articles were removed and 18 articles were used for further analyses . Table Table11 shows the list of obtained RCT articles. While nine studies used glucosamine alone, nine studies used commercial supplements containing both glucosamine and other supplements such as chondroitin . The formula of glucosamine is also varied five studies used sulfate salt of glucosamine , six studies used hydrochloride salt, and one study used N-acetylated glucosamine . Among 18 studies, 9 studies were performed in Japan . We found one Chinese RCT, but the study compared different dosages of glucosamine and was excluded from the analysis .
|Clegg et al.||USA|
|Fransen et al.||Australia|
aChondroitin is involved in the supplement, as well as glucosamine
The American College Of Rheumatology Doesn’t Recommend It
In its guideline updated in 2020, the American College of Rheumatology now strongly recommends against the use of glucosamine for knee osteoarthritis. After weighing the results of multiple studies, the authors found an overall lack of effectiveness and large placebo effects.
The ACR also recommends against the use of combination products that include glucosamine and chondroitin sulfate for osteoarthritis of the knee.
Instead, the ACR recommends the following medications:
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What The Science Says About Safety And Side Effects
- No serious side effects have been reported in large, well-conducted studies of people taking glucosamine, chondroitin, or both for up to 3 years.
- However, glucosamine or chondroitin may interact with the anticoagulant drug warfarin .
- A study in rats showed that long-term use of moderately large doses of glucosamine might damage the kidneys. Although results from animal studies donât always apply to people, this study does raise concern.
- Glucosamine might affect the way your body handles sugar, especially if you have diabetes or other blood sugar problems, such as insulin resistance or impaired glucose tolerance.
If you use dietary supplements, such as glucosamine and chondroitin, read and follow the label instructions, and recognize that ânaturalâ does not always mean âsafe.â
The U.S. Food and Drug Administration regulates dietary supplements, but the regulations for dietary supplements are different and less strict than those for prescription or over-the-counter drugs.
Some dietary supplements may interact with medications or pose risks if you have medical problems or are going to have surgery. Most dietary supplements have not been tested in pregnant women, nursing mothers, or children.
For more information, see Using Dietary Supplements Wisely.
Does Glucosamine Help Knee Pain
May 24, 2016
You’ve seen the commercials advertising the natural supplements glucosamine and chondroitin to reduce joint pain, and maybe you’ve wondered: Could these claims be true?
Researchers wondered the same thing, leading to numerous studies examining the results of these supplements in patients. Although the research results are somewhat mixed, there appears to be little evidence that these supplements help reduce pain and swelling for people with osteoarthritis. A review of 10 different studies in the British Medical Journal showed no evidence that glucosamine supplements reduce inflammation.
“While some of my patients have had improved symptoms of arthritis, which they attribute to glucosamine, the evidence and my experience suggest that in the end, a significant expense has yielded little relief to most patients,” says Dr. Jeremy McCandless, an orthopedic surgeon affiliated with Sharp Coronado and Sharp Grossmont hospitals.
Glucosamine and chondroitin are both naturally occurring substances found in joints and connective tissue, and help create the tissue that forms cartilage. In patients with osteoarthritis, that cartilage wears away, reducing the padding in joints such as knees, hips and shoulders, which results in pain and stiffness.
“Arthritis is disabling and people are desperate. Supplements like glucosamine fill a void by providing hope to patients. Unfortunately, it is largely false hope,” says Dr. McCandless.
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