Patients ask me what my opinion is on taking the supplements glucosamine and chondroitin for arthritis. So, for our monthly journal club I decided to read an article published in the September British Medical Journal (BMJ) on this topic.1 Researchers analyzed randomized controlled trials that studied the effect of supplements glucosamine and chondroitin on pain levels and measured joint space on radiographs (x-rays) in those with hip and knee osteoarthritis. Osteoarthritis is a degenerative condition in which a joint’s cartilage wears away and joint space narrows leading eventually to “bone on bone” arthritis.
Glucosamine and chondroitin are substances that occur naturally within our joints. The supplements claim to reduce pain and improve joint flexibility and have had mixed evidence as to their effectiveness. There have been studies that show glucosamine sulfate to be just as effective at reducing pain as NSAIDs such as ibuprofen.2 This could be a better option due to the supplements having fewer side effects. There are other studies, like the one published in BMJ, which urged that practitioners not recommend the supplements to patients, stating that the evidence was not statistically significant to support the use of the supplements to reduce pain and slow or improve progression of the disease. That being said, even though the supplements’ effect on pain was not shown to be substantial, it was positive in every case. I haven’t found any good longer-term studies to demonstrate its effect on pain and function in osteoarthritis. It’s unfortunate that this particular study did not look at joint ROM and flexibility as I would have liked to have seen the effect of these supplements on more functional measures, rather than on “radiological joint space.”
My answer to the question, “Are glucosamine and chondroitin beneficial?” is … I’m not completely sure. On one hand there are studies (like the referenced BMJ review) that show little benefit to taking these supplements and on the other there is some research and anecdotal evidence to support their use. Many of my patients claim it has great benefits on pain and function. So I say, go ahead and give it a try, but be sure to try it for a few months before making a decision.
- Wandel S, J?ni P, Tendal B, Nuesch E, Villiger PM, Welton NJ, et al. Effects of glucosamine, chondroitin, or placebo in patients with osteoarthritis of hip or knee: network meta-analysis. BMJ 2010;341:c4675. [↩]
- Muller-Fasbender, H, et al.(1994). Glucosamine sulfate compared to ibuprofen in osteoarthritis of the knee. Osteoarthritis Cartilage. 2:61-69. [↩]
MoniqueSerpasPT
My name is Monique Serpas, PT, DPT, OCS. I am a physical therapist and board-certified Orthopaedic Clinical Specialist practicing at the Southeast Louisiana Healthcare System in New Orleans, LA. I realize how difficult it can be to overcome an injury or manage a chronic condition and am focused on helping my clients achieve wellness through a physically active lifestyle. I treat orthopaedic, balance, and vestibular disorders and practice using a combination of hands-on manual therapy, therapeutic exercise, and education. This enables my patients to assist in their own recovery and injury prevention. I also have developed fall prevention and golf-related rehab programs in the past. I hold a Doctor of Physical Therapy from Concordia University Wisconsin (2008) and a Bachelor of Science in Kinesiology from Louisiana State University (2004). I am a member of the American Physical Therapy Association (APTA), Louisiana Physical Therapy Association (LPTA), and the Orthopaedic and Neurology sections of the APTA.
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October 7, 2010
General Information, Orthopaedic