Study: Glucosamine Doesn't Relieve All Joint Pain

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A new study shows glucosamine-condroitin, a supplement used to ease joint pain, does not improve symptoms of mild osteoarthritis. But it may offer relief for moderate-to-severe joint pain, although more research is needed to confirm these findings.

ROBERT SIEGEL, host:

From NPR News. This is ALL THINGS CONSIDERED. I'm Robert Siegel.

MELISSA BLOCK, host:

And I'm Melissa Block. A new study offers mixed reviews for one of the nation's most popular dietary supplements for joint pain. Millions of Americans are taking the supplement glucosamine-condroitin sulfate at a cost of about 730 million dollars a year. NPR's Patricia Neighmond reports on the study in the New England Journal of Medicine.

PATRICIA NEIGHMOND, reporting:

Rheumatologist Daniel Claig(ph) says it's an attractive notion to think that if you eat more of the building blocks of cartilage you'll improve the cartilage. Glucosamine and condroitin sulfate are major components of cartilage, which is the really slippery substance that lines the joints and allows you to move and bend with ease. But when osteoarthritis sets in things change. Claig says patients report feeling pain in their joints.

Dr. DON CLAIG (Rheumatologist, University of Utah School of Medicine): Frequently there's a gelling sensation and so patients will say that when they have been seated for a long time or when they first arise in the morning for a few steps or a few moments the joints feel stiff.

NEIGHMOND: And typically Claig says patients describe their pain as worse with exercise.

Dr. CLAIG: The cartilage is often pitted and worn in places and so there's mechanical derangement within the joint and it just doesn't operate as efficiently as it should and that creates pain.

NEIGHMOND: In the study, Claig and colleagues at the University of Utah's School of Medicine enrolled over 1500 patients over the age of 40. Most were women who were more likely to suffer arthritis than men, and all suffered some arthritic pain in their knees. After six months patients taking glucosamine-condroitin sulfate reported no difference in their pain compared to patients taking a placebo. Claig says that this means that for most patients the nutritional supplement just doesn't make any difference. But there was one important group for whom it did seem to make a difference, patients with more severe pain. Dr. Claig.

Dr. CLAIG: Mild pain would be pain that was there but really didn't limit patients' activities of daily living. And moderate to severe pain would be patients that were modifying what they did because of the pain they were having.

NEIGHMOND: For example, walking less or not climbing stairs. For those patients there was a 24 percent decrease in pain among those taking glucosamine-condroitin compared to placebo and even compared to Celebrex, a prescription arthritis medication. But Claig cautions that this was a small group and there need to be more research focused just on this group before such positive findings can be confirmed.

In the meantime, Rheumatologist Mark Hoffberg, from the University of Maryland's School of Medicine says his advice to patients remains the same. Maintain a healthy weight and exercise.

Dr. MARK HOFFBERG (Rheumatologist, University of Maryland's School of Medicine): I recommend that they participate in aerobic activities, usually either walking in a mall, which is a temperature controlled environment, or participating in some kind of an aquatic exercise program. I make sure that they're provided with, if they need them, any kind of assistant device like a cane or inserts into their shoes in order to reduce the mechanical stress on their knees.

NEIGHMOND: And if needed, patients can take anti-inflammatory medication like ibuprofen or prescription drugs like Celebrex. In the meantime, there's a second part to this study. Patients under went X-rays of their knees to evaluate the extent of knee joint deterioration. Two years after therapy they'll undergo another X-ray. The findings of that study will show whether glucosamine-condroitin sulfate makes a physical difference in strengthening the knee joint. The findings of that study are expected by the end of this year. Patricia Neighmond, NPR News.

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