Justin Peng, MD, FACR
Arthritis and Rheumatism Associates, PC
Osteoarthritis is the most common type of arthritis and ls often referred to as degenerative disease because it is caused by the breakdown of cartilage. In a healthy joint, the ends of the bones are covered with smooth and healthy cartilage. In osteoarthritis, the cartilage in between the joint is worn away, causing narrowing of the joint and jagged, irregular spurs at the edges of bones, which can cause achiness, stiffness, soreness, and limited range of motion.
Glucosamine and Chondroitin are commonly use supplements by patients to help with pain associated with osteoarthritis. But are they really effective? In the United States, they are sold as dietary supplement and, therefore, are regulated as foods rather than medicines. Over the years, they have been used with varying degrees of success.
Glucosamine is a substance that is found in the cartilage and other connective tissues of the body. Glucosamine can be extracted and chemically linked to sulfate or hydrochloric acid (HCl) and used as a drug or supplement. Chondroitin sulfate is a complex carbohydrate that helps by allowing cartilage to retain water.
There have been a number of clinical trials that have studied Glucosamine adn Chondroitin. One of the largest trials was conducted by the National Institutes of Health (NIH) and compared glucosamine HCl alone, chondroitin sulfate alone, the combination of glucosamine and chondroitin, Celebrex and a placebo (a substance containing no medications) in pateints with knee osteoartritis. In this large trial, there were no significant differences in outcome between the glucosamine and chondroitin sulfate groups than with the placebo.
However, in several smaller clinicial trials in Europe, the formulation of glucosamine sulfate (not glucosamine HCl) has shown some possible benefits. The bottom line is that some patients with osteoarthritis do seem, individually, to report some benefits with these supplements.
The American College of Rheumatology 2012 guidelines do not recommend the use of glucosamine or chondroitin for the management of osteoarthritis. However, because there are very few known side effects with these supplements, most physicians have no objection to trial of glucosamine sulfate for a defined period of time (i.e., three months). If there is benefit in terms of pain or function, it may be continued. Patients still should develop a comprehensive plan with their doctors to treat osteoarthritis, which includes diet, exercise, weight loss, and using standard, proven medications.