At Oahu Spine and Rehab, we are frequently asked about joint supplements to treat pain. The most common supplements that patients want more information on are Glucosamine and Chondroitin. These supplements seem to be ubiquitous: they are advertised everywhere, and line the counters at health stores, plus the big chain drugstores, and Walmart and Target. They come with a variety of brand names, in multiple different doses and formulations. So… they obviously must work, right? Well, possibly yes and possibly no. Looking at all the available evidence to date, we can offer our patients an approach to these supplements and some recommendations for use.
The largest medical trial to test these supplements was the GAIT Trial (Glucosamine/Chondroitin Arthritis Intervention Trial). Glucosamine and Chondroitin were tested for osteoarthritis of the knee and/or hip for effectiveness vs. placebo (‘sugar pill’). From the GAIT trial, there was little to no evidence that suggested that Glucosamine and Chondroitin were better than placebo. However, smaller trials have provided anecdotal evidence that may support the use of the supplements. Therefore, we recommend the following to our patients who are interested in trying these supplements:
-First, see your primary care physician for baseline blood tests to check your liver and kidney function, as supplement use may cause side effects (they are not tested or regulated by the FDA) or interact with other medications you are taking.
-Once your PCP gives you the ok, you may do a trial of Glucosamine 500mg 3/day and Chondroitin 400mg 3/day for 6 months.
-After 6 months of use, stop the supplement. After stopping assess your symptoms. If you notice an increase in pain after stopping the supplement, then resume with proper monitoring by your primary care physician. If you stop the supplement and notice no change in symptoms, then you should discontinue any further use.
Regardless of efficacy of supplementation use, the first line of therapy in the treatment of any chronic musculoskeletal pain disorder should always be proper diet, regular aerobic exercise, getting plenty of sleep and maintaining a healthy body weight. All of the above play an important role in joint health. We would be more than happy to discuss any or all of the above with you, during your visit! Contact us for more info!
Reference: Wandel S, Jüni P, Tendal B, et al. Effects of glucosamine, chondroitin, or placebo in patients with osteoarthritis of hip or knee: network meta-analysis. BMJ 2010; 341:c4675.