Does Glucosamine / Chondroitin help osteoarthritis?

Last month the pain in my left knee got so bad I dreaded climbing the seven steps in my tri-level home. That's pretty bad, since each morning to get to work I have to climb seven flights of stairs at the subway toting a backpack.  I went to a doctor and now I am taking anti-inflammatory medication, but my prescription is running out.  So I want to research my options. You see advertisements for Glucosamine frequently, so I wanted to know more about it. Also, some of my followers have asked for information on Glucosamine.

People who suffer with knee pain from osteoarthritis have very few choices. Anti-inflammatory medications provide relief, but you shouldn’t take them for a long time.

Glucosamine is touted as a possible solution. Yet, Glucosamine is expensive, even if you get it “Buy one get one Free.”  So before you spend the money, you want some assurance that it works.

I plowed through Internet reports trying to determine if Glucosamine or Glucosamine / Chondroitin help Osteoarthritis. Google glucosamine and your get  8,740,000 results. How do you know which of these are valid? (see my previous blog “How can you tell if a health study is valid.”)

My Findings: Studies to determine if glucosamine is useful in reducing osteoarthritis pain or preventing osteoarthritis are conflicting. But, according the Quackwatch website, endorsed by the American Medical Association, the best-designed studies evaluating the benefit of glucosamine are negative.¹ 

Still, many doctors think there is no harm, and possibly some benefit, in taking glucosamine provided you follow these conditions:

• Take glucosamine sulfate instead of glucosamine hydrochloride.^1,2
• Take glucosamine alone. There seems to be no evidence that chondroitin helps.
• Pay attention to your cholesterol levels. Several studies indicate glucosamine increases cholesterol counts.
• Buy high quality products, as the quality and effectiveness of glucosamine is not regulated.
• Quit taking glucosamine if your symptoms don’t reduce in three months (at that time, you can assume the glucosamine is not working).

So, what do you do?

1. Dr. Barrett, Quackwatch¹, says you should get a diagnosis from a competent physician and discuss recommended treatments.
2. I’d recommend seeing a Physical Therapist. They’ve always helped me to overcome injuries and minimize chronic problems. They can assess your strength and body structure, suggest exercises and  show you how to do the exercises properly.  Many times your primary care physician overlooks this option, so I frequently go to a sports medicine doctor to recommend a good therapist. With many health care plans you can go directly to a physical therapist.
3. The Arthritis Foundation recommends icing to reduce swelling and fluid leakage. As a long-time runner, I swear by icing. You can buy knee ice wraps, or as the Arthritis Foundation suggests, use a bag of peas. Ice for about 15-20 minutes at a time. Ice several times a day, especially after exercise.  However, heat is recommended in the morning to loosen joints and muscles and don’t ice before exercise.
4. Other suggestions from the Arthritis Foundation include (see the website for all of the suggestions plus exercise and stretching videos):

Exercise. Movement lubricates your joints. Some people say slow movement like Tai Chi is good. The arthritis Foundation and Physical therapists also recommend muscle strengthening exercises to keep help support the knees. They also recommend exercising in water to build strength and range of motion while reducing wear and tear on joints.

Lose weight. Every pound you lose takes four pounds of pressure off your knees

Stretch. Stretching keeps your joints and muscles flexible.

References

1. “Glucosamine and Chondroitin for Arthritis:  Benefit is Unlikely,” Quackwatch, Dr. Steven Barrett, http://www.quackwatch.org/01QuackeryRelatedTopics/DSH/glucosamine.html Note: I did some research to determine if Quackwatch is a legitimate website. Apparently organizations such as the American Medical Association, FDA Commissioner’s Special Citation, The American Cancer Society and many more have endorsed this website.
2. “Glucosamine, Evidence,” The Mayo Clinic, http://www.mayoclinic.com/health/glucosamine/NS_patient-glucosamine/DSECTION=evidence
3. “Glucosamine: Is It A Beneficial Arthritis Treatment?,” Arthritis.about.com,  http://arthritis.about.com/cs/glucosamine/a/glucosamine.htm  
4. “How to Care For Yourself,” Arthritis Foundation, http://www.arthritis.org/how-to-care-for-yourself.php