A study is putting people who have chronic low back pain on notice: If you are considering taking the dietary supplement glucosamine to relieve your symptoms, it probably won’t help.
“Our study answers the question of whether everybody with chronic low back pain should use glucosamine, and the answer is no,” says study author Philip Wilkens, a research fellow and chiropractor at of Oslo University Hospital, in Norway.
Low back pain is the second most common complaint brought to the attention of primary care doctors.
Glucosamine, when naturally produced by the body, helps create cartilage and keep it healthy. Wilkens says that in laboratory tests, glucosamine has appeared to have anti-inflammatory properties and may even help to regenerate cartilage; and though some human studies have replicated those results, others have not. As a dietary supplement, however, its use has become somewhat controversial, as a growing number of studies have begun to call its effectiveness into doubt.
He says questions have also been raised about different brands of the dietary supplement and whether they contain the recommended dose of glucosamine.
For the current study, which was published in the July 7, 2010, issue of the Journal of the American Medical Association, researchers enrolled 250 patients who were at least 25 years old and who had been experiencing pain due to osteoarthritis, or OA, in their lower spine for more than six months.
Half of the study participants got 1,500 milligrams of glucosamine daily for six months. The other half got a placebo. After six months, and then again at one year, researchers found no difference in pain, disability or quality of life between the two groups.
Interestingly, both groups said their pain improved by an average of about 50 percent over the course of the study. Experts think that may be due to a placebo effect – participants expected to feel better, so they did; or to the fact that back pain often improves on its own over time.
Despite these study results, Wilkens says he knows plenty of doctors and patients claim the dietary supplement is effective and he says there may be a reason for that.
“Therapies may have an effect on an individual level not picked up by research as it is conducted today,” Wilkens says.
So he says if patients want to continue taking glucosamine, they can do so knowing there is no real concern of side effects.
“Our findings suggest that glucosamine is not effective to treat chronic low back pain. However, if you’d like to give it a go for your low back pain, it is very safe and probably will not harm you,” Wilkens says.
And he says patients who take glucosamine and who have seen improvements with it should not stop taking it based on this study alone.
“There is some evidence pointing towards an effect for certain brands for knee osteoarthritis. Therefore, if you suffer from knee osteoarthritis it may be worth taking. However, if you do not experience any worthwhile effect in a six-month time period, you can probably stop taking it,” he explains.
Wilkens also says the jury is still out on chondroitin, a substance often added to glucosamine that many feel increases its effectiveness. “There is little research to support or reject this notion, so it is not possible from a scientific point of view to answer if a combination of glucosamine and chondroitin is better than glucosamine alone,” he explains.
He does say because this study looked at whether glucosamine can reduce low back pain if you already have it, future studies could try to determine if glucosamine can prevent development of chronic low back pain or be effective if taken for longer than a year.
Andrew L. Avins, MD, is a researcher at Northern California Kaiser-Permanente and a professor in the Departments of Medicine and Epidemiology and Biostatistics at the University of California, in San Francisco. He wrote an editorial accompanying this study saying the results are disheartening, but scientifically sound.
“Most of the time when we put promising therapies to the test, they fail. And this is yet another example. It’s very disappointing, of course, but the authors should be commended for doing solid work,” Dr. Avins says.
“The more we learn about what truly works and doesn’t, the better off we’ll be, and the faster we’ll get to a place where we have effective therapies to offer patients with lower back pain,” Dr. Avins adds.