Glucosamine Ineffective for Arthritis Pain

[David Baxter PhD]

Glucosamine Ineffective for Lower Back Pain Linked to Arthritis​

By Steven Reinberg, HealthDay

TUESDAY, July 6, 2010

Study finds it's no better than placebo in relieving discomfort or boosting quality of life

The popular supplement glucosamine offers little or no relief for sufferers of chronic lower back pain caused by osteoarthritis, a new study finds.

The Norwegian trial seems to be another knock against glucosamine, with other recent studies showing similar results.

"The study answer the questions: 'I have suffered low back pain for a long time (more than 6 months), will a 6-month intake of glucosamine help me?'" said lead researcher Philip Wilkens, a research fellow in the orthopedic department at the University of Oslo. "And the answer according to this study is no."

On the up side, "glucosamine appears safe to use," he added. "And more research is needed to answer if glucosamine is beneficial to prevent chronic low back pain or have benefits in longer term, like 5 to 10 years."

Osteoarthritis affects more than 20 million Americans, and the number is expected to increase, the researchers note. Glucosamine is a common over-the-counter treatment for osteoarthritis, even though its use has been controversial.

For example, a University of Pittsburgh study presented at a rheumatologists' meeting in October found the supplement did not prevent loss of cartilage in osteoarthritic knees, while studies published in 2008 in Arthritis & Rheumatism and the Annals of Internal Medicine found glucosamine had little or no effect on arthritis of the knee and hips, respectively.

The new report is published in the July 7 issue of the Journal of the American Medical Association.

For the study, Wilkens's team randomly assigned 250 patients with chronic back pain and degenerative lumbar osteoarthritis to 1,500 milligrams daily of glucosamine or an inactive placebo.

The patients' pain was measured using the Roland Morris Disability Questionnaire at 6 weeks, then again at 3, 6 and 12 months. In addition, the researchers evaluated the patients' self-reported quality of life.

At the start of the 6-month trial, patients taking glucosamine scored 9.2 on the pain scale while the patients taking placebo scored 9.7, the researchers note. At the 6-month point, both groups scored 5.0, and after one year the glucosamine group scored 4.8 while the placebo group scored 5.5, Wilkens's group found.

However, the small differences in scores at six months or one year were not statistically significant, the researchers say. Nor were minor differences in quality of life between the two groups deemed significant.

The bottom line, according to Wilkens: "People with chronic low back pain and degenerative osteoarthritis will not benefit more from glucosamine than placebo for treating their back problem."

Dr. Andrew L. Avins, a scientist in the division of research at Kaiser Permanente Northern California and the author of an accompanying journal editorial, said that, "from a clinical standpoint, the study demonstrates that glucosamine does not appear to be better than placebo for patients with chronic low back pain and spinal arthritis."

However, the study found no ill effects from taking the supplement. So, patients who take glucosamine and feel that it is helping them should be reassured that it's at least not harmful, said Avins, who is also professor of medicine, epidemiology & biostatistics at the University of California, San Francisco.

"The larger implications [of this study] are that we still know very little about how to help most patients with chronic low back pain, and we need much more careful, directed research to help make progress in providing relief to patients with back pain," he added.

Even though back pain is an incredibly important public health and quality of life problem, it suffers from insufficient attention and research funding, Avins believes. "In the U.S., we spend far more on treatments of little or questionable value than we spend on research to find effective therapies; it's a poor use of scarce health-care resources," he said.

Dr. Andrew Sherman, an associate professor and vice-chair of the department of rehabilitation medicine at the University of Miami Leonard M. Miller School of Medicine, agreed that the findings should dissuade doctors from recommending glucosamine to patients with back pain.

However, "this [study] is not going to stop people from trying it," he added, and the finding does not mean that glucosamine won't work for other forms of arthritis.

More information
For more information on arthritis, visit the U.S. National Library of Medicine.

​

SOURCES: Philip Wilkens, M.Chiro., research fellow, orthopedic department, University of Oslo, Norway; Andrew L. Avins, M.D., M.P.H., research scientist, Division of Research, Kaiser Permanente Northern California, professor, of medicine, epidemiology & biostatistics, University of California, San Francisco; Andrew Sherman, M.D., associate professor and vice-chair, department of rehabilitation medicine, University of Miami Leonard M. Miller School of Medicine, July 7, 2010, Journal of the American Medical Association​

 

[Daniel E.]

Predicting Arthritis for the Next Generations - USNews
July 27, 2018

...Just because age is a risk factor for many kinds of arthritis, it doesn’t mean you’ll get it. Inflammatory arthritis may have a genetic component that may be triggered by your diet or environmental exposure, although doctors don’t know exactly what causes the immune system to go on the attack.

It’s better known what leads to osteoarthritis. Age is one risk factor (the older you are, the higher your risk). Others include:

Family history. If your parents have osteoarthritis, your risk for developing the condition increases.

Muscle weakness. “Weakness in the quadriceps [in front of the thigh] has been shown to be a risk factor for knee osteoarthritis,” Shakoor says.

Being overweight. A spare tire around the middle puts extra pressure on the knees, hips, ankles and toes. The Arthritis Foundation reports that each pound of excess fat adds 4 pounds of pressure on the knees (so 10 pounds amounts to 40 pounds of pressure).

Overuse and injury. Both of these contribute to the degradation of cartilage, which doesn’t grow back once it wears away. Overuse can occur when your joints take too much of a pounding – anything from running on pavement to texting on a smartphone. “Repeatedly looking down at technology stresses that neck. That can predispose you to getting neck osteoarthritis. Texting continually with your thumbs can predispose you to getting osteoarthritis in those joints,” Schwartz says.

Smoking. Lighting up is a risk factor for rheumatoid arthritis, according to the CDC. Smoking is also associated with more joint damage and greater joint pain...

Numerous studies are underway to understand the causes of arthritis and better ways to treat it – from medications to gait training that takes pressure off the knee. But right now, without any proven ways to prevent arthritis or slow its progression, Shakoor says all we can do is speculate about reversing risk factors. “Since we know that quadriceps weakness is a risk factor for knee osteoarthritis, you can extrapolate that if you have better quad strength and maintain physical strength, you may be able to delay the onset or progression. But we don’t have any studies that show this,” she says.

It’s still worth a try, she suggests. An attempt to reduce risk could then include:

Losing weight. “Losing even 10 percent of your weight will greatly reduce the burden on your lower back, hips and knees,” Schwartz says.

Exercising. Get 150 minutes per week of moderate intensity exercise (like brisk walking). Avoid exercises that put too much pressure on your joints, like running. Instead try using an elliptical machine, swimming or riding a recumbent bicycle.

Strength training. Strive to do strength training at least two days per week, but avoid exercises that overburden a joint, such as deep knee bends.

Diet. Eat a healthy diet to help maintain a healthy weight. But keep in mind that no diet has been shown to reduce the risk of getting any kind of arthritis.

Footwear. Wear shoes that relieve burden on the joints. “So far it seems that flat, flexible footwear is most effective in terms of reducing knee load,” Shakoor says.

Again, none of these steps will guarantee that you’ll avoid arthritis in the future.

But remember: “Maintaining a healthy lifestyle with exercise and diet is important not just for arthritis,” Shakoor points out, “but for all chronic conditions, including heart disease and diabetes.”

It’s advice you should put into practice as soon as possible, say the experts, no matter what your generation.

 

[Daniel E.]

The 15-Minute Arthritis Workout

Best Approach to Managing Osteoarthritis

Emotional Impact of Pain

5 Tips for Driving When You Have Arthritis or Back Problems -- Cleveland Clinic