Joint Pain Supplements

SUPPLEMENTS

Joint Pain Supplements

The market for joint pain supplements is enormous — and only set to grow as baby boomers age.

More than 46 million Americans are diagnosed with arthritis, and while glucosamine and chondroitin are popular treatments, study results are inconsistent on their benefits.

While the variety of joint pain supplements keeps growing, just a few have been well studied, and even fewer have been shown to work. But the best of these studies have been funded by the supplement's manufacturers, leading some experts to question the findings.

Here in the U.S., two supplements are popular: glucosamine and chondroitin, both natural components of joint tissue. The compounds have been used in Europe and Asia for decades and became popular in the U.S. about 10 years ago. They're among the bestselling of all supplements on the market and are also the best-studied.

Recently, large-scale, well-designed studies have examined the effects of the two supplements together and independently, usually in people with knee osteoarthritis, one of the most common forms of arthritis.

In 2006, researchers at the University of Utah in Salt Lake City published results of the Glucosamine/Chondroitin Arthritis Intervention Trial (GAIT), a study of more than 1,500 adults with knee osteoarthritis, randomized to take either glucosamine, a form of chondroitin called chondroitin sulfate, both, a prescription anti-inflammatory drug or a placebo daily for six months.

Neither glucosamine nor chondroitin sulfate — taken alone or together — worked much better than the placebo, the researchers found. But among patients with severe pain, the combination of glucosamine plus chondroitin sulfate did appear to reduce pain; 79% of those with severe pain experienced relief compared with just over half of those who took the placebo. Overall, the drug provided the most relief — and did so faster than the supplements or placebo..

A review by a group of U.S. and Canadian researchers was published last year by the Cochrane Collaboration, a nonprofit organization that reviews the science on health topics. Analyzing data from the 25 top studies on glucosamine alone for arthritis, they found that, on average, the supplements result in a 22% reduction in pain, but, again, in some studies the supplements worked no better than a placebo.

The Cochrane review included another observation: Glucosamine seemed to work best to reduce knee pain in studies that used a standardized, prescription form of glucosamine sulfate sold in Europe, made by the German company Rottapharm.

The findings on Rottapharm's glucosamine sulfate constitute the best evidence in favor of the compound to date, says study author Dr. Marc Hochberg, professor of medicine and head of the division of rheumatology and clinical immunology at the School of Medicine in Baltimore.

The problem is complicated by the fact that glucosamine comes in several forms — including glucosamine, glucosamine sulfate and glucosamine hydrochloride — but only glucosamine sulfate has been shown to have the potential to reduce pain. Likewise, the bulk of evidence seems to support the use of chondroitin sulfate over other forms of chondroitin.

The daily doses used in most studies are 1,500 milligrams of glucosamine and 1,200 milligrams of chondroitin. Based on the existing evidence, taking both appears more likely to reduce joint pain than taking either one alone.

If there's one good piece of news for people with arthritis pain, it's this: Side effects of both supplements are rare to nonexistent. So at least they're safe for those who want to give them a try.