TUESDAY, July 6 (HealthDay News) -- 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
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.
For more information on arthritis, visit the
U.S. National Library of Medicine.