From the Guidelines
Glucosamine supplements are strongly recommended against for patients with knee, hip, and/or hand osteoarthritis (OA) due to a lack of efficacy and large placebo effects. The 2020 American College of Rheumatology guideline for the management of osteoarthritis of the hand, hip, and knee states that pharmaceutical-grade preparations of glucosamine have been studied in multiple trials, but the data deemed to have the lowest risk of bias fail to show any important benefits over placebo 1.
Key points to consider when evaluating glucosamine supplements include:
- The potential toxicity of glucosamine is low, though some patients exposed to glucosamine may show elevations in serum glucose levels 1
- Many patients perceive that glucosamine is efficacious, and clinicians should be aware of this when advising patients 1
- The evidence indicates a lack of efficacy and large placebo effects, which is a change from the prior conditional recommendation against the use of glucosamine 1
It is essential to consult with a healthcare provider before starting glucosamine, especially if you have diabetes, are pregnant, or take other medications. Other approaches like exercise, weight management, and prescription medications may provide more reliable relief for joint pain.
From the Research
Effectiveness of Glucosamine Joint Supplements
- Glucosamine has been shown to be effective in relieving the symptoms of osteoarthritis, with studies indicating a greater decrease in symptom severity compared to placebo 2, 3.
- The supplement has also been found to be similar in efficacy to ibuprofen in reducing joint pain and improving articular pain scores 2, 3.
- Long-term oral glucosamine therapy has been shown to prevent joint space narrowing and improve symptoms in patients with osteoarthritis 2.
Comparison with Other Treatments
- Glucosamine has been compared to ibuprofen and piroxicam in several studies, with results indicating that it is better tolerated and has a lower incidence of gastrointestinal disturbances 2.
- A combination of glucosamine hydrochloride, chondroitin sulfate, and bio-curcumin has been shown to ameliorate pain and improve algofunctional scores in knee osteoarthritis patients when added to physical therapy 4.
Mechanism of Action and Future Research
- The precise mechanism of action of glucosamine remains to be established, but it is thought to stimulate the synthesis of glycosaminoglycan, proteoglycan, and hyaluronic acid 2.
- Future research priorities include investigating the effects of glucosamine on cartilage ageing, metabolic/kinetic and maintenance of joint health, as well as reduction of risk of OA development 5.
Limitations and Controversies
- Some studies have reported conflicting results, with one study finding no significant differences in pain reduction and mouth opening improvement between glucosamine and placebo groups 6.
- The evidence for the therapeutic effects of glucosamine on temporomandibular joint osteoarthritis is limited, and conclusions must be interpreted with caution due to the presence of major drawbacks in included studies 6.