Currently, there is relatively little research on the effects of nutritional supplements on spine health and specifically on osteoarthritis of the spine. At this point in time, existing studies of glucosamine and chondroitin sulfate are inconclusive as to whether or not the dietary supplements can prevent or reverse the joint cartilage degeneration associated with osteoarthritis.
Some studies show that certain patients with mild to moderate osteoarthritis who take the supplements may have pain relief at a similar level to patients who take non-steroidal anti-inflammatory drugs (NSAIDs).1 One study on knee and hip osteoarthritis showed a "moderate benefit" of taking glucosamine and chondroitin sulfate supplements.
The studies mentioned above generally showed that if no pain relief occurred after taking glucosamine and chondroitin sulfate for two months, there was little chance of improvement if the patient took the supplements for a longer duration. However, a standard duration of treatment and expected course of improvement for glucosamine and chondroitin sulfate have not yet been determined.
Further Research on Glucosamine and Chondroitin Sulfate Supplements
It is important to note that nutritional supplements such as glucosamine and chondroitin sulfate are not subject to the same strict regulations by the U.S. Food and Drug Administration (FDA) as are medications (such as NSAIDs or narcotic pain medications).
During a meeting held in January 1998, a group consisting of National Institutes of Health (NIH) and FDA staff as well as experts in osteoarthritis, alternative medicine and other specialties identified the need for more in-depth testing of the safety, efficacy, and side effects of glucosamine and chondroitin sulfate for osteoarthritis.2
As a result of the 1988 meeting, the National Center for Complementary and Alternative Medicine (NCCAM) and the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) have begun a study called the Glucosamine/Chondroitin Arthritis Intervention Trial (GAIT). The study is the first multi-center trial in the United States to test glucosamine and chondroitin sulfate for reducing pain and improving function for patients with knee osteoarthritis.
The study randomly assigned patients to groups test either the effects of taking glucosamine alone, chondroitin alone, glucosamine and chondroitin sulfate in combination, Celebrex (celecoxib, a popular COX-2 inhibitor), or a placebo. GAIT also tested whether glucosamine and chondroitin sulfate nutritional supplements can help slow or stop the progression of knee osteoarthritis.
In May 2004, enrollment for the GAIT study was completed and data were being analyzed. At the time of this article, the report on study findings has not yet been published.2
Benefits of Glucosamine and Chondroitin Sulfate Dietary Supplements
While more scientific research is needed on the effects and safety of glucosamine and chondroitin nutritional supplements, many physicians consider them a viable osteoarthritis treatment for the following reasons:
- There is some available evidence supporting the benefits of glucosamine and chondroitin sulfate. More research is currently underway with GAIT, the study run by the NIH and FDA.
- There is currently a lack of more effective traditional medical treatments for osteoarthritis pain.
- Glucosamine and chondroitin sulfate nutritional supplements have a low incidence of serious side effects.
For maximum pain relief, glucosamine and chondroitin sulfate can be used in combination with other non-surgical treatments for osteoarthritis and, as appropriate, with lifestyle modifications (such as rest, gentle exercise or weight loss). Patients should always work with a physician to ensure safe use of all nutritional supplements.