Does Glucosamine Relieve Joint Pain and Arthritis
Joint pain can come from numerous types of arthritis including osteoarthritis, rheumatoid, gout and even TMJ. Does glucosamine help symptoms of arthritis, here are the studies.
What Arthritis Is
Arthritis actually means joint inflammation, and there are more than 100 conditions that can be classified as arthritis.
Simply put, a joint is where a bone moves against another bone. Some examples of joints are the knees, elbow, ankle, jaw (TMJ), shoulder, wrists and fingers. Cartilage is the tough and flexible tissue that covers the end of the bones at a joint. This helps the proper and smooth movements of our joints. If it were not for the cartilage protecting these joint areas, the bones would rub together, causing pain. This type of cartilage is called hyaline or articulare cartilage. At the joints, there is a space and within this space is fluid known as synovial fluid, which keeps the cartilage and joint healthy.
Joint pain can be caused by an injury to the joint or ligaments that hold the bones and joint together and helps them move. Joint pain from arthritis can also be caused from the joint wearing out or actually losing the fluid causing the cartilage to wear down. When this happens, the bones can rub against each other causing the pain. Other medical conditions that can cause joint pain and arthritis include a type of autoimmune disease or an infection that gets into the joints.
Most of the studies with glucosamine dealt with osteoarthritis, which is the most common type of arthritis and joint pain. Osteoarthritis occurs when the cartilage actually loses its elastic ability. The symptoms of osteoarthritis develop and slowly get worse over time. Repetitive use of these joints can cause the joints and cartilage to wear down leading to osteoarthritis. Obesity is a leading cause of knee pain from osteoarthritis; the extra weight puts a lot of extra stress on the knee joints.
Glucosamine can be made naturally in our body by combining sugar with the amino acid glutamine. It is the combination of glutamine and glucose, which is what the body turns simple sugars and carbohydrates into. As we age, our natural production of glucosamine decreases.
The thinking behind glucosamine supplements is that since our naturally occurring glucosamine is what heals and maintains our cartilage, a supplement would do the same thing. Glucosamine supplements are usually used to relieve the inflammation of the joints, which would reduce the pain. Another thought is that glucosamine will help rebuild the cartilage.
The Different Types of Glucosamine
There are different types of glucosamine supplements, glucosamine hydrochloride and glucosamine sulfate. Both glucosamine supplements are made from the shells of crustaceans, like shrimp and other shellfish. Some companies make their glucosamine supplements from corn.
There is a much higher amount of sodium in glucosamine sulfate than in glucosamine hydrochloride. If you have a problem with too much sodium, you should check the sodium amount on the container. Glucosamine hydrochloride is absorbed more quickly than glucosamine sulfate. Some glucosamine supplements also add MSM (Methylsulfonylmethane)
Does Glucosamine Work
As usual there are conflicting findings with numerous studies. In 2002, a three-year randomized placebo-controlled study using 202 patients defined with mild to moderate osteoarthritis of the knee were given 1500 mg (milligrams) of glucosamine sulfate once per day with the second group given a placebo. The study tested the narrowing of the joint spacing (narrowing means worsening) and found that there was no further narrowing with the patients using the glucosamine sulfate. The narrowing did progress in the placebo group. Significant improvement was found with pain, stiffness and function of the knee joints. The conclusion of this study was that glucosamine slowed the progression of knee osteoarthritis .
A large 6- month double-blind placebo controlled study, titled GAIT (Glucosamine/chondroitin Arthritis Intervention Trial) and reported in the February 2006 New England Journal of Medicine, studied 1583 patients with osteoarthritis of the knee. This study was designed to find out if these supplements alone or together would be effective in the treatment of knee osteoarthritis compared with the celecoxib (COX-2 inhibitor) or a placebo. The group was given one of the five following treatments per day.
- 500 mg of glucosamine hydrochloride 3 times per day (1500 mg daily), or
- 400 mg of chondroitin sulfate 3 time per day (1200 mg daily), or
- Combination of 500 mg of glucosamine hydrochloride 3 times per day (1500 mg daily) plus 400 mg of chondroitin sulfate 3 time per day (1200 mg daily), or
- 200 mg of celecoxib (Celebrex by Pfizer) per day, or
- A placebo
The conclusion of the GAIT study was that glucosamine hydrochloride and chondroitin alone or in combination did not effectively reduce pain in the overall group with knee osteoarthritis. In a subgroup of patients with moderate to severe knee osteoarthritis pain, this combination did reduce pain more than the placebo did. This could be because those with more severe knee joint pain were more readily able to notice the relief from the pain .
Glucosamine for Rheumatoid Arthritis, Sciatica and TMJ
A small 12-week long study in 2007 of 51 patients with rheumatoid arthritis showed noticeable improvements in symptoms. 25 of the patients received 1,500 mg of glucosamine hydrochloride per day and 26 patients received a placebo .
Glucosamine and Fish Oil Relieves Joint Pain from Arthritis Better
A new study using glucosamine combined with modest amounts of omega-3 fish oil was found to bring significantly better relief of joint pain than glucosamine by itself.
The study used 177 patients with moderate to severe knee or hip pain from arthritis. Half the patients received 1,500 mg glucosamine sulfate and the other half used 1,500 mg of glucosamine sulfate combined with 440 mg of fish oil daily for 26 weeks .
Sometimes these supplements combine both glucosamine with chondroitin. Chondroitin can be synthetically made and or made from shark or cow cartilage. Synthetically made is recommended since the dosage and safety is more easily controlled. A meta-analysis published in 2007 found that chondroitin was minimal or useless for healing or relieving hip or knee joint pain from osteoarthritis and recommended that its use should be discontinued for these reasons .
Most doctors will recommend trying 1,500 mg of glucosamine for 90 days. If there is no improvement in your joint pain, you could then try it again with the other type of glucosamine, hydrochloride or sulfate. Here is a list of glucosamine supplements that Consumer Reports reviewed.
Studies have shown that SAM-e relieves pain from osteoarthritis and fibromyalgia better than glucosamine does and is just as effective as prescription medicine.
Warnings and Side Effects
None of the studies found any serious side effects from glucosamine. If you are allergic to fish, then you could be allergic to glucosamine made from shellfish. Glucosamine might cause or worsen insulin resistance, a major concern with diabetes and metabolic syndrome. In theory, glucosamine could worsen bleeding in people with a bleeding condition or who take any blood-thinning medications. Make sure you talk to your doctor if you are on any type of medication, especially insulin, heart medication and Warfarin or other blood thinner. Some Glucosamine products could be high in sodium, causing a problem for people with high blood pressure.
© 2010 Sam Montana
National Institute of Arthritis and Musculoskeletal and Skin Diseases
National Institute of Health
 Pavelká K, Gatterová J, Olejarová M, Machacek S, Giacovelli G, Rovati LC. Glucosamine sulfate use and delay of progression of knee osteoarthritis: a 3-year, randomized, placebo-controlled, double-blind study. Arch Intern Med. 2002 Oct 14;162(18):2113-23.
 Effects of glucosamine administration on patients with rheumatoid arthritis. Nakamura H, Masuko K, Yudoh K, Kato T, Kamada T, Kawahara T. Pub Med
 Effect of glucosamine sulfate with or without omega-3 fatty acids in patients with osteoarthritis. Pub Med
 Meta-analysis: chondroitin for osteoarthritis of the knee or hip. Pub Med