Glucosamine and Hip Arthritis

Glucosamine is a substance produced by the body and it is present in healthy cartilage in joints in the human body. Commercially it is produced as a food supplement and used by many arthritis sufferers.

According to the results of a study from the Netherlands, released in February 2008, it was found to be no better at relieving the pain of hip osteoarthritis than a placebo.

This was a small trial which involved 222 patients in Holland with mild to moderate osteoarthritis. They were treated with either 1,500 mg per day of glucosamine sulfate or placebo for two years.

The study was lead by Rianna Rozendaal, M.Sc. and colleagues of the Erasmus Medical Center, and according to the researchers showed the dietary supplement had neither a therapeutic effect nor side effect on patients with osteoarthritis of the hips.

The researchers evaluated the differences in pain and function on the Western Ontario and McMaster Universities (WOMAC) scale after two years. The WOMAC differences were also evaluated at three, 12, and 24 months.

The pain score and function score between the glucosamine and placebo groups were insignificant according to the study.

Critics of the study praised the methods, but expressed concerns with other issues.

Among the concerns was the expected rate of cartilage reduction; only the hip joint was studied; 15 of the 222 study participants underwent hip replacement surgery which made analysis complicated; and a longer study might have produced different results had patients with more severe osteoarthritis been studied.

Johannes Bijlsma, M.D., Ph.D., and Floris Lafeber, Ph.D., of the Utrecht University Medical Center in the Netherlands suggested the study may not be definitive because a lower than expected loss of cartilage would make it difficult for researchers to see any potential effect. Their comments were in an editorial which accompanied the results of the study.

In November 2005 a study presented at the American College of Rheumatology Annual Scientific Meeting in San Diego showed glucosamine sulfate might have more ability to control pain in knee osteoarthritis than acetaminophen. That study suggested once-daily 1500 mg of glucosamine sulfate, taken orally, might be the preferred for treating pain and improving flexibility in knee osteoarthritis.

In the New England Journal of Medicine in 2006, scientists from the National Institutes of Health said that although glucosamine-chondroitin sulfate did not provide significant relief from osteoarthritis pain among all participants, a smaller study of participants with moderate-to-severe pain had greatly reduced pain while taking the dietary supplement.

The US Centers for Disease Control and Prevention says that one in five Americans have been diagnosed with arthritis and it is the leading cause of disability in the United States. There are prescription medications designed to treat the symptoms of arthritis but, as the saying goes sometimes, ‘the cure is worse than the disease.’ It would seem that those who suffer from arthritis have few safe and effective choices for managing their discomfort.

Advocates of alternative and natural medications suggest that arthritis patients should try glucosamine sulfate. There are positives for trying it as a therapy: it is relatively cheap at around 20 cents per day; it has no side effects; it doesn’t have the digestive problems and possibility of bleeding associated with aspirin and NSAID’s; and it could help with arthritis pain and stiffness.

Dr. Bijlsma said that taking glucosamine should remain an option for patients. “I advise them to use it for three months, if they experience improvement, I advise them to continue. If there is no improvement, I advise them to stop. I’m aware that a lot of the osteoarthritis problems for patients are indeed symptoms (pain, stiffness) that are subjective, but patients can decide for themselves. In practice, between 60 and 70 percent of the patients continue this treatment for a more prolonged period of time.”

Consumers should be aware that glucosamine sulfate, because it is considered a food supplement, not a drug, has no legally designated dosage. Most studies have suggested 1,500 mg per day. It is not an overnight cure, continued use is necessary to obtain the best results. As with all medications and supplements, be sure that your health care provider is aware that you are taking glucosamine sulfate.