Glucosamine won't help a bad back

BMJ Group News

What do we know already?

Glucosamine is a natural supplement, often made from shellfish, although you can also get synthetic, vegetarian forms. It's a building block for the chemicals used by the body to make cartilage - the smooth, shock-absorbing material that helps protect your joints. The theory is that taking glucosamine helps prevent the breakdown of cartilage and so reduces joint pain.

Glucosamine supplements are a popular treatment for arthritis, and increasingly for back pain. Despite their popularity, the scientific evidence around glucosamine supplements is fairly limited, with the best quality studies suggesting little benefit.

In a new study, researchers have looked at whether glucosamine supplements can help people with long-term back pain caused by arthritis of the spine.

What did the research say?

For six months, 250 people were given either daily glucosamine supplements or an inactive placebo treatment. The amount of disability people had because of their back pain fell, but this was the same for both groups. There was no difference between glucosamine and a placebo.

The researchers also looked at the amount of back pain people had, both at rest and when active. Glucosamine didn't make any difference. People taking glucosamine got the same amount of pain as people taking a placebo.

The most common side effects were skin problems and an upset stomach, but overall, people taking glucosamine didn't get any more problems than the people taking a placebo.

How reliable is the research?

This was a good-quality study looking at 250 people. People were allowed to carry on with any other treatments they were using, such as painkillers, although a similar number of people did this from the placebo and glucosamine groups, so it shouldn't have affected the results.

By counting the leftover pills, the researchers worked out that people had taken about 80 percent of the recommended dose of glucosamine. This reflects the real world, where it's easy to forget treatment every so often. Even so, it's theoretically possible that people would have seen more benefit if they'd taken the full dose.

Where does the study come from?

The study was done in Oslo, Norway. It was published in the Journal of the American Medical Association, which is owned by the American Medical Association.

Funding came from the Norwegian Low Back Pain Association, the Norwegian Chiropractic Associations Research Fund, and the Wilhelmsens Research Fund. The supplements used in the study were provided by a company called Pharma Nord.

What does this mean for me?

The study shows fairly clearly that glucosamine isn't likely to help people with low back pain that's caused by arthritis.

What should I do now?

Back pain can be hugely frustrating, as there's often no one treatment that makes a big difference. People often try lots of things before they find something that works for them. It's often a case of finding a way to live with back pain, rather than finding a cure.

Your GP can suggest treatments that are worth trying, and some people also find seeing a physiotherapist helpful. Many people do try alternative treatments, but make sure you're clear about what the benefits and side effects are likely to be.