Glucosamine not helpful for chronic low back pain

Optimizing the biochemical environment of a joint to support the pathways for cartilage repair can be beneficial but it doesn't address the inflammatory component of joint and connective tissue disorders. A paper just published in JAMA (the Journal of the American Medical Association) looks for evidence of benefit from glucosamine, a precursor for cartilage synthesis, in chronic low back pain. The authors observe"

"Chronic low back pain (LBP) with degenerative lumbar osteoarthritis (OA) is widespread in the adult population. Although glucosamine is increasingly used by patients with chronic LBP, little is known about its effect in this setting."

To investigate the effect of glucosamine in patients with chronic LBP and degenerative lumbar OA they conducted a double-blind, randomized, placebo-controlled trial with 250 patients with chronic LBP (>6 months) and degenerative lumbar OA. The study subjects were given 1500 mg of oral glucosamine per day or placebo or 6 months, then assessed after 6 months and 1 year. What did the data show?

"No statistically significant difference in change between groups was found when assessed after the 6-month intervention period and at 1 year."

The evidence clearly points to this disappointing, but not surprising, conclusion:

"Among patients with chronic LBP and degenerative lumbar OA, 6-month treatment with oral glucosamine compared with placebo did not result in reduced pain-related disability after the 6-month intervention and after 1-year follow-up."

This brings to mind an earlier post on a study showing more benefit from glucosamine plus omega-3 fatty acids than glucosamine alone. The omega-3 FAs would, of course, help to reduce inflammation.