Glucosamine no better than placebo for lower back pain

A Norwegian study published in the Journal of the American Medical Association showed that glucosamine has no effect on relieving lower back pain. Six million Americans take glucosamine supplements.

For six months, he and his colleagues gave 250 adults with chronic lower back pain and degenerative osteoarthritis either 2,500 mg daily of glucosamine sulfate or a placebo. At the six-month and one-year marks, there weren't any significant differences among patients in the two groups. Both groups did seem to be helped by the placebo effect, which is common in pain patients, in which people apparently feel better simply because they are receiving treatment.

Glucosamine No Remedy for Lower Back Pain, Says Study (via Consumerist)

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hassenpfeffer

It doesn’t work for back pain, but, according to the Merck Manual: “Strong scientific evidence supports use of glucosamine sulfate for treatment of mild to moderate osteoarthritis of the knee. Its role in the treatment of more severe knee osteoarthritis and osteoarthritis in other locations is less well defined.”
Rob

“Back pain” is such a generalized and goofy ailment that, honestly, nothing in relation to it can be taken seriously. IMHO.

Glucosamine has been, for me, personally, effective in dealing with various joint issues. FWIW.
- Snig
  
  I agree back pain is a nebulous term that encompassess muscle spasm/tightening/tendonitis of six layers of back muscles, and a handful of abdominal muscle, any one or cluster of which can cause pain. There’s also central or lateral stenosis, a wide gradient of disc injuries, stiffness or fixation in joints. Additionally there’s visceral issues (hiatal hernia, ulcer, pancreatitis, abdominal aneurysm) that can present as back pain. A lot of people have a combination of issues, the expression being your dog is allowed to have ticks and fleas. It’s great for you if your experience with it is the short term mild self-resolving flavor, but not everyone is so lucky. The unlucky ones often have to take it seriously. The Sarno book is great for who it works for, but it doesn’t work for everyone, and I think it should contain a huge disclaimer saying “If this book doesn’t work for you, stop blaming yourself for being weak minded”. The McKenzie approach is another do it yourself kit book, consisting of exercises that are sometimes helpful for some. Pain is not normal, so if it’s not resolving, get yourself seen by a doctor.
  
  The research is tricky, as the studies are often unknowingly comparing apples, oranges, the flavor of tinfoil and the memory of a lost love, as there’s a great variety between people’s source of pain.
  
  Don’t know of anyone who’s been trying to promote glucosamine as a back pain, but it’s absolutely not a placebo, as the NIH knee study didn’t show what was hoped by many but showed some efficacy for some people w/ severe arthritis. If I was in that category, it’s something I’d try, as the only side effect seems to be you’re out $30 for a month’s dose.
MollyMaguire

I bet Grok never had lower back pain.
Billegible

Back when I worked in a health food store, glucosamine was touted as being the building blocks for the stuff in your joints – so you’d take it if you were having problems with arthritis, or for knee surgery, to give your body the stuff it needed to build the requisite tissue. Never heard of it for back pain.
Daemon

Fortunately, placebos are fairly effective at controlling pain.
McLuhanesque

As many other posters noted, back pain is a non-specific diagnosis. The fact that it might be co-occurring with osteoarthritis does not mean that the arthritis is necessarily causative in all or even most cases.

In my own case, as a middle-aged dancer, I found that after two or three hours of dancing, I would have debilitating hip pain for several days. Researching the medical literature (not websites, but an actual literature review of scholarly, peer-reviewed journals) I found that glucosamine supplements are efficacious in about 50% of the population, and that it is the sulphate form (from sea-beastie cartilage) that is significantly more effective (as opposed to the hydrochloride form). Also, it takes up to 3 months of treatment (at 1500 mg per day as the typical therapeutic dose) to determine whether you’re among the lucky 50%.

For me, beginning treatment (750 mg twice per day), the hip pain cleared up within three weeks, and has remained at bay ever since, despite increasing the intensity of dancing. At one point, I ran out of the supplements and was off the treatment for about a week or so. Guess what? Hip pain returned by the end of the week (even though I truly thought that I was over it), and then subsided once again after restarting the treatment.

Comment to Cory: By publishing an “aha, gotcha” link debunking supplements (which, I’m guessing, corresponds to your politics on the issue), you seem to be stooping to the same promotion of junk science as the lesser credibility websites and supermarket checkout tabloids. Check out Ioannidis, J. P. A. (2005). Why most published research findings are false. Public Library of Science – Medicine, 2(8), to understand why even (especially) JAMA, NEJM, Lancet, etc. are not to be blindly trusted. (Also see Latour, B., & Woolgar, S. (1986). Laboratory life: The construction of scientific facts ( 2nd ed.). Princeton, NJ: Princeton University Press.)
nnguyen

Just an FYI, JAMA and at least a few other medical journals have a huge bias against supplements. These journal committees are typically composed of people who either doesn’t know anything about supplements because they went to medical school long before supplements were popular, or they saw their pharmaceutical investments dwindling because of supplements and vitamins.
Freddie Freelance

My Uncle takes Glucosamine for arthritic knees and it works well for him; I took a daily Glucosamine/Chondroitin supplement while I worked in a warehouse when I was younger, and it helped immeasurably for joint soreness & swelling. Neither of these reasons for taking the supplements were for a bad back, so they neither prove nor disprove anything.
Xopher

As many other posters noted, back pain is a non-specific diagnosis.

This is very true. A friend of mine had back pain as the first symptom of metastatic prostate cancer.

Don’t ignore your back pain.
Anonymous

It becomes clearer each day that sugar pills are the cure for everything. Quick, someone market it!
- Chuck
  
  I’d like to see a TV commercial for Placebo, if only to hear the ridiculously long list of imaginary side effects.
- soybeans
  
  They already market sugar pills as a cure all for everything. It’s the ridiculously implausible quackery known as homeopathy.
Anonymous

“A Norwegian study published in the Journal of the American Medical Association showed that glucosamine has no effect on relieving lower back pain. Six million Americans take glucosamine supplements.”

Surely you’re not insinuating that those 6 million people who take glucosamine supplements are doing so for lower back pain.

While I applaud efforts to expose quackery and snake oil, let’s not jump to conclusions in the process, eh?
Anonymous

I give it to my dog for arthritis. She was starting to stumble a lot and while she was on it, she stopped. I tried cutting it out for summer, because her arthritis is less then, but she went back to tripping, so she’s back on it. I don’t think I’m imagining her lack of a limp.
Anonymous

Meh. My email spammers have switched to acai berries, which are PROVEN to cure any and all ailments. Obviously everyone knows by now that glucosamine is a scam, it’s been widely disproved by scientists. Acai on the other hand is an all natural and totally effective cure which amethystine deluxe, dividend bethesda astrology, butyrate approbation

http://acaiberriezforsupplimentinfo3xy778.biz
- -j-
  
  Yet another example of a product that is supposed solve the inadequacies of your body. Pretty much anything that is said to cure back pain is based on placebo effect.
an0nymous

Well. Okay. No more effective than a placebo.
But the placebo did help.
It works because they think it works.
Is it better to replace that with nothing? They are experiencing a relief of symptoms. The mechanism is entirely internal to the consumer, but if the goal is reduction of symptoms, it does work.
What alternative placebo do the authors recommend?
Anonymous

Glucosamine (most often taken with chondroitin) is normally taken for arthritic joint (knee) pain. My completely dubious-quality evidence is that it eliminates my knee pain, and I’ve only encountered one person who’s tried them and not had them relieve symptoms of arthritic knees.

As other posters have pointed out, these supplements aren’t indicated (recommended) for back pain. Generic back pain is complicated (as Snig and Rob point out).

What will they study next: the ability of a defensive driving course to relieve migranes?
Anonymous

I tried Glucosamine, Chondroitin and MSM both separately and combined over a period of about 8 months. I can honestly say that this is a complete SCAM (for me at least). These products (for knee joint pain) have honestly done zero, nothing, nada, zip. This is the absolute 100% truth!!!
Nathan
-j-

That is because much of the back pain we experience is due to stress and a connection between the mind and the rest of the body. Unfortunately the main-stream medical community doesn’t recognize this. I had daily debilitating back pain for years (with only temporary relief from medical therapies) until I found out about Tension Myositis Syndrome (TMS) from a book. You can read about it on Wikipedia (http://en.wikipedia.org/wiki/Tension_myositis_syndrome). Now I am completely free of back pain.
The idea that back pain can be cured with things like glucosamine, medicinal patches or equipment that turns you upside down is just a result of clever marketing. The marketing targets our fear that somehow part of our body is defective and we can buy something to fix it. The idea of a ‘bad back’ is for the most part B.S. Don’t buy into it
blatantdisregard

I’m with several other commenters here. I’ve never heard of glucosamine being used to treat back pain. I always thought it was more of a preventative medicine to help keep your joints lubed up.
sonipitts

It seems to do a pretty good job of making my arthritic old cat feel better. At least, he’s markedly sprier and bouncier when I give it to him. And I’m pretty sure the placebo effect doesn’t work on cats, especially if you add it to their food when they can’t see you, lol.
- Pantograph
  
  The placebo effect may not work on cats, but it certainly works on cat owners.
JEM

My dad suffers from both bad knees and a bad back. Glucosamine helps his knees but not his back.
dolo54

Glucosamine and Chondritin helped my dear departed old dog get moving again. After 3 weeks of taking it he went from barely able to walk, to going on 2 mile walks. It’s not really for back pain, it’s to help replace the cartilage in your joints as your body doesn’t as well in old age.
- Mazoola
  
  Glucosamine and Chondritin helped my dear departed old dog get moving again.
  
  Let’s see a placebo try that.
Anonymous

heres somethings that work better and faster – MSM , Boswellia and Turmeric … with a host of other side benefits
Bahumat

Glucosamine with Chondritin might not do anything for lower back pain, but it’s magnificent for keeping my arthritic-since-childhood fingers moving and flowing.

The only downside is that for the first two weeks or so, it makes my fingers hurt more (rebuilding, combined with lots of typing movement), but after the first two weeks, my fingers move smooth and quiet. No crackle-crunch, no seizing, no need to crack them and stretch them often.

Usually after a month to five weeks of the stuff, my fingers are good for most of the year again.
Anonymous

“Viagra no better than placebo for lowering cholesterol”

I work in the supplement industry and have never heard of glucosamine being used for lower back pain, only joints.
braininavat

I have found the best cure for lower back pain (following a mountain biking injury) is activity combined with attention to posture. At the time of my injury I worked at a physically demanding job and never took any time off for recuperation. This was some years ago, my back is fine now. Less chair time (sitting) is essential for back pain cures, sitting is VERY hard on your back.