By GRETCHEN REYNOLDS New York Times
Q Do glucosamine and MSM relieve joint pain?
The glucosamine-MSM controversy continues: My 43-year-old physician’s assistant says, “I couldn’t get in the car and drive to work in the morning if I didn’t take glucosamine for joint pain.” My primary-care physician is wholly noncommittal re the efficacy of glucosamine-MSM formulations. In recovery from hip surgery, my night nurse sympathizes. “I’ve had four hip surgeries.” she says. “Glucosamine is indispensable for me.” The veteran orthopedic surgeon stops in at 8 a.m. “Glucosamine just gives you expensive urine. Don’t waste your money.” she pronounces authoritatively. The local drug store has a display six feet wide by six feet high of glucosamine-MSM products. The attendant pharmacist judges me a fool for even asking about the relative value of any of them. What says WELL, finally and expertly, about the use of any (which?) glucosamine-MSM formulation for relief of joint pain?
Asked by vishmael
A People have wildly conflicting opinions about the benefits of glucosamine, a compound found naturally in healthy joints, and MSM, short for methylsulfonylmethane. The two, usually sold as separate preparations, are popular nutritional supplements that promise to lessen the creaking and soreness of knees, backs, hips and other joints.
But the results of scientific studies of the supplements are equivocal. For instance, in the largest study to date of glucosamine, published in 2006, more than 1,500 adults with knee osteoarthritis were randomly assigned to receive the supplement, a painkiller or a placebo. After 24 weeks, only those participants taking the painkiller reported less knee pain. Glucosamine had been no more effective than a placebo.
Two years later, the researchers checked in again on 600 of the participants, each of whom had continued to take glucosamine, painkillers or a placebo. They still found no “clinically important” benefit from the glucosamine, though a few of the volunteers taking glucosamine reported less soreness (as did some of those taking the placebo). In effect, they concluded, glucosamine had provided little pain relief to most, some help to a few, and no particular harm to anyone, as side effects were rare.
Studies of MSM use are more scarce, and the results both encouraging and cautionary. In a noteworthy animal experiment published earlier this year, Japanese scientists bred mice to develop premature knee arthritis, then dosed some with levels of MSM equivalent to that found in most over-the-counter preparations for people, while others received 10 times as much MSM, and others none.
After a month, the animals taking either dose of MSM had developed less degeneration of the cartilage in their knees than the control animals. But those taking megadoses of the supplement did have signs of incipient liver and spleen damage.
The upshot? “I tell people that if they want to spend their money” on glucosamine or MSM, “that’s up to them,” said Dr. Michael Parks, an orthopedic surgeon at the Hospital for Special Surgery in New York City, who frequently treats patients with arthritis. At recommended doses, the supplements “are generally safe,” he said, “and some people do say that they make them feel better.”
But if you decide to experiment with the supplements, he advised, keep your expectations low. “In my experience, most people do not benefit.”