Let’s get provocative…
Glucosamine, Pain and Placebo Effects
One can depend on two things in this world: (1) lots of people swear by the benefits of glucosamine, and (2) the medical establishment won’t find clinical proof of efficacy. The latest study in the July 7th JAMA reports a randomized, placebo-controlled trial with 6- and 12-month follow-ups, looking at osteoarthritic low back pain. They found no difference between the glucosamine and the placebo. This is not the first time.
Some will complain that the glucosamine needs to be mixed with chondroitin to be effective. Others will disbelieve the study. What else can we say about this?
I think we need to look back at the placebo effect. Placebos are placed in studies to see if the product is better than a “sham pill”, and those who improve on the placebo are immediately discounted. But they got better, didn’t they? Both groups reported significant improvements in pain – there just wasn’t a difference between them.
So what happened? Did time heal their wounds? Did they make other unconscious lifestyle changes? Did the taking of a pill harness some internal psychosomatic healing pathway? Does it matter if they feel better (other than considerations of cost and side effects).
One lesson we should take from placebo-controlled trials is that many people get better, even when we can’t explain why. If you take glucosamine and your pain gets better, and you like taking it, I see no reason why you have to stop.