Exposed: Glucosamine vs NSAIDs

Compare the effects and benefits of NSAIDs and Glucosamine...

Over 3.5 million Australians have arthritis. Paracetamol is usually recommended as a first-line treatment as it effectively reduces mild to moderate pain. It does not have an anti-inflammatory action, however, and has little effect on joint swelling or stiffness. Non-steroidal anti-inflammatory drugs (NSAIDs) are therefore prescribed when both pain-relief and an anti-inflammatory action are needed, but their use is limited by their potential for side effects.

The desire for an alternative to NSAIDs means that glucosamine is now one of the most popular supplements. Glucosamine both reduces arthritis joint pain and limits inflammation with very few adverse effects.

The effects and benefits of NSAIDs and Glucosamine

NSAIDs

• Are artificial synthetic drugs not found in nature.
• Offer symptomatic relief from the pain and inflammation associated with arthritis, but may hasten progression of some forms of arthritis.
• Has no effect on joint space.
• Improve pain quickly, from the first dose. In higher doses, produces an anti-inflammatory response within 1 or 2 weeks.
• Stops working soon after treatment is discontinued.
• Are suitable for people with a shellfish allergy.
• NSAIDs are responsible for around 12,000 admissions to hospital each year to treat serious side effects, and as many as 2,600 deaths.
• Can cause peptic ulceration.
• Can increase the risk of heart attack and stroke.

Glucosamine

• Occurs naturally in the body but is often in short supply.
• Addresses the underlying cause of arthritis, helping to repair joint damage and improve the quality of joint fluids.
• Slows progression of joint space narrowing for a beneficial disease modifying action.
• Produces similar or better improvements to pain and inflammation than NSAIDs, but with a slower onset of action (2 to 4 weeks).
• Benefits remains for at least 8 weeks after treatment is discontinued, due to disease modifying action.
• Glucosamine derived from crustacean shells is not suitable for people with a shellfish allergy; howeverproducts with non-shellfish derived forms of glucosamine are available.
• Is tolerated as well as inactive placebo. Can increase intestinal gas production.
• Is not associated with peptic ulceration.
• Does not increase the risk of heart attack or stroke.

For the majority of people, glucosamine is a better choice for treating arthritis symptoms than NSAIDs. A systematic review of 20 randomised controlled trials found that, in people with osteoarthritis, glucosamine was more effective at relieving pain than placebo with a 28% improvement in pain and a 21% improvement in joint function. It may be combined with paracetamol during the first few weeks before its full effect is achieved.

Author: Dr Sarah Brewer

Sarah Brewer graduated as a doctor from Cambridge University in 1983. She was a full-time GP for five years and now works in hospital medicine. She is the author of 40 books and writes widely on all aspects of health including complementary medicine.