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Can Glucosamine Prevent Facet Joint Pain?

In the nutritional supplements aisle of any store, you will find several brands of glucosamine tablets. Glucosamine sulfate is a naturally-occurring chemical in the body. It plays a role in developing joint cartilage. However, the cartilage that cushions bone-on-bone contact can wear thin (osteoarthritis) from aging or use. The facet joints in the spinal column are subject to such wear and tear, and this can lead to mild to severe back pain. Can taking glucosamine supplements help prevent facet cartilage damage, or even relieve the pain from facet joint osteoarthritis?

Laboratory tests suggest that oral glucosamine sulfate may limit cartilage breakdown. Most human studies on the effectiveness of glucosamine have been done on knee pain, with inconsistent results. Some people experience gradual improvement in knee pain with continued use of glucosamine, but not everyone does. Supplements that combine glucosamine with another natural cartilage-related substance called chondroitin may have a stronger effect – but here, too, the results are spotty. In one large, randomized and double-blinded study regarding knee pain, 70% of participants with moderate-to-severe knee pain who took glucosamine/chondroitin reported a 20% decrease in pain, while those with mild knee pain were not significantly helped.i

Glucosamine for facet pain

In 2013, a review of published literature was published on the use of glucosamine supplements for chronic low back pain thought to be caused by facet osteoarthritis.ii Aside from one study that reported significant clinical improvement (but which had signs of research bias), the authors wrote that “based on insufficient data and the low quality of existing studies,” it’s not possible to say if glucosamine has any impact one way or the other.

That said, there is no evidence that glucosamine has harmful effects. If you have back pain and are considering adding glucosamine (or a glucosamine/chondroitin combo), we recommend:

  1. Discuss this with your doctor or specialist before starting so they can note it in your records.
  2. Consult your doctor on diet and exercise, both of which can have a big impact on reducing discomfort naturally.
  3. Purchase your desired product from a reputable source, and only buy a well-respected brand. Many products state “clinically tested” on their labels, but this does often means the manufacturer referred to studies done by others, and not using identical ingredients.
  4. Don’t expect immediate results. Neither glucosamine nor chondroitin is formulated as an anti-inflammatory. If it works, it may be due to slowing further deterioration rather than actual rebuilding of cartilage, which has not been clinically demonstrated by x-rays or other imaging.

If your lower back is bothering you, taking steps like improving your posture, losing extra weight, managing stress effectively, getting a good night’s sleep, etc. is just as important as taking a well-chosen supplement. Gradually adding lifestyle changes can lead to a synergistic effect in terms of reducing back pain. However, if back pain continues or worsens, it’s important to obtain a correct diagnosis of the source. For acute facet pain, the Sperling Medical Group offers noninvasive MRI-guided Focused Ultrasound (MRgFUS) that can bring durable pain relief. Contact the Sperling Medical Group for more information.

iiSodha R, Sivanadariah N, Alam N. The use of glucosamine for chronic low back pain: a systematic review of randomised control trials. BMJ Open. 2013 Jun 20;3(6).

Facet Pain