Supplements for knee pain. For patients with knee pain, health supplements which claim to be anti-inflammatory and reparative sound more appealing than painkillers. For a while now, supplements such as glucosamine sulphate have been widely touted to alleviate symptoms of osteoarthritis (OA). However, the latest 2019 guidelines issued by the American College of Rheumatology (ACR) and the Arthritis Foundation do not recommend using glucosamine, chondroitin sulphate, as well as combination products which include both substances, in the treatment of patients with knee OA. Instead, ACR recommends topical non-steroidal anti-inflammatory drugs and intraarticular glucocorticoid injections in their guideline.

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There are significant discrepancies in the results reported between clinical research trials that are industry-sponsored versus publicly funded, hence raising serious concerns about publication bias. The data with the lowest risk of bias are being studied again and it shows that glucosamine has offered no important benefits over the placebo given to patients in studies.

Yet, glucosamine remains a favourite dietary supplement in the United States, and many OA patients perceive that it is effective. Why?

What is glucosamine?

Glucosamine is the actual building block of cartilage (the smooth cushioning tissue which protects the joints) and it helps to maintain the integrity of tendons, ligaments, and the production of the thick lubricant fluid in the joints. In patients suffering from knee osteoarthritis, the cartilage has broken down and become very thin, and hence, it is believed that consuming glucosamine will help to boost cartilage repair and joint lubricant fluid production.

Glucosamine sulphate is one of the most popular glucosamine supplements, at a recommended dosage of 1500mg daily. However, after intensive clinical research worldwide, it is evident that these supplements do not cure osteoarthritis and cannot substitute painkillers.

Although glucosamine has not been proven to be beneficial, the potential toxicity of glucosamine is low, except that glucosamine and chondroitin may sometimes interact with the blood thinning drug warfarin (Coumadin).

Other supplements

Fish oil, methylsulfonylmethane (MSM), vitamin D, pycnogenol, S-Adenosyl-L-methionine (SAMe), Boswellia serrata, curcumin, avocado and soybean oils, willow bark and collagen type II are some of the other dietary supplements which are gaining fame in treating OA. But once again, multiple clinical research studies showed that their efficacy are weak and many of them carry some side effects.

Check with your medical doctor before trying a new dietary supplement. No matter how holistic or healthy some products may sound from advertisements, they could have some side effects and affect your well-being.

Most importantly, do seek proper medical treatment for knee problems. Minor strain or inflammation should resolve within one to two weeks with a short course of anti-inflammatory medication prescribed by the family doctor. Should your pain persist for more than two weeks, or does not respond to the standard treatment, you should consult an orthopaedic surgeon (a specialist doctor who takes care of bones and joints) to determine the root cause of your knee pain and recommend the most appropriate treatment.

This article has been verified medically by Dr Henry Chan, orthopaedic surgeon at Surgi-TEN Specialists, Farrer Park Hospital (Singapore).