Glucosamine has a long history dating back to the 1970s when it was used in veterinary medicine. At the time, it was an injectable only. The molecule was unstable in the sense that it was hydroscopic or would absorb moisture, which precluded it from being used as an oral supplement.
Then, an Italian company, Rottapharm, received a U.S. patent for glucosamine in the early 1990s. The brand is known in the U.S. as Dona. Despite few Americans ever having heard of this glucosamine, 90% of the published peer-reviewed research on glucosamine has, in fact, been done specifically on Dona glucosamine. See www.donausa.com.
Shortly after we introduced glucosamine in 1994, a multitude of glucosamine products hit the market. However, there was one major problem ... the patent! To get around the patent, several other glucosamines were sold, such as glucosamine HCL, glucosamine KCL, N-Acetyl glucosamine, etc.
Confusion
Doctors are confused, patients are confused, the majority of us are confused when it comes to joint health. Why? Almost everything we read about glucosamine is, in fact, marketing material with a whole lot of spin added and very little actual science. It has been nearly 2 decades since then and the good news is that there are several other natural options we have to offer patients.
The Good
All too often when we think of joint health, we immediately think of glucosamine when, in fact, there are many therapeutic options.
The Bad
The Cochrane Collaboration (www.cochrane.org) is an international, not-for-profit, independent organization that produces and disseminates systematic reviews of health care interventions. Cochrane is one of the most, if not the most, respected organization of its type in the world. According to their 2009 review of glucosamine, which included 25 studies with 4963 patients, only one brand of glucosamine was found more effective than placebo. This was the Dona brand from Rottapharm.
GAIT
If there is one glucosamine trial you need to be familiar with, it is GAIT (Glucosamine Arthritis Intervention Trial). GAIT is the largest and most rigorous investigation of glucosamine that has ever been done. The GAIT trial took place at 16 universities across America, was conducted by the National Institute for Health (NIH) and included 1583 patients.
There were ten treatment groups: five early stage osteoarthritis and five moderate to severe osteoarthritis. The groups were broken down as follows:
Five of the sixglucosamine and/or chondroitin groups failed to show benefit over the placebo for pain relief after six months. Only one of the six, which was one of the two groups receiving both glucosamine and chondroitin appeared to benefit. This group was small with only 72 participants.
The GAIT researchers cautioned not to draw any conclusions from this sixth group because of its small size and also, most importantly, because the results were inconsistent with the results from the other five groups. GAIT participants were given the opportunity to continue for another 18 months in order to see if there were any benefits to the cartilage after two years. If glucosamine and/or chondroitin was beneficial to the cartilage, then the researchers would expect to see a reduction in joint space loss. When the joint spacing was measured, the result was that there was no statistically significant difference between the glucosamine and/or chondroitin groups and placebo. Ironically, the participants receiving both glucosamine and chondroitin had slightly more joint space loss than placebo. It was a minor difference and not statistically significant, but certainly not a benefit!
The Ugly
Many brands offer GAIT results as proof glucosamine works; bizarre, but true. It makes one wonder at what point does advertising research results as positive when the authors report them as negative become an abuse of free speech? Many glucosamine containing products claim they are the best, despite little or, in most cases, no research whatsoever, let alone peer-reviewed research. These brands often add chondroitin, MSM, green lipped muscle, milk protein, egg shell membrane, HA, enzymes, hot herbs, fish oil etc., to create the "ultimate" joint product. Ask your sales rep for the actual product research. Chances are it does not exist. All too often, ads state "contains clinically proven ingredients,"which on the surface sounds good. However, this usually means the actual product was, in fact, never tested.
Is Glucosamine Obsolete?
Patients expect their chiropractors to be experts and at the forefront when it comes to joint health and natural products. Glucosamine maybe popular today, but so were electric typewriters when word processors were introduced. At what point is a technology considered obsolete? Science marches forward and today there are far better therapeutic options available.
When sports chiropractors first appeared at the Olympic Games in the 1980s, it was alongside individual athletes who had experienced the benefits of chiropractic care in their training and recovery processes at home. Fast forward to Paris 2024, where chiropractic care was available in the polyclinic for all athletes, and the attitude has now evolved to recognize that “every athlete deserves access to sports chiropractic."
It is estimated that 61% of patients with CTS avoid taking surgical options due to postoperative complications and costly surgical procedures. Chiropractic care offers a comprehensive and effective treatment for carpal tunnel syndrome, addressing the condition from multiple angles. Recent studies also have unveiled a game-changing adjunct to chiropractic treatments for CTS: nerve flossing.
Some doctors thrive in a personality-based clinic and have a loyal following no matter what services or equipment they offer, but for most chiropractic offices who are trying to grow and expand, new equipment purchases help us stay relevant and continue to service our client base in the best, most up-to-date manner possible. So, regarding equipment purchasing: should you lease, get a bank loan, or pay cash?
