No BP Relief from Glucosamine

Do you suffer from low back pain?  Well, you’re not alone.  Nearly everyone has back pain that interferes with work, daily activities or recreation sometime in their life.
Americans spend an astronomical $50+ billion each year diagnosing and treating back pain.  It is the most common cause of work-related disability and a leading contributor to work absenteeism.  Back pain is also the second most common neurological complaint in the United States.  Headaches are the first.
 
Short-term (acute) back pain usually lasts from a few days to a few weeks.  Most acute back pain is the result of trauma or a disorder such as arthritis.  Some acute pain syndromes can become more serious if left untreated.
Chronic back pain persists for more than three months, is often progressive and the cause can be difficult to determine.

Conditions that can cause low back pain and require treatment by a health specialist include:

*Bulging Disc:  (herniated or ruptured) occurring mostly in lower lumbar portion of the spine.
*Sciatica:  condition when a bulging disk, tumor or cyst presses on the sciatic nerve and carries nerve fibers to the leg causing shock-like or burning low back pain. This can also be caused by metastatic disease or sciatic nerve root degeneration.
*Spinal degeneration from disc wear and tear narrowing the spinal canal.
*Spinal stenosis:   a congenital narrowing of the bony canal.
*Osteoporosis:   a metabolic bone disease marked by a progressive decrease in bone density.
*Skeletal irregularities which strain the vertebrae and surrounding muscles, tendons and tissues
*Spondylitis:   a chronic back pain and and stiffness caused by severe infection or inflammation of the spinal joints.

Glucosamine, a dietary supplement, has been heralded by many as a chronic low back pain reliever.  However, a  team led by Philip Wilkens of Oslo University Hospital and University of Oslo did a randomized clinical trial -- the most scientifically rigorous kind -- to see what effect glucosamine had in 250 people over age 25 with chronic lower back pain.
Participants were assessed at six months and again six months later using a pain and disability questionnaire.  No significant difference in scores between the group that took Glucosamine and the group that took the placebo were noted. 

"Based on our results, it seems unwise to recommend Glucosamine to all patients with chronic lumbar pain and degenerative lumbar osteoarthritis," Wilkens and colleagues wrote in the Journal of the American Medical Association.

While it doesn’t seem like Glucosamine is the remedy for chronic low back pain, there are many other supported options.

The American Chronic Pain Association, in their Consumer’s Guide: Practice Guidelines for Low Back Pain, list these therapies as beneficial in improving chronic back pain and/or function: spinal manipulation, acupuncture, exercise, massage therapy, yoga, behavioral therapy  and intensive interdisciplinary rehabilitation.

Also listed are medications such as Tylenol, non-steroidal anti-inflammatory drugs (NSAIDS) offered over the counter as well as some NSAIDS that require a prescription from your doctor.  Opoids for pain, muscle relaxants and antidepressants can be helpful, but carry significant risks which must be evaluated and discussed with your physician.  Herbal supplements such as willow bark, devil’s claw and cayenne may be somewhat beneficial, and don’t appear to be harmful.

Management of chronic pain - how can psychology help? Written by Dr. Helen Poole, Sr. Lecturer in Psychology, Liverpool John Moore’s University and published by the Pain Relief Foundation, says “psychologists are important members of the pain management team. His or her purpose is not to prove that someone’s pain is “all in the mind.” Rather, it is to help people in pain to build good coping skills so that they can enjoy a good quality of life despite their pain, and often reduce their pain by becoming fitter, happier and more active. Not everybody needs this type of pain management, but it’s good to know it’s there if we do.”

Chronic pain, no matter what the cause, affects the life not only of the one suffering, but also the lives of their families, loved ones, co-workers and friends. 
Laura King