In the US, chondroitin sulfate is usually sold as a dietary supplement and taken in conjunction with glucosamine to treat arthritis pain. Most well-controlled trials in this country have shown that this combination is no better than placebo.

The Power of Pharmaceutical-Grade Chondroitin Sulfate:

A large new European study demonstrates, however, that pharmaceutical-grade chondroitin sulfate is significantly better than placebo at alleviating the pain of knee osteoarthritis. In the six-month long trial, 604 patients were randomly assigned to take either 200 mg of celecoxib (Celebrex), 800 mg of chondroitin sulfate (Chondrosulf) or placebo every evening with water. The volunteers kept a diary of their pain levels and how often they needed an additional dose of acetaminophen for pain control.

What Results Did the Scientists Find?

In the course of this study, all three groups reported improvement in their knee pain. The investigators found no significant differences between chondroitin sulfate and celecoxib in their effects. Both were significantly better than placebo.

What About Side Effects?

A few patients reported stomachaches as a side effect, but no one group had disproportionately more such reports.

Reginster et al, Annals of the Rheumatic Diseases, online May 22, 2017 

Solving a Puzzle?

These findings may help explain a mystery that has long puzzled us. European studies of glucosamine and chondroitin, alone or in combination, frequently demonstrate benefit for arthritis pain (Tio et al, Medicina Clinica, online Feb. 25, 2017; Sterzi et al, European Journal of Physical and Rehabilitation Medicine, June 2016; Rovati et al, Seminars in Arthritis and Rheumatism, Feb. 2016, Supplement).

In contrast, most studies conducted in the US show that neither glucosamine nor chondroitin is helpful. Such trials include the GAIT study (Sawitzke et al, Annals of the Rheumatic Diseases, Aug. 2010; Clegg et al, New England Journal of Medicine, Feb. 23, 2006). Even some European reviews of research have concluded that the evidence doesn’t show these compounds help arthritis pain (Vasiliadis & Tsikopoulos, World Journal of Orthopedics, Jan. 2017; Rojas-Briones et al, Medwave, April 26, 2017, Supplement 2).

Does Pharmaceutical-Grade Chondroitin Make a Difference?

Perhaps differences in the products used explain some of the discrepancies in these results. Not all US studies use pharmaceutical-grade chondroitin sulfate.

Moreover, systematic analysis of chondroitin sulfate found that not all preparations were as labeled (Santos et al, Pharmaceuticals, April 1, 2017). Some pills that were supposed to be sulfated were not.

One review found that patented crystalline glucosamine sulfate reduced knee pain, while other formulations did not (Bruyère et al, Seminars in Arthritis and Rheumatism, Feb. 2016, 4 Supplement).

We suspect that the quality of the supplement might make a difference in whether people with arthritic knees get pain relief. Unfortunately, Americans have no good way to determine whether they are taking a good quality preparation.

Alternatives for Arthritis:

For more information on non-drug approaches to pain relief, you may wish to read our online resource, Alternatives for Arthritis. This information is provided as an online resource. When you buy it, you will be emailed a link just for you that allows you to visit it whenever you wish, as many times as you like. You will be able to read it on any device that you have connected to the internet. We hope you enjoy this new resource and find it helpful.

Related People's Pharmacy Health Guide

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