Q. Is glucosamine tablets better or transdermal creams?
Glucosamine is a substance that is found in our joint cartilage. Cartilage is the cushion that lines the surfaces of our joints, and allows smooth and pain-free motion. When cartilage wears out, it leads to joint pain, stiffness and loss of function. This condition is known as osteoarthritis.
Because glucosamine is a natural building block of joint cartilage, preparations containing glucosamine are marketed as supplements that support the structure and function of cartilage, particularly in patients with osteoarthritis.
However, the use of glucosamine in the treatment of osteoarthritis of the knee is controversial in medical circles. Some studies suggest that it is helpful in relieving pain and improving function, while others indicate no such benefit. In fact, several recent large-scale, independent studies have shown no improvement in pain relief or functional improvement with the use of glucosamine. The vast majority of studies have been done using glucosamine tablets. Very few have looked at topical glucosamine. From a physiological point of view, it is quite unlikely that glucosamine is able to enter joints directly through the skin after topical application. Therefore I would not recommend glucosamine creams.
As for glucosamine tablets, I do not routinely prescribe glucosamine tablets unless patients ask for them specifically. In these cases, I advise patients to try taking glucosamine for three months. If they feel symptomatically better, I tell them to carry on. If they experience no difference in their symptoms, I advise them to stop. There are after all other more effective treatment options for osteoarthritis, such as physiotherapy, weight loss, activity modification and painkillers. If these non-surgical options fail, surgical treatment may be considered. – Dr Lingaraj Krishna, consultant, Division of Hip and Knee Surgery, National University Hospital