J writes in asking about reasonable treatment for lingering lower back pain due to arthritis.
She has been seen by her primary care doctor as well as by an orthopedist, had an MRI of her back that showed changes usually seen with degenerative arthritis (also called osteoarthritis), and has done physical therapy but continues to have a little discomfort. She wondered whether she could take glucosamine to treat her low back pain since a friend of hers got relief from knee osteoarthritis with glucosamine.
It's a great thought, J, but recent research suggests that glucosamine doesn't work very well for low back pain due to degenerative arthritis.
In the study, performed in Norway, people diagnosed with low back pain from osteoarthritis received either glucosamine sulfate (the form of glucosamine best studied so far) or placebo and were watched over the course of a year. The majority of people got better over that time but there was no significant difference between those who took glucosamine and those who took the placebo pill.
Low back pain can be due to many different factors, degenerative arthritis being just one, and finding signs of arthritis on an x-ray or MRI doesn't mean that's the source of your pain. Inflammation of the soft tissues surrounding your spine, including your muscles and ligaments, can cause pain that might seem to be coming from your spine. Glucosamine doesn't seem to help in that instance.
But it looks like glucosamine may not help even if the source of your low back pain is mild inflammation that involves your bony spine.
Other options to treat persistent low back pain due to arthritic changes include acupuncture, chiropractic or osteopathic manipulation, massage therapy, gentle yoga stetches, and the use of low-dose anti-inflammatory agents - my favorites come from FOOD (like the omega-3 fatty acids found in cold water fish and the spice turmeric).
Certainly if your pain is worsening, or becoming associated with other symptoms such as leg pan, abdominal discomfort, or bowel and bladder problems be sure to see your doctor.
I hope this helps, J, and that you feel better soon!
Be well.
Dr. Russ
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