Glucosamine or Tylenol for Joint Pain?

Every 7 years I take a test to maintain my medical board certification. This test is prepared by the American Board of Family Medicine. The last time I took the test I clearly remember a multiple choice question regarding osteoarthritis. The choice of answers disturbed me. The question basically asked the ideal long term treatment for osteoarthritis. The choices were a) The use of aspirin, b) The use of NSAIDs such as naproxen or ibuprofen (Motrin), c) The use of acetaminophen (Tylenol) up to 4 grams a day, and d) Combination of aspirin and other NSAIDs. What disturbed me was that there was no option provided for glucosamine and chondroitin or other natural methods. In fact, throughout the whole test, I hardly remember any questions regarding the use of nutrition or nutritional supplements in the treatment of common medical conditions. Later I found out the “correct” answer was c) Tylenol.


I recently came across a study comparing glucosamine versus acetaminophen. Researchers from Madrid, Spain, compared the benefit of glucosamine sulfate versus acetaminophen (Tylenol) on the symptoms of knee osteoarthritis during a 6-month treatment course. Patients were randomly assigned to receive oral glucosamine sulfate 1,500 mg once daily, acetaminophen 3 gm a day, or placebo. There were more responders to glucosamine sulfate (39%) and acetaminophen (33%) than to placebo (21%). Safety was good, and was comparable among groups. The findings of this study indicate that glucosamine sulfate is more effective than placebo and more or as effective as acetaminophen in treating knee osteoarthritis symptoms.


Dr. Sahelian Comments: Acetaminophen works quicker to relieve pain, but can cause harm to the liver, even at doses of one gram a day. I do not think it is a good drug to be taken long term for a chronic condition such as osteoarthritis. There is a possibility that if glucosamine is combined with chondroitin and other nutrients or herbs it may be more beneficial than by itself. I wonder how many years it will take for the American Board of Family Medicine to include natural supplements as options in their multiple choice questions and answers.


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Ray Sahelian MD Written by Ray Sahelian MD

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