“Chondroitin relieves osteoarthritis pain.”
Chondroitin eases osteoarthritis pain only slightly on average, and the better trials found a difference too small for most people to notice.
Chondroitin gives most people too little pain relief to notice. It is not the reliable pain reliever it is often sold as.
If you are thinking about chondroitin, ask your clinician about treatments with stronger evidence for osteoarthritis pain first. If you already take it and do not notice a clear difference, you can stop.
Safety note: Chondroitin taken with glucosamine has been linked to bleeding in people taking the blood thinner warfarin, so ask your pharmacist before combining them. Many products also contain glucosamine, which may raise blood sugar in some people. Little is known about safety during pregnancy or breastfeeding.
Talk to a healthcare professional if: you take warfarin, you have diabetes and are considering a product that also contains glucosamine, you are pregnant or breastfeeding, or joint pain is keeping you from daily activities.
The largest and best-run trials agree that chondroitin's effect on pain is small, about the same size as glucosamine's and below what most patients notice. Confidence is Moderate because many smaller positive trials are low quality and their results vary widely.
Chondroitin eases osteoarthritis pain only slightly on average, and the better trials found a difference too small for most people to notice. In the two best-quality trials (1,253 people), 53 in 100 people on chondroitin had at least a 20% drop in knee pain, compared with 47 in 100 on a placebo pill.
A Cochrane review of 43 trials found less pain with chondroitin in short studies, but that evidence was low quality and results varied a lot between trials. The benefit became uncertain when the review looked only at larger or better-designed trials, or trials without drug-company funding. In the US GAIT trial of 1,583 people, 65.4% on chondroitin had at least 20% less pain after 24 weeks, compared with 60.1% on placebo, a gap that could be due to chance. A pooled analysis of the 10 largest trials found chondroitin lowered pain by 0.3 points on a 10-point scale, less than the 0.9 points most patients would notice. Among the better studies, one pharmaceutical-grade product did better than other brands.
The American College of Rheumatology and Arthritis Foundation (2019) strongly recommend against chondroitin for knee and hip osteoarthritis. They conditionally recommend it for hand osteoarthritis, based on a single trial. The Osteoarthritis Research Society International (2019) strongly recommends against it for knee osteoarthritis because the evidence is low quality. The American Academy of Orthopaedic Surgeons (2021) lists it as possibly helpful, with inconsistent evidence. A European expert group (ESCEO, 2019) supports only prescription chondroitin sulfate.
- Singh JA, Noorbaloochi S, MacDonald R, Maxwell LJ. Chondroitin for osteoarthritis. Cochrane Database of Systematic Reviews. 2015;(1):CD005614. DOI: 10.1002/14651858.CD005614.pub2
- Clegg DO, Reda DJ, Harris CL, et al. Glucosamine, chondroitin sulfate, and the two in combination for painful knee osteoarthritis. New England Journal of Medicine. 2006;354(8):795-808. DOI: 10.1056/NEJMoa052771. PMID: 16495392
- Wandel S, Jüni P, Tendal B, Nüesch E, Villiger PM, Welton NJ, Reichenbach S, Trelle S. Effects of glucosamine, chondroitin, or placebo in patients with osteoarthritis of hip or knee: network meta-analysis. BMJ. 2010;341:c4675. DOI: 10.1136/bmj.c4675. PMID: 20847017
- Kolasinski SL, Neogi T, Hochberg MC, et al. 2019 American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee. Arthritis Care & Research. 2020;72(2):149-162. DOI: 10.1002/acr.24131. PMID: 31908149
- National Center for Complementary and Integrative Health. Glucosamine and Chondroitin for Osteoarthritis: What You Need To Know. Last updated October 2023