Does Glucosamine Work?

Glucosamine and Chondroitin are common over the counter supplements that are marketed as a treatment for arthritis and joint pains. These can be purchased in pill form in nearly every pharmacy. They are also the active ingredients in the drink “Joint Juice”. These supplements are often marketed as being able to rebuild cartilage, and many patients purchase these supplements for that reason. In a sense, people are led to believe that these pills can turn back time and re-grow the cartilage that is worn away by arthritis. At least once per week a patient asks for my opinion on whether these supplements work. Unfortunately, there is not a simple yes or no answer.

So here we go…….

By way of background, arthritis is a disease where the cartilage is worn away.  Cartilage is essentially the buffer between the bones forming a joint. So, when the cartilage is gone the bones start to grind on each other. Arthritis is an incredibly common problem, which causes pain and stiffness for many people. Wouldn’t it be nice to be able to regrow that cartilage that is worn away?

Cartilage is composed of many things, but one of its main ingredients are glucosamine and chondroitin.  The question is, “Does eating glucosamine and chondroitin cause your body to rebuild cartilage?” Unfortunately, the answer to that is no! The body is more complicated than that. Sadly, we cannot regrow parts by simply eating the ingredients.  If life were that simple, we could all become muscular by eating lots of protein without exercising, or we could regrow dead heart muscle (caused by a heart attack) by eating the proteins found in heart. 

The news is not all bad for these supplements. Although they can’t turn back time, they may be able to ease your pain. Studies have shown that these medications do reduce pain caused by arthritis. Generally speaking they are about as effective as an anti-inflammatory medication such as Ibuprofen.  Unfortunately, they are much more expensive than Ibuprofen.

Here are my take home points:

1.     Glucosamine and Chondroitin may decrease pain caused by arthritis

2.     They are about as effective as Ibuprofen

3.     They cost a lot more

4.     Glucosamine and Chondroitin do not regrow cartilage that is worn away by arthritis

Does your doctor charge a facility fee?

Have you ever heard of a "facility fee"? Probably not, but you may soon. Many Americans are quickly learning about this unpleasant medical billing practice.
Here is the quick and dirty on facility fees: Hospitals charge an additional fee for services performed in the hospital. This is called a facility fee. So when a patient of mine has an MRI of her shoulder done at the hospital she will receive a bill for the MRI and an additional facility fee will be tacked on because the MRI was done at a hospital. You can think of it is a surtax. If this same MRI is performed in a non-hospital owned center a facility fee is not charged, and therefore the cost is lower.
This is becoming a big issue in the United States because hospitals are buying doctors' practices at a  rapid rate. If a physician practice is hospital owned some hospitals are claiming that the services provided are occurring in a hospital and are now charging facility fees. To give you an example, an older gentlemen has been going to the same primary care physician for many years. His office visits are generally billed between 100 to 300 dollars depending on how complex the visit. This past year his primary care doctor was bought out by a large hospital corporation. Now his bills are between 300 to 500 dollars, because an additional 200 dollars is being charged by the hospital as a facility fee. This fee is charged for no other reason than the practice is owned by a hospital...... seems a little unfair to the patient!

The bottom line is that we are all consumers of our healthcare. Costs are rising, and the amount we each have to pay is rising as well. Most insurances have high deductibles and co-pays, etc. that the consumer is having to pay. We should all be informed shoppers, when you choose a doctor you should be aware that many large hospital owned practices charge facility fees. You should ask your doctor if they charge a facility fee, and you should check your bill. There have even been class action lawsuits where patients were being charged these fees without being informed!