Clinical question
How effective is chondroitin for treating osteoarthritis (OA) compared to placebo, active controls or herbal medications?
Bottom line
Chondroitin (alone or in combination with glucosamine) was better than placebo in improving pain in participants with OA in short-term studies (< six months). The benefit was small to moderate, with an eight point greater improvement in pain (range 0 to 100; NNT* 5) and a two point greater improvement in Lequesne Index, a combination of pain, physical function and disability (range 0 to 24), both seeming clinically meaningful. Chondroitin had a lower risk of serious adverse events compared with control. There was also a statistically significant lesser reduction in minimal joint space width with chondroitin compared to placebo, based on moderate to high quality evidence.
*NNT = number needed to treat to benefit one individual.
Caveat
The majority were studies of knee OA (a few hand, one hip) ranging from one month to three years. Several studies were funded by makers of chondroitin.
Context
OA is common, and is one of the leading causes of disability. Chondroitin has emerged as a new treatment, and is popular among patients as an over-the-counter supplement.
Cochrane Systematic Review
Singh JA et al. Chondroitin for osteoarthritis. Cochrane Reviews, 2015, Issue 3. Art. No.: CD005614.DOI: 10.1002/14651858. CD005614.pub2. This review contains 43 studies involving 9,110 participants.
Cochrane Systematic Reviews for primary care practitioners
Developed by the Cochrane Primary Care Field, New Zealand Branch of the Australasian Cochrane Centre at the Department of General Practice and Primary Health Care, University of Auckland and funded by the Ministry of Health and New Zealand Doctor. PEARLS are meant for educational use and not to guide clinical care. New Zealanders can access the Cochrane Library free via www.cochrane.org.nz
![Barbara Fountain, editor of New Zealand Doctor Rata Aotearoa, and Paul Hutchison, GP and senior medical clinician at Tāmaki Health [Image: Simon Maude]](/sites/default/files/styles/thumbnail_cropped_100/public/2025-03/Barbara%20Fountain%2C%20editor%20of%20New%20Zealand%20Doctor%20Rata%20Aotearoa%2C%20and%20Paul%20Hutchison%2C%20GP%20and%20senior%20medical%20clinician%20at%20T%C4%81maki%20Health%20CR%20Simon%20Maude.jpg?itok=-HbQ1EYA)
![Lori Peters, NP and advanced health improvement practitioner at Mahitahi Hauora, and Jasper Nacilla, NP at The Terrace Medical Centre in Wellington [Image: Simon Maude]](/sites/default/files/styles/thumbnail_cropped_100/public/2025-03/2.%20Lori%20Peters%2C%20NP%20and%20advanced%20HIP%20at%20Mahitahi%20Hauora%2C%20and%20Jasper%20Nacilla%2C%20NP%20at%20The%20Terrace%20Medical%20Centre%20in%20Wellington%20CR%20Simon%20Maude.jpg?itok=sUfbsSF1)
![Ministry of Social Development health and disability coordinator Liz Williams, regional health advisors Mary Mojel and Larah Takarangi, and health and disability coordinators Rebecca Staunton and Myint Than Htut [Image: Simon Maude]](/sites/default/files/styles/thumbnail_cropped_100/public/2025-03/3.%20Ministry%20of%20Social%20Development%27s%20Liz%20Williams%2C%20Mary%20Mojel%2C%20Larah%20Takarangi%2C%20Rebecca%20Staunton%20and%20Myint%20Than%20Htut%20CR%20Simon%20Maude.jpg?itok=9ceOujzC)
![Locum GP Helen Fisher, with Te Kuiti Medical Centre NP Bridget Woodney [Image: Simon Maude]](/sites/default/files/styles/thumbnail_cropped_100/public/2025-03/4.%20Locum%20GP%20Helen%20Fisher%2C%20with%20Te%20Kuiti%20Medical%20Centre%20NP%20Bridget%20Woodney%20CR%20Simon%20Maude.jpg?itok=TJeODetm)
![Ruby Faulkner, GPEP2, with David Small, GPEP3 from The Doctors Greenmeadows in Napier [Image: Simon Maude]](/sites/default/files/styles/thumbnail_cropped_100/public/2025-03/5.%20Ruby%20Faulkner%2C%20GPEP2%2C%20with%20David%20Small%2C%20GPEP3%20from%20The%20Doctors%20Greenmeadows%20in%20Napier%20CR%20Simon%20Maude.jpg?itok=B0u4wsIs)
![Rochelle Langton and Libby Thomas, marketing advisors at the Medical Protection Society [Image: Simon Maude]](/sites/default/files/styles/thumbnail_cropped_100/public/2025-03/6.%20Rochelle%20Langton%20and%20Libby%20Thomas%2C%20marketing%20advisors%20at%20the%20Medical%20Protection%20Society%20CR%20Simon%20Maude.jpg?itok=r52_Cf74)
![Specialist GP Lucy Gibberd, medical advisor at MPS, and Zara Bolam, urgent-care specialist at The Nest Health Centre in Inglewood [Image: Simon Maude]](/sites/default/files/styles/thumbnail_cropped_100/public/2025-03/7.%20Specialist%20GP%20Lucy%20Gibberd%2C%20medical%20advisor%20at%20MPS%2C%20and%20Zara%20Bolam%2C%20urgent-care%20specialist%20at%20The%20Nest%20Health%20Centre%20in%20Inglewood%20CR%20Simon%20Maude.jpg?itok=z8eVoBU3)
![Olivia Blackmore and Trudee Sharp, NPs at Gore Health Centre, and Gaylene Hastie, NP at Queenstown Medical Centre [Image: Simon Maude]](/sites/default/files/styles/thumbnail_cropped_100/public/2025-03/8.%20Olivia%20Blackmore%20and%20Trudee%20Sharp%2C%20NPs%20at%20Gore%20Health%20Centre%2C%20and%20Gaylene%20Hastie%2C%20NP%20at%20Queenstown%20Medical%20Centre%20CR%20Simon%20Maude.jpg?itok=Z6u9d0XH)
![Mary Toloa, specialist GP at Porirua and Union Community Health Service in Wellington, Mara Coler, clinical pharmacist at Tū Ora Compass Health, and Bhavna Mistry, specialist GP at Porirua and Union Community Health Service [Image: Simon Maude]](/sites/default/files/styles/thumbnail_cropped_100/public/2025-03/9.%20Mary%20Toloa%2C%20Porirua%20and%20Union%20Community%20Health%20Service%20in%20Wellington%2C%20Mara%20Coler%2C%20T%C5%AB%20Ora%20Compass%20Health%2C%20and%20Bhavna%20Mistry%2C%20PUCHS%20CR%20Simon%20Maude.jpg?itok=kpChr0cc)