Nonsteroidal anti-inflammatory drug or glucosamine reduced pain and improved muscle strength with resistance training in a randomized controlled trial of knee osteoarthritis patients

Arch Phys Med Rehabil. 2011 Aug;92(8):1185-93. doi: 10.1016/j.apmr.2011.03.009.


Objectives: To investigate the effect of 12 weeks of strength training in combination with a nonsteroidal anti-inflammatory drug (NSAID), glucosamine, or placebo on muscle cross-sectional area (CSA), strength (primary outcome parameters), and function, power, pain, and satellite cell number (secondary outcome parameters) in patients with knee osteoarthritis (OA).

Design: Double-blinded, randomized controlled trial.

Setting: Hospital.

Participants: Patients (N=36; 20 women, 16 men; age range, 50-70y) with bilateral tibiofemoral knee OA. A total of 181 patients were approached, and 145 were excluded.

Interventions: Patients were randomly assigned to treatment with the NSAID ibuprofen (n=12), glucosamine (n=12), or placebo (n=12) during 12 weeks of quadriceps muscle strength training.

Main outcome measures: Muscle CSA and strength.

Results: No differences between groups were observed in gains in muscle CSA. Training combined with ibuprofen increased maximal isometric strength by an additional .22Nm/kg (95% confidence interval [CI], .01-.42; P=.04), maximal eccentric muscle strength by .38Nm/kg (95% CI, .05-.70; P=.02), and eccentric muscle work by .27J/kg (95% CI, .01-.53; P=.04) in comparison with placebo. Training combined with glucosamine increased maximal concentric muscle work by an additional .24J/kg versus placebo (95% CI, .06-.42; P=.01).

Conclusions: In patients with knee OA, NSAID or glucosamine administration during a 12-week strength-training program did not improve muscle mass gain, but improved maximal muscle strength gain in comparison with treatment with placebo. However, we do not find that the benefits are large enough to justify taking NSAIDs or glucosamine.

Trial registration: NCT00833157.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use*
  • Double-Blind Method
  • Female
  • Glucosamine / therapeutic use*
  • Humans
  • Ibuprofen / therapeutic use*
  • Male
  • Middle Aged
  • Muscle Strength / drug effects*
  • Muscle Strength / physiology*
  • Osteoarthritis, Knee / drug therapy*
  • Osteoarthritis, Knee / physiopathology
  • Osteoarthritis, Knee / rehabilitation*
  • Pain / drug therapy*
  • Pain / rehabilitation*
  • Pain Measurement
  • Placebos
  • Resistance Training*
  • Satellite Cells, Skeletal Muscle / drug effects
  • Satellite Cells, Skeletal Muscle / physiology
  • Treatment Outcome


  • Anti-Inflammatory Agents, Non-Steroidal
  • Placebos
  • Glucosamine
  • Ibuprofen

Associated data