Protect your joints and relieve osteoarthritis aches and pains. According to research or other evidence, the following self-care steps may be helpful.
Use topical ointment
Treat discomfort with an ointment or cream containing 0.025 to 0.075% capsaicin four times a day over painful joints: make sure not to let capsaicin come in contact with the eyes.
Eat more fruits and vegetables and take 400 to 1,600 IU a day of vitamin E to put antioxidants to work protecting your joints.
Help prevent joint damage with GS and CS
Take 1,500 mg a day of glucosamine sulfate, 800 to 1,200 mg a day of chondroitin sulfate, or a combination of both supplements, for pain and to protect joints.
Start a gentle program of walking and strengthening exercise to reduce pain and improve joint function.
These recommendations are not comprehensive and are not intended to replace the advice of your doctor or pharmacist. Continue reading for more in-depth, fully referenced information.
Achieve and maintain a healthy weight to reduce stress to joints and prevent osteoarthritis.
A gentle program of walking and strengthening exercise has been shown to benefit people with osteoarthritis—so get a jumpstart by staying active before problems start.
These recommendations are not comprehensive and are not intended to replace the advice of your doctor or pharmacist. Continue reading for more in-depth, fully referenced information.
About This Condition
Osteoarthritis is a chronic disease of the joints, especially the weight-bearing joints that develops when the linings of joints degenerate, leading to lipping and spurring of bone, pain, and decreased mobility and function.
osteoarthritis is a universal consequence of aging among animals with a bony skeleton. Many factors contribute to the development of osteoarthritis; the disease is primarily associated with aging and injury and was once called “wear-and-tear” arthritis. osteoarthritis may occur secondary to many other conditions. However, in most cases, the true cause of osteoarthritis is unknown.
The onset of osteoarthritis is gradual and most often affects the hips, knees, fingers, and spine, although other joints also may be involved. Pain is the main symptom, which usually worsens with exercise and is relieved by rest. Morning stiffness is also common and diminishes with movement. As osteoarthritis progresses, joint motion is lost, and tenderness and grating sensations may develop. osteoarthritis of the spine may lead to shooting pains down the arms or legs.
Healthy Lifestyle Tips
Obesity increases the risk of osteoarthritis developing in weight-bearing joints, and weight loss in women is associated with reduced risk for developing osteoarthritis.1, 2 Weight loss is also thought to reduce the pain of existing osteoarthritis.3
Several clinical trials have examined the efficacy of acupuncture for osteoarthritis, with mixed results. Some trials found acupuncture treatment to be no more effective than either placebo4 or sham acupuncture5 at relieving osteoarthritis pain. Other trials have demonstrated a significant effect of acupuncture on the relief of osteoarthritis pain compared to placebo.6, 7 A well-designed trial found that acupuncture treatments (twice weekly for eight weeks) significantly improved pain and disability in people with osteoarthritis of the knee compared to no treatment.8 When the group receiving no treatment was switched to acupuncture treatments, they experienced similar improvements.
In a controlled trial, a combination of manual physical therapy (by a qualified physical therapist) and supervised exercise significantly improved walking distance and pain in a group of people with osteoarthritis of the knee.9 The therapeutic regimen consisted of manual therapy to the knee, low back, hip, and ankle as necessary, as well as a standardized knee-exercise program performed at home and in the clinic. The treatments were given twice weekly at the clinic for four weeks.
The right diet is the key to managing many diseases and to improving general quality of life. For this condition, scientific research has found benefit in the following healthy eating tips.
Try the Warmbrand diet
A diet free of meat, poultry, dairy, chemicals, sugar, eggs, and processed foods has helped people with rheumatoid arthritis and osteoarthritis in anecdotal reports. Work with a specialist to ensure healthy nutrition.
In the 1950s through the 1970s, Dr. Max Warmbrand used a diet free of meat, poultry, dairy, chemicals, sugar, eggs, and processed foods for people with rheumatoid arthritis and OA, anecdotally claiming significant success.10 He reported that clinical results took at least six months to develop. The Warmbrand diet has never been properly tested in clinical research. Moreover, although the diet is healthful and might reduce the risk of being diagnosed with many other diseases, it is difficult for most people to follow. This difficulty, plus the lack of published research, leads many doctors who are aware of the Warmbrand diet to use it only if other approaches have failed.
Avoid nightshade vegetables
Abstain from eating tomatoes, white potatoes, peppers (except black pepper), and eggplant, which contain solanine, a substance that may contribute to osteoarthritis.
Solanine is a substance found in nightshade plants, including tomatoes, white potatoes, all peppers (except black pepper), and eggplant. In theory, if not destroyed in the intestine, solanine may be toxic. One horticulturist hypothesized that some people might not be able to destroy solanine in the gut, leading to solanine absorption and resulting in OA. This theory has not been proven. However, eliminating solanine from the diet has been reported to bring relief to some arthritis sufferers in preliminary research.11, 12 In a survey of people avoiding nightshade plants, 28% claimed to have a “marked positive response” and another 44% a “positive response.” Researchers have never put this diet to a strict clinical test; however, the treatment continues to be used by some doctors with patients who have OA. As with the Warmbrand diet, proponents claim exclusion of solanine requires up to six months before potential effects may be seen. Totally eliminating tomatoes and peppers requires complex dietary changes for most people. In addition, even proponents of the diet acknowledge that many arthritis sufferers are not helped by using this approach. Therefore, long-term trial avoidance of solanine-containing foods may be appropriate only for people with OA who have not responded to other natural treatments.
If other therapies are unsuccessful in relieving symptoms, talk to your doctor about identifying and eliminating possible food allergies.
Most of the studies linking allergies to joint disease have focused on rheumatoid arthritis, although mention of what was called “rheumatism” in older reports (some of which may have been OA) suggests a possible link between food reactions and aggravations of OA symptoms.13 If other therapies are unsuccessful in relieving symptoms, people with OA might choose to discuss food allergy identification and elimination with a physician.
Our proprietary “Star-Rating” system was developed to help you easily understand the amount of scientific support behind each supplement in relation to a specific health condition. While there is no way to predict whether a vitamin, mineral, or herb will successfully treat or prevent associated health conditions, our unique ratings tell you how well these supplements are understood by some in the medical community, and whether studies have found them to be effective for other people.
For over a decade, our team has combed through thousands of research articles published in reputable journals. To help you make educated decisions, and to better understand controversial or confusing supplements, our medical experts have digested the science into these three easy-to-follow ratings. We hope this provides you with a helpful resource to make informed decisions towards your health and well-being.
3 StarsReliable and relatively consistent scientific data showing a substantial health benefit.
2 StarsContradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit.
1 StarFor an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support.
Boswellia, Ashwagandha, Turmeric, and Zinc
1,000 mg daily boswellia resin herbal extract or two capsules, three times per day of Aticulin-F (formula containing 100 mg boswellia, 450 mg ashwagandha, 50 mg turmeric, and 50 mg zinc)
A combination of boswellia, ashwagandha, turmeric, and zinc effectively treated pain and stiffness in one study, without the stomach irritation that is a common side effect of NSAIDs.
Boswellia has anti-inflammatory properties that have been compared to those of the NSAIDs used by many for inflammatory conditions.14 Clinical trials have found that boswellia is more effective than a placebo for relieving pain and swelling and preventing loss of function in people with osteoarthritis.15 Boswellia has also been found to be as effective as the anti-inflammatory drug valdecoxib (Bextra). In addition, while the improvements occurred more slowly in the boswellia group than in the valdecoxib group, they persisted for a longer period of time after treatment was discontinued.16 One clinical trial found that a combination of boswellia, ashwagandha, turmeric, and zinc effectively treated pain and stiffness associated with OA but did not improve joint health, according to X-rays of the affected joint.17 Unlike NSAIDs, long-term use of boswellia does not lead to irritation or ulceration of the stomach.
100 mg of a freeze-dried preparation daily
Cat’s claw has been used traditionally for osteoarthritis. In one trial, cat's claw was significantly more effective than a placebo at relieving pain and improving overall condition.
Cat’s claw has been used traditionally for osteoarthritis. In a double-blind trial, 100 mg per day of a freeze-dried preparation of cat's claw taken for four weeks was significantly more effective than a placebo at relieving pain and improving the overall condition.18
Apply 0.025 to 0.075% capsaicin ointment four times per day over painful joints
When rubbed over painful joints, cayenne extract creams containing 0.025 to 0.075% capsaicin may reduce the pain and tenderness of osteoarthritis.
Several double-blind trials have shown that topical use of cayenne extract creams containing 0.025 to 0.075% capsaicin reduces pain and tenderness caused by osteoarthritis.19, 20, 21, 22 These creams are typically applied four times daily for two to four weeks, after which twice daily application may be sufficient.23 Products containing capsicum oleoresin rather than purified capsaicin may not be as effective.24
800 to 1,200 mg a day
Many trials have shown that supplementing with chondroitin sulfate reduces pain, increases joint mobility, and promotes healing within the joints.
Chondroitin sulfate (CS) is a major component of the lining of joints. The structure of CS includes molecules related to glucosamine sulfate. CS levels have been reported to be reduced in joint cartilage affected by osteoarthritis. Possibly as a result, CS supplementation may help restore joint function in people with osteoarthritis.25 On the basis of preliminary evidence, researchers had believed that oral CS was not absorbed in humans;26 as a result, early double-blind CS research was done mostly by giving injections.27, 28 This research documented clinical benefits from CS injections. It now appears, however, that a significant amount of CS is absorbable in humans,29 though dissolving CS in water leads to better absorption than swallowing whole pills.30
Strong clinical evidence now supports the use of oral CS supplements for osteoarthritis. Many double-blind trials have shown that CS supplementation consistently reduces pain, increases joint mobility, and/or shows evidence (including X-ray changes) of healing within joints of people with osteoarthritis.31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41 Most trials have used 400 mg of CS taken two to three times per day. One trial found that taking the full daily amount (1,200 mg) at one time was as effective as taking 400 mg three times per day.42 Reduction in symptoms typically occurs within several months.
510 mg daily of a concentrated herbal extract, taken in divided doses
Ginger has historically been used for arthritis and rheumatism. Studies have shown it to be effective at relieving pain and swelling in people with osteoarthritis.
Ginger has historically been used for arthritis and rheumatism. A preliminary trial reported relief in pain and swelling among people with arthritis who used powdered ginger supplements43 More recently, a double-blind trial found ginger extract (170 mg three times a day for three weeks) to be slightly more effective than placebo at relieving pain in people with osteoarthritis of the hip or knee.44 In another double-blind study, a concentrated extract of ginger, taken in the amount of 255 mg twice daily for six weeks, was significantly more effective than a placebo, as determined by the degree of pain relief and overall improvement.45
1,500 mg daily
Glucosamine sulfate is necessary for joint cartilage synthesis and repair. It has been shown to significantly reduce osteoarthritis symptoms and appears to be virtually free of side effects.
Glucosamine sulfate (GS), a nutrient derived from seashells, is a building block needed for the synthesis and repair of joint cartilage. GS supplementation has significantly reduced symptoms of osteoarthritis in uncontrolled46, 47 and single-blind trials.48, 49 Many double-blind trials have also reported efficacy.50, 51, 52, 53, 54, 55 One published trial has reported no effect of GS on osteoarthritis symptoms,56 and GS has been found to be ineffective for low back pain related to lumbar spine osteoarthritis.57 While most research trials use 500 mg GS taken three times per day, results of a three-year, double-blind trial indicate that 1,500 mg taken once per day produces significant reduction of symptoms and halts degenerative changes seen by x-ray examination.58 GS does not cure people with osteoarthritis, and they may need to take the supplement for the rest of their lives in order to maintain benefits. Fortunately, GS appears to be virtually free of side effects, even after three or more years of supplementation. Benefits from GS generally become evident after three to eight weeks of treatment.
1200 mg daily
SAMe has anti-inflammatory, pain-relieving, and tissue-healing properties that may help protect the health of joints and reduce osteoarthritis symptoms.
SAMe (S-adenosyl methionine) possesses anti-inflammatory, pain-relieving, and tissue-healing properties that may help protect the health of joints,59, 60 though the primary way in which SAMe reduces osteoarthritis symptoms is not known. A very large, though uncontrolled, trial (meaning that there was no comparison with placebo) demonstrated “very good” or “good” clinical effect of SAMe in 71% of over 20,000 osteoarthritis sufferers.61 In addition to this preliminary research, many double-blind trials have shown that SAMe reduces pain, stiffness, and swelling better than placebo and equal to drugs such as ibuprofen and naproxen in people with osteoarthritis.62, 63, 64, 65, 66, 67, 68, 69 These double-blind trials all used 1,200 mg of SAMe per day.
Lower amounts of oral SAMe have also produced reductions in the severity of osteoarthritis symptoms in preliminary clinical trials. A two-year, uncontrolled trial showed significant improvement of symptoms after two weeks at 600 mg SAMe daily, followed by 400 mg daily thereafter.70 This amount was also used in a double-blind trial, but participants first received five days of intravenous SAMe.71 A review of the clinical trials on SAMe concluded that its efficacy against osteoarthritis was similar to that of conventional drugs but that patients tolerated it better.72
Refer to label instructions
Supplemental niacinamide (a form of vitamin B3) has been reported to increase joint mobility, improve muscle strength, and decrease fatigue in people with osteoarthritis.
In the 1940s and 1950s, one doctor reported that supplemental niacinamide (a form of vitamin B3) increased joint mobility, improved muscle strength, and decreased fatigue in people with osteoarthritis.73, 74, 75 In the 1990s, a double-blind trial confirmed a reduction in symptoms from niacinamide within 12 weeks of beginning supplementation.76 Although amounts used have varied from trial to trial, many doctors recommend 250 to 500 mg of niacinamide four or more times per day (with the higher amounts reserved for people with more advanced arthritis). The mechanism by which niacinamide reduces symptoms is not known.
Avocado and Soybean Unsaponifiables
Refer to label instructions
An extract of avocado and soybean oils, known as avocado/soybean unsaponifiables, appears to reduce inflammation and help repair damaged cartilage tissue.
An extract of avocado and soybean oils, known as avocado/soybean unsaponifiables (ASU), was found in a double-blind trial to reduce joint pain and improve overall functioning in people with osteoarthritis of the knee or hip. The amount used was 300 mg per day for six months.77 In a three-month double-blind trial, 71% of people taking ASU, but only 36% of those taking a placebo, were able to decrease their pain medicine or anti-inflammatory medicine by more than 50%.78 In a longer-term double-blind trial (two years), ASU treatment did not improve symptoms when compared with a placebo, and did not slow the progression of osteoarthritis (as determined by the amount of joint cartilage lost). However, in the subgroup of patients with the most severe disease, ASU treatment did significantly decrease the loss of joint cartilage.79 ASU is believed to work by reducing inflammation and by aiding in the repair of damaged cartilage tissue. ASU is approved as a prescription drug in France and is available over the counter in some other countries.
Cartilage and Collagen
Refer to label instructions
Taking collagen hydrolysate may help relieve pain associated with osteoarthritis of the hip and knee.
In a double-blind study, collagen hydrolysate was compared with gelatin and egg protein as a treatment for osteoarthritis of the hip and/or knee. When subjects took 10 grams per day either of gelatin or collagen hydrolysate for two months, they reported significantly more pain relief than when they took a similar amount of egg protein.80 More research is needed to confirm the benefits of gelatin or collagen hydrolysate in osteoarthritis.
540 mg per day by mouth for 30 days
Cetyl myristoleate appears to be effective as a joint “lubricant” and anti-inflammatory agent.
Cetyl myristoleate (CMO) has been proposed to act as a joint “lubricant” and anti-inflammatory agent. In a double-blind trial, people with various types of arthritis who had failed to respond to nonsteroidal anti-inflammatory drugs (NSAIDs) received CMO (540 mg per day orally for 30 days), while others received a placebo.81 These people also applied CMO or placebo topically, according to their perceived need. A statistically significant 63.5% of those using CMO improved, compared with only 14.5% of those using placebo.
Devil’s claw extract was found in one trial to reduce pain associated with osteoarthritis as effectively as the slow-acting analgesic/ cartilage-protective drug diacerhein.
Devil’s claw extract was found in one clinical trial to reduce pain associated with osteoarthritis as effectively as the slow-acting analgesic/cartilage-protective drug diacerhein.82 The amount of devil’s claw used in the trial was 2,610 mg per day. The results of this trial are somewhat suspect, however, as both devil’s claw and diacerhein are slow-acting and there was no placebo group included for comparison.
90 mg of bromelain and 48 mg of trypsin, with 100 mg of rutosid, taken in enteric-coated pills three times per day
In one study, people with painful osteoarthritis of the knee who received an oral enzyme-flavonoid preparation saw more improvement in pain and joint function than those who took a nonsteroidal anti-inflammatory (NSAID).
In a double-blind study, a group of people with painful osteoarthritis of the knee received an oral enzyme-flavonoid preparation or a nonsteroidal anti-inflammatory (NSAID) for six weeks. While both treatments relieved pain and improved joint function, the enzyme-flavonoid product appeared to be slightly more effective than the NSAID. No serious side effects were seen.83 The enzyme-flavonoid product used in this study was Phlogenzym (Mucos Pharma, Geretsried, Germany). Each enteric-coated tablet contained 90 mg of bromelain, 48 mg of trypsin, and 100 mg of rutosid (a derivative of the flavonoid rutin); one tablet was given three times a day.
Apply a gel containing 25% DMSO under the direction of a qualified healthcare practitioner
Topical DMSO appears to be anti-inflammatory and able to relieve pain associated with osteoarthritis, possibly by inhibiting the transmission of pain messages by nerves.
The therapeutic use of DMSO (dimethyl sulfoxide) is controversial because of safety concerns, but some preliminary research shows that diluted preparations of DMSO, applied directly to the skin, are anti-inflammatory and alleviate pain, including pain associated with osteoarthritis.84, 85 A recent double-blind trial found that a 25% concentration of DMSO in gel form relieved osteoarthritis pain significantly better than a placebo after three weeks.86 DMSO appears to reduce pain by inhibiting the transmission of pain messages by nerves87 rather than through a process of healing damaged joints. DMSO comes in different strengths and different degrees of purity; in addition, certain precautions must be taken when applying DMSO. For these reasons, DMSO should be used only with the supervision of a doctor.
1,050 to 2,100 mg daily of freeze-dried powder or 210 mg daily of lipid extract
New Zealand green-lipped mussel supplements have been shown in various studies to reduce joint tenderness and stiffness and improve pain, including knee pain in people with osteoarthritis.
The effects of New Zealand green-lipped mussel supplements have been studied in people with osteoarthritis. In a preliminary trial, either a lipid extract (210 mg per day) or a freeze-dried powder (1,150 mg per day) of green-lipped mussel reduced joint tenderness and morning stiffness, as well as improving overall function in most participants.88 In a double-blind trial, 45% of people with osteoarthritis who took a green-lipped mussel extract (350 mg three times per day for three months) reportedly had improvements in pain and stiffness.89 Another double-blind trial reported excellent results from green-lipped mussel extract (2,100 mg per day for six months) for pain associated with arthritis of the knee.90 Side effects, such as stomach upset, gout, skin rashes, and one case of hepatitis have been reported in people taking certain New Zealand green-lipped mussel extracts.91
500 mg of a concentrated extract (3.5% guggulsterones) three times per day
In one trial, supplementing with guggul significantly improved symptoms in people with osteoarthritis of the knee.
In a preliminary trial, supplementation with 500 mg of a concentrated extract (3.5% guggulsterones) of Commiphora mukul (guggul) three times per day for one month resulted in a significant improvement in symptoms in people with osteoarthritis of the knee.92 Double-blind trials are needed to rule out the possibility of a placebo effect.
300 mg per day
In one study, people who took krill oil saw significant reduction in arthritis severity and used less pain-relief medication than those taking placebo.
In a double-blind study, people with high levels of C-reactive protein (CRP), an indicator of systemic inflammation in the body, most of whom also had osteoarthritis, were given 300 mg each morning of krill oil from Antarctic krill (a zooplankton crustacean) or a placebo. After one month those taking krill oil had significantly greater reduction in arthritis severity based on a questionnaire focusing on joint pain, stiffness, and loss of function related to osteoarthritis of the knee and hip. Use of pain-relief medication was also reduced compared to those taking placebo.93
2.25 to 6.0 grams per day
In one trial, supplementing with methyl-sulfonylmethane significantly reduced pain and improved overall physical functioning in patients with osteoarthritis of the knee.
According to a small double-blind trial, 2,250 mg per day of oral methylsulfonylmethane (MSM), a variant of DMSO, reduced osteoarthritis pain after six weeks.94 In another double-blind trial, supplementation with 3 grams of MSM twice a day for 12 weeks significantly reduced pain and improved overall physical functioning in patients with osteoarthritis of the knee.95
Apply stinging nettle under the direction of a qualified healthcare practitioner
Stinging nettle has historically been used for joint pain and has been shown to be safe and effective for relieving the pain of osteoarthritis.
has historically been used for joint pain. Topical application with the intent of causing stings to relieve joint pain has been assessed in preliminary and double-blind trials. The results found intentional nettle stings to be safe and effective for relieving the pain of osteoarthritis. The only reported adverse effect is a sometimes painful or numbing rash that lasts 6 to 24 hours.
100 to 150 mg per day
Double-blind research has shown that Pycnogenol may improve symptoms of osteoarthritis, including reducing pain and the use of pain-relieving medication and improving walking performance.
In a double-blind trial, 100 mg per day of Pycnogenol reduced pain and other osteoarthritis symptoms, improved walking performance, and reduced the use of pain-relieving medication.96 Another double blind trial found that 150 mg per day also improved symptoms and reduced use of pain-relieving medication.97
5 grams of rose hips powder daily
In a study of people with osteoarthritis of the knee or hip, supplementing with rose hips powder significantly reduced pain, joint stiffness, and overall disease severity.
In a double-blind study of people with OA of the knee or hip, supplementation with 5 grams of rose hips powder per day resulted in a significant reduction in pain after three weeks, compared with a placebo.98 After three months of treatment with rose hips, joint stiffness and overall disease severity were also improved.
400 to 1,600 IU per day
As an antioxidant, vitamin E appears to help protect joints.
People who have osteoarthritis and eat large amounts of antioxidants in food have been reported to exhibit a much slower rate of joint deterioration, particularly in the knees, compared with people eating foods containing lower amounts of antioxidants.99 Of the individual antioxidants, only vitamin E has been studied as a supplement in controlled trials. Vitamin E supplementation has reduced symptoms of osteoarthritis in both single-blind100 and double-blind research.101, 102 In these trials, 400 to 1,600 IU of vitamin E per day was used. Clinical effects were obtained within several weeks. However, in a six-month double-blind study of patients with osteoarthritis of the knee, 500 IU per day of vitamin E was no more effective than a placebo.103
Take an extract supplying 240 mg of salicin per day
Willow has anti-inflammatory and pain-relieving properties. Although pain relief from willow supplementation may be slow in coming, it may last longer than pain relief from aspirin.
Willow has anti-inflammatory and pain-relieving properties. Although pain relief from willow supplementation may be slow in coming, it may last longer than pain relief from aspirin. One double-blind trial found that a product containing willow along with black cohosh, guaiac (Guaiacum officinale, G. sanctum), sarsaparilla, and aspen (Populus spp.) bark effectively reduced osteoarthritis pain compared to placebo.104 Another trial found that 1,360 mg of willow bark extract per day (delivering 240 mg of salicin) was somewhat effective in treating pain associated with knee and/or hip osteoarthritis.105
Refer to label instructions
Boron affects calcium metabolism, and people with OA have been reported to have low bone stores of boron. Supplementing with boron may replenish stores and improve symptoms.
Boron affects calcium metabolism, and a link between boron deficiency and arthritis has been suggested.106 Although people with osteoarthritis have been reported to have lower stores of boron in their bones than people without the disease, other minerals also are deficient in the bones of people with osteoarthritis.107 One double-blind trial found that 6 mg of boron per day, taken for two months, relieved symptoms of osteoarthritis in five of ten people, compared with improvement in only one of the ten people assigned to placebo.108This promising finding needs confirmation from larger trials.
Refer to label instructions
Several trials have suggested that supplementing with bovine cartilage, either topically or injected, may relieve symptoms.
Several trials have suggested that people with osteoarthritis may benefit from supplementation with bovine cartilage, which contains a mixture of protein and molecules related to chondroitin sulfate. In one preliminary trial, use of injected and topical bovine cartilage led to symptom relief in most people studied.109 A ten-year study confirmed improvement with long-term use of bovine cartilage.110 Optimal intake of bovine cartilage is not known.
Refer to label instructions
The omega-3 fatty acids present in fish oil, EPA and DHA, have anti-inflammatory effects and may relieve pain.
The omega-3 fatty acids present in fish oil, EPA and DHA, have anti-inflammatory effects and have been studied primarily for rheumatoid arthritis, which involves significant inflammation. However, osteoarthritis also includes some inflammation.111 In a 24-week controlled but preliminary trial studying people with osteoarthritis, people taking EPA had “strikingly lower” pain scores than people who took placebo.112 However, in a double-blind trial by the same research group, supplementation with 10 ml of cod liver oil per day was no more effective than a placebo.113
Refer to label instructions
Studies have shown glucosamine hydrochloride to be effective at reducing pain and improving symptoms in people with osteoarthritis.
A few trials have evaluated glucosamine hydrochloride (GH), another form of glucosamine sulfate (GS), as a single remedy for osteoarthritis. One trial found only minor benefits from 1,500 mg per day of GH for 8 weeks in people with osteoarthritis of the knee.114 However, these people were also taking up to 4,000 mg per day of acetaminophen for pain relief, and that treatment might have masked a beneficial effect of GH. In another study, supplementing with GH (2,000 mg each morning for 12 weeks) significantly improved symptoms, compared with a placebo, in people with knee pain due to cartilage damage or osteoarthritis.115 In a four-week study from China, GH was as effective as GS in people with osteoarthritis of the knee.116 Another study found that the combination of GH and chondroitin sulfate was more effective than a placebo in people with moderate to severe knee pain from osteoarthritis, but not in those with mild pain.117 Despite the reported beneficial effects of GH, some investigators believe that the sulfate component of GS itself helps relieve osteoarthritis, and that GS would therefore be more effective than GH.118
Refer to label instructions
Horsetail has anti-arthritis actions and is rich in silicon, a trace mineral that plays a role in making and maintaining connective tissue.
Horsetail is rich in silicon, a trace mineral that plays a role in making and maintaining connective tissue. Practitioners of traditional herbal medicine believe that the anti-arthritis action of horsetail is due largely to its silicon content. The efficacy of this herb for osteoarthritis has not yet been evaluated in controlled clinical trials.
Refer to label instructions
Injection of hyaluronic acid compounds into osteoarthritic joints, primarily the knee, has been shown to improve symptoms.
Hyaluronic acid is a normal component of joint fluid, but its amount and molecular structure are altered in osteoarthritic joints.119 Injection of hyaluronic acid compounds into osteoarthritic joints, primarily the knee, has been investigated in many double-blind trials with some improvement demonstrated.120, 121, 122 However, no research has been done to determine whether oral supplementation with hyaluronic acid is an effective treatment for osteoarthritis.
Refer to label instructions
Meadowsweet has been historically used to treat complaints of the joints and muscles. The herb contains salicylates, chemicals related to aspirin, that may account for its ability to relieve osteoarthritis pain.
Meadowsweet was historically used for a wide variety of conditions, including treating complaints of the joints and muscles.123 The herb contains salicylates, chemicals related to aspirin, that may account for its reputed ability to relieve the pain of osteoarthritis.
Refer to label instructions
Supplementing with D-phenylalanine (DPA) has been shown to reduce chronic pain due to osteoarthritis. DPA inhibits the enzyme that breaks down some of the body’s natural painkillers.
Supplementation with D-phenylalanine (DPA), a synthetic variation of the amino acid, L-phenylalanine (LPA), has reduced chronic pain due to osteoarthritis in a preliminary trial.124 In that study, participants took 250 mg three to four times per day, with pain relief beginning in four to five weeks. Other preliminary trials have confirmed the effect of DPA in chronic pain control,125 but a double-blind trial found no benefit.126 DPA inhibits the enzyme that breaks down some of the body’s natural painkillers, substances called enkephalins, which are similar to endorphins. An increase in the amount of enkephalins may explain the reported pain-relieving effect of DPA. If DPA is not available, a related product, D,L-phenylalanine (DLPA), may be substituted (1,500 to 2,000 mg per day). Phenylalanine should be taken between meals, because protein found in food may compete for uptake of phenylalanine into the brain, potentially reducing its effect.127
80 mg anthocyanins, the equivalent of approximately 100–120 cherries, 16–24 ounces tart cherry juice blend, 1 ounce of liquid concentrate, or 400 mg of concentrate in tablets or capsules
In a preliminary trial, people with osteoarthritis who took tart cherry extract for three months reported reduced joint tenderness and less joint pain and disability.
Tart cherries contain anthocyanins and other flavonoids that have anti-inflammatory effects according to test tube and animal studies.128, 129, 130 In a preliminary human trial, people with osteoarthritis who took 400 mg per day of tart cherry extract (supplying 100 mg per day of anthocyanins) for three months had reduced joint tenderness and reported less joint pain and disability.131 Double-blind research is needed to confirm these promising results.
Refer to label instructions
Yucca contains saponins, which appear to block the release of toxins from the intestines that inhibit normal cartilage formation. In doing so, yucca may reduce osteoarthritis symptoms.
According to arthritis research, saponins found in the herb yucca appear to block the release of toxins from the intestines that inhibit normal formation of cartilage. A preliminary, double-blind trial found that yucca might reduce symptoms of osteoarthritis.132 Only limited evidence currently supports the use of yucca for people with osteoarthritis.
15. Kimmatkar N, Thawani V, Hingorani L, Khiyani R. Efficacy and tolerability of Boswellia serrata extract in treatment of osteoarthritis of knee - a randomized double blind placebo controlled trial. Phytomedicine 2003;10:3-7.
16. Sontakke S, Thawani V, Pimpalkhute S, et al. Open, randomized, controlled clinical trial of Boswellia serrata extract as compared to valdecoxib in osteoarthritis of knee. Indian J Pharmacol 2007;39:27-9.
17. Kulkarni RR, Patki PS, Jog VP, et al. Treatment of osteoarthritis with a herbomineral formulation: A double-blind, placebo-controlled, cross-over study. J Ethnopharmacol 1991;33:91-5.
18. Piscoya J, Rodriguez Z, Bustamante SA, et al. Efficacy and safety of freeze-dried cat's claw in osteoarthritis of the knee: mechanisms of action of the species Uncaria guianensis. Inflamm Res 2001;50:442-8.
19. McCarthy GM, McCarty DJ. Effect of topical capsaicin in the therapy of painful osteoarthritis of the hands. J Rheumatol 1992;19:604-7.
20. Altman RD, Aven A, Holmburg CE, et al. Capsaicin cream 0.025% as monotherapy for osteoarthritis: a double-blind study. Sem Arth Rheum 1994;23(Suppl 3):25-33.
21. Deal CL, Schnitzer TJ, Lipstein E, et al. Treatment of arthritis with topical capsaicin: A double-blind trial. Clin Ther 1991;13:383-95.
22. Schnitzer T, Morton C, Coker S. Topical capsaicin therapy for osteoarthritis pain: achieving a maintenance regimen. Sem Arth Rheum 1994;23(Suppl 3):34-40.
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