Supplements

A mounting body of research is showing that certain widely available supplements, such as fish oil and glucosamine, may have a beneficial effect in relieving pain and facilitating range of motion in patients who have osteoarthritis of the knee.  


Before buying supplements for your osteoarthritis, you need to understand that dietary supplements are not regulated by the FDA. Despite label and marketing claims, supplements do not undergo the rigorous manufacturing and regulatory processes that help to guarantee the potency, consistency, and composition of prescription drugs. Supplements are prone to wide fluctuations in batch-to-batch (or even pill-to-pill) consistency. This lack of regulation has stymied attempts to flesh out the benefits—or lack thereof—attributed to nutritional supplements and has also contributed to the inconclusive results of many clinical trials.

That said, the naturally occurring chemicals in certain dietary supplements may have an effect on the body’s inflammatory mechanisms. Inflammation is the body’s natural way of protecting itself. Inflammation helps to fight infections, increase blood flow to areas that need healing, and generate pain signals. However, these same inflammatory chemicals can also contribute to osteoarthritis.  

Here is a collection of some widely available supplements that may benefit people with osteoarthritis. Always check first with your doctor or pharmacist before starting any supplement. There may be unintended side effects if you’re already taking other medications.

Curcumin (in turmeric) and resveratrol (in grapes, wine, berries, peanuts, and chocolate) are two nutritional supplements that have a variety of anti-inflammatory actions. Turmeric, and thus curcumin, has been used in traditional Hindu medicine for at least a thousand years for various ailments, including joint disorders and arthritis. However, it has been only in the past 20 to 30 years that resveratrol has been studied in laboratories and humans for its effects on inflammation and arthritis, which have been promising but not conclusive.  

Omega-3 fatty acids also show a spectrum of anti-inflammatory activities that appear to account for much of their cardioprotective effects. A few studies have shown that rheumatoid subjects who consumed large doses of DHA and EPA omega-3 fatty acids (upwards of 2 to 4 grams daily in some studies) were able to cut back on their nonsteroidal anti-inflammatory use.    

The American diet is often high in omega-6 fatty acids, considered pro-inflammatory, and weak in anti-inflammatory omega-3 fatty acids. In addition to increasing consumption of cold-water and fatty fish (tuna, sardines, salmon, etc.), people with osteoarthritis might also benefit from choosing canola and olive oils over corn and coconut oils (and foods processed with them), and including foods such as walnuts and foods rich in anti-inflammatory ALA (a major plant source of omega-3s), such as soybeans, flaxseed, pumpkin seeds, and tofu.

Glucosamine is another supplement that has shown inconsistent results in human trials of people with osteoarthritis, despite its high ranking in dietary supplement sales. Glucosamine is necessary for health and maintenance of cartilage as well as other joint structures such as the synovial lining and supportive ligaments. Taken as a dietary supplement, glucosamine has anti-inflammatory properties as well as effects on the integrity of joint cartilage. Some studies indicate glucosamine may retard or slow the progression of osteoarthritis.  

Boswellia serrata (frankincense).  Boswellia serrata is an ancient herb from India known among herbalists as a treatment for arthritis. It is also beneficial in decreasing inflammation and promoting joint health. Extracts of boswellia serrata have natural anti-inflammatory activity at sites where chronic inflammation is present, by switching off pro-inflammatory cytokines and mediators, which initiate the process.

Harpagophytum procumbens (Devil’s Claw, Grapple plant) Taking devil’s claw alone or along with nonsteroidal anti-inflammatory drugs (NSAIDs) seems to help decrease osteoarthritis-related pain. Some evidence suggests that devil’s claw works about as well as diacerhein (a slow-acting osteoarthritis drug that is not available in the United States) to improve osteoarthritis pain in the hip and knee after 16 weeks of treatment. Some people taking devil’s claw seem to be able to lower the dose of NSAIDs they need for pain relief. This evidence comes from a study that used a specific powdered devil’s claw root product.