Written by Sandy Cho, MD and reviewed by Julie A. Cerrato, PhD, AP, CYT, CAP
Glucosamine and Chondroitin
A large clinical trial called the Glucosamine/Chondroitin Arthritis Intervention Trial (GAIT) that examined whether or not Glucosamine/Chondroitin together were effective in treating the pain associated with knee arthritis and if they could be used to treat the structural damage associated with OA was conducted. The authors concluded that these supplements were as effective as NSAIDS in treating pain. They also found that that they provided benefit for those experiencing moderate to severe pain. Another study concluded that chondroitin and glucosamine also helped reduce joint knee swelling. Glucosamine and chondroitin can also reduce total body inflammation, including lowering C-reactive protein levels.
The use of this supplement, especially when used in combination with Glucosamine and Chondroitin, has been shown in studies to reduce the pain of osteoarthritis as well as help restore clinical functioning. In one clinical trial, the effects of 3 grams of MSM taken twice a day compared to placebo demonstrated a significant improvement in pain and clinical functioning.
Arnica montana may be especially effective for the treatment of knee and hand osteoarthritis. It has been demonstrated for reducing inflammation of the joints. The application of Arnica topically to the hands or knees can be very effective in reducing pain and inflammation.
Avocado-Soybean Unsaponifiable (ASU)
Several clinical studies have demonstrated the efficacy of ASU for the treatment of OA, especially hip OA which can be especially debilitating. In one study, approximately 400 patients were randomized to be given either 300 mg of ASU or placebo and followed over a three-year period. The authors felt that the ASU helped to reduce the joint space narrowing in the hip, meaning that it helped to reduce the degree of structural damage when compared to the placebo group.
The main ingredient of the commonly used spice turmeric, this antioxidant can help reduce the pain and inflammation associated with OA. It helps to reduce inflammation by reducing certain cellular pathways of inflammation, including Nf-KappaB. Another inflammatory pathway that Curcumin can inhibit is the cyclooxygenase enzyme, which is the same enzyme that is inhibited by NSAIDS. Curcumin also has other potential effects including improving heart health and has anti-cancer properties as well.
The use of antioxidants are important in reducing inflammation and combating the free radical load and oxidative stress that can accompany osteoarthritis. Consider adding a supplement high in antioxidant value to your daily regimen.
This herb has also demonstrated effectiveness for the treatment of OA. In one study examining Devils’ Claw in the treatment of hip and knee OA, the authors noted the effectiveness in reducing pain and improving joint mobility.
Omega 3 fish oil
Supplementation with Omega 3 fish oil can decrease the inflammation and reduce the pain associated with OA. In one study, the use of Omega 3 fish oil and glucosamine together markedly showed a decrease in stiffness and pain compared to those who just received glucosamine.
- A good anti-inflammatory dose is at least 3-4 grams a day to start and slowly increase to a maximum of 7-8 grams.
- As this supplement can thin the blood, if you are on any blood thinners, you may wish to start at a lower dose and increase upwards.
Morinda citrifolia (Noni)
This is a tropical plant from East Asia that has been used for many years. It has anti-inflammatory properties and can help in the treatment of pain due to osteoarthritis.
- Noni can come in capsule or juice form. If you take the juice form, consider beginning at 1 oz twice a day and increase slowly to 4-6 oz a day.
- Some forms of Noni can have a high potassium content so if you have kidney disease you need to be mindful of this.
- Extremely high doses of this may have an adverse effect on the liver, although this is controversial. The several ounces a day that we mention here is very low dosage of this supplement.
This is an herb that has anti-inflammatory properties, especially in the treatment of arthritis. It can help maintain the structural health of the joint cartilage.
Ginger may provide significant pain relief for osteoarthritis. Its effects appear to be attributable to inhibition of the pain pathway involving cyclooxygenase and lipoxygenase. Effective doses range from 170 mg ginger extract 3 times per day to 250 mg 4 times per day.
Note that there are many formulations that combine many of these important supplements that can reduce pain and inflammation. There are also wonderful bone and mineral formulations that can provide the nutrients to the bones that are so desperately needed in OA.
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