- Cat's Claw
- Chinese Herbal Medicine
- Chinese Skullcap
- Comfrey (topical)
- Devil's Claw
- Green-lipped Mussel
- Krill Oil
- Methyl Sulfonyl Methane (MSM)
- Multimineral Supplement
- Oligomeric Proanthocyanidins (Pine Bark Extract)
- Proteolytic Enzymes
- Rose Hips
- Velvet Antler
- White Willow
In osteoarthritis, the cartilage in joints has become damaged, disrupting the smooth gliding motion of the joint surfaces. The result is pain, swelling, and deformity.
The pain of osteoarthritis typically increases with joint use and improves at rest. For reasons that aren't clear, although x-rays can find evidence of arthritis, the level of pain and stiffness experienced by people does not match the extent of injury noticed on x-rays.
Many theories exist about the causes of osteoarthritis, but we don't really know what causes the disease. Osteoarthritis is often described as "wear and tear" arthritis. However, evidence suggests that this simple explanation is not correct. For example, osteoarthritis frequently develops in many joints at the same time, often symmetrically on both sides of the body, even when there is no reason to believe that equal amounts of wear and tear are present. Another intriguing finding is that osteoarthritis of the knee is commonly (and mysteriously) associated with osteoarthritis of the hand. These factors, as well as others, have led to the suggestion that osteoarthritis may actually be a body-wide disease of the cartilage.
During one's lifetime, cartilage is constantly being turned over by a balance of forces that both break down and rebuild it. One prevailing theory suggests that osteoarthritis may represent a situation in which the degrading forces get out of hand. Some of the proposed natural treatments for osteoarthritis described later may inhibit enzymes that damage cartilage.
When the cartilage damage in osteoarthritis begins, the body responds by building new cartilage. For several years, this compensating effort can keep the joint functioning well. Some of the natural treatments described below appear to work by assisting the body in repairing cartilage. Eventually, however, building forces cannot keep up with destructive ones, and what is called end-stage osteoarthritis develops. This is the familiar picture of pain and impaired joint function.
Principal Proposed Natural Treatments
Several natural treatments for osteoarthritis have a meaningful, though not definitive, body of supporting evidence indicating that they can reduce pain and improve function. In addition, there is some evidence that glucosamine and chondroitin might offer the additional benefit of helping to prevent progressive joint damage.
Inconsistent evidence hints that glucosamine can reduce symptoms of mild to moderate arthritis; a small amount of evidence indicates that regular use can slow down the gradual worsening of arthritis that normally occurs with time.
Glucosamine is widely accepted as a treatment for osteoarthritis. However, the supporting evidence that it works is somewhat inconsistent, with several of the most recent studies failing to find benefit. Two types of studies have been performed: those that compared glucosamine against placebo and those that compared it against standard medications.
Two studies reported that glucosamine can slow the progression of osteoarthritis. However, as with the positive studies of glucosamine for reducing symptoms, both of these studies were funded by a major glucosamine manufacturer.
For more information, including dosage and safety issues, see the full Glucosamine article.
According to some but not all double-blind, placebo-controlled studies chondroitin may relieve symptoms of osteoarthritis.
Another way of comparing the results is to look at maximum walking speed among participants. Whereas individuals in the chondroitin group were able to improve their walking speed gradually over the course of the trial, walking speed did not improve at all in the placebo group. Additionally, there were improvements in other measures of osteoarthritis, such as pain level, with benefits seen as early as 1 month. This suggests that chondroitin was able to stop the arthritis from gradually getting worse.
Some evidence suggests that, like glucosamine, chondroitin might slow the progression of arthritis.
During the 3 years of the study, only 8.8% of those who took chondroitin sulfate developed severely damaged joints, whereas almost 30% of those who took placebo progressed to this extent.
Looking at the sum of the evidence, it does appear that chondroitin sulfate may actually protect joints from damage in osteoarthritis. However, the scientific record suffers from a paucity of truly independent researchers.
For more information, including dosage and safety issues, see the full Chondroitin article.
The results indicate that SAMe provided as much pain-relieving effect as naproxen and that both treatments were significantly better than placebo. However, differences did exist between the two treatments. Naproxen worked more quickly, producing readily apparent benefits at the 2-week follow-up, whereas the full effect of SAMe was not apparent until 4 weeks. By the end of the study, both treatments were producing the same level of benefit.
For more information, including dosage and safety issues, see the full SAMe article.
Avocado/Soybean Unsaponifiables (ASUs)
Cetylated Fatty Acids
A type of naturally occurring fatty acid called cetylated fatty acids have shown growing promise for osteoarthritis. It is used both as a topical cream and as an oral supplement.
Three double-blind placebo-controlled studies have found cetylated fatty acids helpful for osteoarthritis . Two involved a topical product, and one used an oral formulation.
For more information, including dosage and safety issues, see the full Cetylated Fatty Acid article.
Slight statistical difference between real and fake acupuncture could easily have been due to problems of single-blind studies. Acupuncturists who know they are performing real acupuncture may subconsciously convey more confidence to their patients than those who know they are performing fake acupuncture. The history of medical studies makes it clear that such unconscious communications can greatly affect results; since, in fact, the evidence shows only a minute difference between the results of real and fake acupuncture, it is quite possible that this transmission of confidence (or lack of it) is the entire cause of the difference, and that the specific techniques and theories of acupuncture themselves play no role at all.
For more information, see the full Acupuncture article.
Other Proposed Natural Treatments
Traditional Chinese herbal medicine has also shown some promise for osteoarthritis. However, one study that compared a commonly used Chinese herbal product (Duhuo Jisheng Wan) to the drug diclofenac found that the herb worked more slowly than the drug, yet produced about an equal rate of side effects.
Chinese skullcapScutellaria baicalensis Acacia catechu
Numerous other herbs and supplements sometimes recommended for osteoarthritis include: beta-carotene , boron , cartilage , chamomile , copper , dandelion , D-phenylalanine , feverfew , molybdenum , selenium , turmeric , and yucca . However, there is little to no evidence as yet that these treatments are effective.
For a discussion of homeopathic approaches to osteoarthritis, see the Homeopathy Database .
Various herbs and supplements may interact adversely with drugs used to treat osteoarthritis. For more information on this potential risk, see the individual drug article in the Drug Interactions section of this database.
- Reviewer: EBSCO CAM Review Board
- Review Date: 09/2014 -
- Update Date: 05/04/2015 -