Osteoarthritis
Supplements studied for osteoarthritis.
Overview
Several supplements show medium-strength evidence for osteoarthritis. Curcumin (WA 68; medium effect size, very high evidence, medium trust; 35 studies) may reduce knee pain and stiffness and decrease pain-medication use, though effects vary by product and population. Boswellia (WA 68; medium effect size, very high evidence, medium trust) and Ginger (WA 68; medium effect size, very high evidence, medium trust) may lessen joint pain, especially in knee or hip OA. SAMe (WA 68; medium effect size, very high evidence, medium trust) may reduce pain and improve function at doses of 400–1200 mg daily, with effects comparable to some NSAIDs over time.
Devil's Claw (WA 68; medium effect size, high evidence, high trust) is listed with medium ratings but no summary is available. See the heatmap and evidence reviews below for product-level comparisons.
Effect graph
Relevant supplements
Relevant supplements sorted by DEX Score.
| SAMe | ★★★★★ | Medium |
| Ginger | ★★★★★ | Medium |
| Devil's Claw | ★★★★★ | Medium |
| Curcumin | ★★★★★ | Medium |
| Boswellia | ★★★★★ | Medium |
| Probiotics | ★★★★★ | Medium |
| Glucosamine | ★★★★★ | Low |
| Collagen | ★★★★★ | Medium |
| Chondroitin Sulfate | ★★★★★ | Low |
| Resveratrol | ★★★★★ | Low |
| Fish Oil | ★★★★★ | Low |
| L-Carnitine | ★★★★★ | Low |
| Vitamin D | ★★★★★ | Low |
| Panax Ginseng | ★★★★★ | Low |
| Nattokinase | ★★★★★ | Low |
| Garlic | ★★★★★ | Low |
| Flaxseed | ★★★★★ | Low |
| Eleuthero | ★★★★★ | Low |
| Cissus Quadrangularis | ★★★★★ | Low |
| Ashwagandha | ★★★★★ | Low |
| Apigenin | ★★★★★ | Low |
| Arnica | ★★★★★ | Low |
| Alpha-Lipoic Acid | ★★★★★ | Low |
| Vitamin E | ★★★★★ | Very Low / None |
| Vitamin A | ★★★★★ | Very Low / None |
| Selenium | ★★★★★ | Very Low / None |
Studies
Find individual evidence reviews for supplements sorted by DEX Score.
26 supplements for , and rated at least stars. All purchase bands. No minimum star filter.
BoswelliaView supplement →
Consider purchase·★★★★★
How we scored this▸
- Taking Boswellia serrata by mouth, either alone or with other ingredients, may help reduce pain and stiffness and improve movement in people with knee osteoarthritis.
- Some studies show it works better than placebo or no treatment, but results are mixed when compared with other medicines like glucosamine.
- Specific Boswellia supplements and extracts have helped in some studies.
- Some products combining Boswellia with other natural ingredients such as ashwagandha, turmeric, and ginger have also helped improve symptoms after a few months of use.
- However, these benefits have not been clearly shown in arthritis of the hands.
- Most studies are small and short, so more research is needed.
Browse 17 studies·2 meta-analyses
RCTA standardized Boswellia serrata extract shows improvements in knee osteoarthritis within five days — a double-blind, randomized, three-arm, parallel-group, multi-center, placebo-controlled trial2024n=35
A manufacturer-funded study including 98 newly diagnosed osteoarthritis patients found that boswellia serrata supplementation (300 mg/day or 600 mg/day) led to improvements in pain from 5 days after starting supplementation. After 90 days, pain scores were reduced by 45.3% in the 300 mg/day group and by 61.9% in the 600 mg/day group (Visual Analog Scale). Distance walked in 6 minutes improved by 21.2% (300 mg/day) and 21.9% (600 mg/day) after 90 days. After 90 days, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain score improved by 70.2% (300 mg/day) and 73.9% (600 mg/day). WOMAC stiffness improved by by 65.6% (300 mg/day) and 68.9% (600 mg/day). WOMAC function improved by 68.8% (300 mg/day) and 74.2% (600 mg/day). WOMAC total score (Pain, Stiffness & Function) improved by 68.5% (300 mg/day) and 73.6% (600 mg/day). Levels of TNF-alpha, hs-CRP and IL-6 were reduced in the boswellia serrata group compared to placebo. This manufacturer-funded study included study authors employed by Sami-Sabinsa Group Limited.
- Effect
- Benefit
- Duration
- 90 days
- Dose
- 300 mg/day
- Population
- OA patients
- Participants
- 35
MetaEfficacy evaluation of standardized Boswellia serrata extract (AflapinⓇ) in osteoarthritis: A systematic review and sub-group meta-analysis study2024n=712
A meta-analysis of 9 osteoarthritis RCTs (712 participants) found Boswellia serrata supplementation significantly reduced pain VAS; standardized Aflapin® extract showed larger reductions in VAS, LFI, and WOMAC subscores than other Boswellia extracts.
- Effect
- Benefit
- Participants
- 712
MetaEfficacy of Extracts of Oleogum Resin of Boswellia in the Treatment of Knee Osteoarthritis: A Systematic Review and Meta-Analysis2024
A meta-analysis of 13 knee osteoarthritis trials found high heterogeneity overall, but subgroup analysis showed Boswellia oleogum resin extracts significantly lowered WOMAC scores versus placebo.
- Effect
- Benefit
- Population
- Patients with knee osteoarthritis
RCTEfficacy and Safety of Aflapin®, a Novel Boswellia Serrata Extract, in the Treatment of Osteoarthritis of the Knee: A Short-Term 30-Day Randomized, Double-Blind, Placebo-Controlled Clinical Study2023n=35
In 67 adults with knee osteoarthritis, Aflapin® 100 mg/day for 30 days improved VAS, LFI, and WOMAC pain, stiffness, and function scores by 40–66% versus baseline, with benefits seen by day 5.
- Effect
- Benefit
- Duration
- 30 days
- Dose
- 100 mg/day
- Population
- Adults
- Participants
- 35
RCTEfficacy and safety of a supplement combination on hand pain among people with symptomatic hand osteoarthritis: an internet-based, randomised clinical trial (the RADIANT study)2021n=106
In 106 adults with symptomatic hand osteoarthritis over 12 weeks, a supplement combining Boswellia, pine bark, MSM, and curcumin did not reduce hand pain VAS more than placebo (between-group difference 5.34; 95% CI −2.39 to 13.07).
- Effect
- No Benefit
- Duration
- 12 weeks
- Dose
- 250 mg/day
- Population
- Women
- Participants
- 106
- Ages
- 40+
Open-labelProspective, Multicenter Evaluation of a Polyherbal Supplement alongside Standard-of-Care Treatment for Mild Knee Osteoarthritis2021n=107
In 107 adults with symptomatic mild knee osteoarthritis followed ~36 weeks, adding Tregocel® (curcumin, Boswellia, harpagophytum, celery, ginger) to standard care increased 6-minute walk distance by 26 m, improved WOMAC scores, and cut regular OA medication use from 99% to 55%.
- Effect
- Benefit
- Duration
- 36 weeks
- Population
- Women
- Participants
- 107
- Avg age
- ~60
RCTDouble-blind trial of solid lipid Boswellia serrata particles (SLBSP) vs. standardized Boswellia serrata gum extract (BSE) for osteoarthritis of knee2020
In knee osteoarthritis treated 2 months, solid lipid Boswellia serrata particles (SLBSP) and standard BSE both improved WOMAC and VAS scores similarly, but SLBSP markedly reduced rescue analgesic use and lowered pro-inflammatory cytokines versus rising levels on BSE.
- Effect
- Benefit
- Population
- Patients with knee osteoarthritis
RCTA pilot, randomized, double-blind, placebo-controlled trial to assess the safety and efficacy of a novel Boswellia serrata extract in the management of osteoarthritis of the knee2019n=48
In 48 patients with knee osteoarthritis treated 120 days, Boswellin® Boswellia serrata extract significantly reduced pain and stiffness versus placebo, improved radiographic joint gap, and lowered high-sensitivity C-reactive protein without serious adverse events.
- Effect
- Benefit
- Duration
- 120 days
- Population
- OA patients
- Participants
- 48
RCTMethylsulfonylmethane and boswellic acids versus glucosamine sulfate in the treatment of knee arthritis: Randomized trial2016n=120
In 120 patients with knee arthritis treated 60 days, MSM plus boswellic acids (5 g + 7.2 mg/day) and glucosamine sulfate (1500 mg/day) each improved VAS pain and Lequesne Index scores, with a trend favoring the MSM/BA group at 6 months.
- Effect
- Benefit
- Duration
- 60 days
- Dose
- 5 g/day
- Population
- Patients with osteoarthritis
- Participants
- 120
RCTAyurvedic medicine offers a good alternative to glucosamine and celecoxib in the treatment of symptomatic knee osteoarthritis: a randomized, double-blind, controlled equivalence drug trial2013n=26
In 440 patients with symptomatic knee osteoarthritis over 24 weeks, Ayurvedic formulations containing Boswellia serrata were equivalent to glucosamine sulfate and celecoxib for reducing pain and improving knee function.
- Effect
- Benefit
- Duration
- 24 weeks
- Dose
- 2 g/day
- Population
- Knee OA patients
- Participants
- 26
RCTClinical evaluation of a formulation containing Curcuma longa and Boswellia serrata extracts in the management of knee osteoarthritis2013n=54
In 28 osteoarthritis patients, a Curcuma longa plus Boswellia serrata formulation (500 mg twice daily) outperformed celecoxib 100 mg twice daily on symptom scores and clinical examination, with no dose-related toxicity.
- Effect
- Benefit
- Dose
- 500 mg 2×/day
- Population
- OA patients
- Participants
- 54
RCTA double blind, randomized, placebo controlled clinical study evaluates the early efficacy of aflapin in subjects with osteoarthritis of knee2011n=30
A 30-day manufacturer-funded study including 59 patients with mild to moderate osteroarthritis found that 100 mg/day boswellia (Aflapin) led to significant reductions (P < 0.001) in pain (-49.1%, VAS), function (-34.4%, LFI), WOMAC pain (-49.5%), WOMAC stiffness (-48.4%) and WOMAC function scores (-45.2%) compared to placebo. Boswellia supplementation to significant reductions in pain (-14.8%, VAS) and improved function (+16.3%, Lequesne’s Functional Index) as early as 5 days after beginning supplementation. This study was funded by the Laila Group of Industries, India.
- Effect
- Benefit
- Duration
- 30 days
- Dose
- 100 mg/day
- Population
- OA patients
- Participants
- 30
- Ages
- 40–80
RCTClinical evaluation of Boswellia serrata (Shallaki) resin in the management of Sandhivata (osteoarthritis)2011n=29
A non-placebo-controlled study of 49 patients (aged 40 to 70 yrs) with mild osteoarthritis found boswellia supplementation (6 g/day in 3 divided doses after meals) or boswellia supplementation + local topical application of boswellia ointment led to significant improvements in overall joint mobility, joint pain, joint stiffness and joint swelling. The addition of topical boswellia to oral supplementation did not confer a greater benefit for complete remission or marked improvement of overall symptoms compared to oral supplementation alone.
- Effect
- Benefit
- Duration
- 2 months
- Dose
- 6 g/day
- Population
- OA patients
- Participants
- 29
- Ages
- 40–70
RCTComparative efficacy and tolerability of 5-Loxin and Aflapin Against osteoarthritis of the knee: a double blind, randomized, placebo controlled clinical study2010n=20
A 90-day manufacturer-funded study including 57 patients with mild to moderate osteroarthritis found that whilst both 100 mg/day 5-Loxin and 100 mg/day Aflapin led to significant improvements in joint function and pain, aflapin exhibited better therapeutic efficiency. Aflapin worked faster than 5-Loxin to reduce knee pain, with benefits as early as 7 days after initiating treatment. Both formulations had similar safety profiles. This study was funded by the Laila Group of Industries, India.
- Effect
- Benefit
- Duration
- 90 days
- Dose
- 100 mg/day
- Population
- OA patients
- Participants
- 20
RCTA double blind, randomized, placebo controlled study of the efficacy and safety of 5-Loxin for treatment of osteoarthritis of the knee2008n=25
In 70 knee osteoarthritis patients over 90 days, 5-Loxin (100 or 250 mg/day) significantly improved pain and physical function versus placebo; the 250 mg dose improved scores by day 7 and reduced synovial fluid MMP-3.
- Effect
- Benefit
- Duration
- 90 days
- Dose
- 100–250 mg/day
- Population
- RA patients
- Participants
- 25
- Ages
- 40–80
RCTEfficacy and tolerability of Boswellia serrata extract in treatment of osteoarthritis of knee – a randomized double blind placebo controlled trial2003n=30
An 8-wk crossover study (8-week treatment + 8 week placebo) including 30 knee osteoarthritis patients (mean age 59.03 yrs) found that boswellia supplementation (1000 mg/day for 8 weeks) led to clinically and statistically significant reductions in pain severity, swelling and loss of function (all P < 0.001).
- Effect
- Benefit
- Duration
- 8 weeks
- Dose
- 1000 mg/day
- Population
- OA patients
- Participants
- 30
- Avg age
- ~59
RCTTreatment of osteoarthritis with a herbomineral formulation: a double-blind, placebo-controlled, cross-over study1991n=42
In 42 osteoarthritis patients, herbomineral Articulin-F containing ashwagandha reduced pain and disability versus placebo over a crossover trial, without radiographic change.
- Effect
- Benefit
- Population
- OA patients
- Participants
- 42
CurcuminView supplement →
Consider purchase·★★★★★
How we scored this▸
- Turmeric supplements, either alone or combined with other ingredients, may help reduce knee pain and stiffness and improve movement in people with osteoarthritis.
- Some research shows turmeric can also reduce the need for pain medications.
- Turmeric seems less effective in older people or those with higher body weight.
- Different turmeric products, such as Meriva, Theracurmin, and others, have shown benefits, but not all products work the same.
- Using turmeric creams on the skin over the knee can also reduce pain and stiffness.
- Some products combine turmeric with herbs like boswellia, ashwagandha, or ginger to help with joint pain.
- Although turmeric might help, it's unclear how well it compares to common painkillers like ibuprofen.
- More studies are needed to know which turmeric products work best and how they compare to other treatments.
Browse 35 studies·5 meta-analyses
MetaEfficacy and safety of curcumin therapy for knee osteoarthritis: A Bayesian network meta-analysis2024n=80
A Bayesian network meta-analysis of 23 RCTs (2,175 knee osteoarthritis patients) found curcumin significantly reduced pain (VAS MD −1.63) and total WOMAC score (MD −18.85) versus placebo, with fewer adverse events than NSAIDs.
- Effect
- Benefit
- Population
- RA patients
- Participants
- 80
RCTRevolutionizing Knee Osteoarthritis Treatment: Innovative Self-Nano-Emulsifying Polyethylene Glycol Organogel of Curcumin for Effective Topical Delivery2024
In a double-blind trial of a topical curcumin nano-emulsifying organogel for knee osteoarthritis over 8 weeks, pain, stiffness, and physical function improved substantially more in the curcumin group than with placebo.
- Effect
- Benefit
- Duration
- 8 weeks
RCTEfficacy and Safety of a Highly Bioavailable Curcumin Formulation in Modulating Outcomes of Mild Knee Osteoarthritis: Multi-Centric, Randomized, Double-Blind, Placebo-Controlled Study2023
A manufacturer funded study found that curcumin (CurcuWin Ultra+) reduced knee pain, improved knee stiffness and increased walking ability. [10214] [View External Resource]
- Effect
- Benefit
MetaEfficacy and Safety of Curcumin and Curcuma longa Extract in the Treatment of Arthritis: A Systematic Review and Meta-Analysis of Randomized Controlled Trial2022n=2,396
A meta-analysis of 29 RCTs (2,396 participants with osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, and other arthritis types) found curcumin doses of 120–1500 mg/day for 4–36 weeks improved inflammation and pain.
- Effect
- Benefit
- Duration
- 4–36 weeks
- Dose
- 120–1500 mg/day
- Population
- RA patients
- Participants
- 2,396
MetaEfficacy and safety of curcuminoids alone in alleviating pain and dysfunction for knee osteoarthritis: a systematic review and meta-analysis of randomized controlled trials2022n=1,670
A meta-analysis of 15 RCTs (1,670 knee OA patients) found curcuminoids alone significantly improved VAS pain and all WOMAC subscales versus placebo and were not inferior to NSAIDs, without increased adverse events.
- Effect
- Benefit
- Population
- Healthy adults
- Participants
- 1,670
RCTThe Oral Administration of Highly-Bioavailable Curcumin for One Year Has Clinical and Chondro-Protective Effects: A Randomized, Double-Blinded, Placebo-Controlled Prospective Study2022
A manufacturer-funded study of knee surgery patients found no change in self-assessed pain from 180 mg/day curcumin supplementation compared to placebo after one year. However, there was a small reduction in cartilage stiffness and roughness one year after surgery. [10216] [View External Resource]
- Effect
- Benefit
- Dose
- 180 mg/day
RCTAcute Effects of Turmeric Extracts on Knee Joint Pain: A Pilot, Randomized Controlled Trial2021n=68
In a pilot RCT of 68 adults (ages 18–65) with mild/moderate knee pain over 1 week, B-Turmactive turmeric extract did not differ from placebo on WOMAC pain, though it significantly lowered high-sensitivity CRP at 1 week.
- Effect
- No Benefit
- Duration
- 1 week
- Dose
- 500 mg/day
- Population
- Adults
- Participants
- 68
- Ages
- 18–65
RCTAn Investigation into the Effects of a Curcumin Extract (Curcugen®) on Osteoarthritis Pain of the Knee: A Randomised, Double-Blind, Placebo-Controlled Study2021n=101
A manufacturer funded study found that curcumin (Curcugen) reduced participants knee pain but did not improve knee stiffness, function or quality of life. [10215]
- Effect
- Benefit
- Duration
- 3 months
- Dose
- 500 mg 2×/day
- Population
- Adults
- Participants
- 101
- Ages
- 45–70
MetaEfficacy and Safety of Turmeric Extracts for the Treatment of Knee Osteoarthritis: a Systematic Review and Meta-analysis of Randomised Controlled Trials2021n=1,810
A meta-analysis of 16 RCTs (1,810 adults with knee OA, up to 16 weeks) found turmeric extracts significantly reduced pain and improved physical function versus placebo, with effects similar to NSAIDs and fewer adverse events.
- Effect
- Benefit
- Population
- Adults
- Participants
- 1,810
Open-labelProspective, Multicenter Evaluation of a Polyherbal Supplement alongside Standard-of-Care Treatment for Mild Knee Osteoarthritis2021n=107
In 107 adults with symptomatic mild knee osteoarthritis followed ~36 weeks, adding Tregocel® (curcumin, Boswellia, harpagophytum, celery, ginger) to standard care increased 6-minute walk distance by 26 m, improved WOMAC scores, and cut regular OA medication use from 99% to 55%.
- Effect
- Benefit
- Duration
- 36 weeks
- Population
- Women
- Participants
- 107
- Avg age
- ~60
MetaThe efficacy of high- and low-dose curcumin in knee osteoarthritis: A systematic review and meta-analysis2021n=1,258
A meta-analysis of 11 RCTs (1,258 knee OA patients) found curcuminoids improved VAS and WOMAC pain scores versus comparators, with no significant difference between high-dose (≥1000 mg/day) and low-dose regimens.
- Effect
- Benefit
- Dose
- 1000 mg/day
- Population
- Healthy adults
- Participants
- 1,258
RCTEffectiveness of Curcuma longa Extract for the Treatment of Symptoms and Effusion-Synovitis of Knee Osteoarthritis : A Randomized Trial2020n=36
A 12-week manufacturer-funded study of 70 participants with knee osteoarthritis found improvements in knee pain but not effusion-synovitis volume on magnetic resonance imaging (MRI). [10217]
- Effect
- Benefit
- Duration
- 12 weeks
- Population
- OA patients
- Participants
- 36
RCTFish oil supplementation reduces osteoarthritis-specific pain in older adults with overweight/obesity2020
A 16-week manufacturer-funded study of 131 osteoarthritis patients with chronic pain found that neither curcumin (160 mg /day) nor curcumin + fish oil (2 g DHA + 0.4 g EPA /day) reduced osteoarthritic pain. Fish oil alone did confer some benefit for pain. [10218]
- Effect
- No Benefit
- Duration
- 16 weeks
- Dose
- 160 mg/day
- Population
- OA patients
- Ages
- 50–80
RCTThe effect of curcumin ointment on knee pain in older adults with osteoarthritis: a randomized placebo trial2020n=72
In 72 older adults (60+) with knee osteoarthritis, topical 5% curcumin ointment applied twice daily for 6 weeks significantly reduced knee pain intensity versus Vaseline placebo, exceeding the minimal clinically important difference.
- Effect
- Benefit
- Duration
- 6 weeks
- Dose
- 5% ointment twice daily
- Population
- Older adults
- Participants
- 72
- Ages
- 60+
RCTThe Effect of Nanocurcumin in Improvement of Knee Osteoarthritis: A Randomized Clinical Trial2020n=36
In a 6-week double-blind RCT of 71 knee OA patients, nanocurcumin 40 mg every 12 hours significantly reduced overall WOMAC scores and pain, stiffness, and physical function subscales versus placebo.
- Effect
- Benefit
- Dose
- 40 mg/day
- Population
- OA patients
- Participants
- 36
Open-labelThe Efficacy and Safety of Highly-Bioavailable Curcumin for Treating Knee Osteoarthritis: A 6-Month Open-Labeled Prospective Study2020n=50
An open-label study of 50 knee OA patients (ages 40+, Kellgren-Lawrence grade II–IV) given 180 mg/day Theracurmin for 6 months reported symptom improvement in 75.6% of patients with no major adverse events.
- Effect
- Benefit
- Duration
- 6 months
- Dose
- 180 mg/day
- Population
- Healthy adults
- Participants
- 50
- Ages
- 40+
ACE inhibitory peptides in standard and fermented deer velvet: an in silico and in vitro investigation2019
An in silico and in vitro study of deer velvet antler found fermentation released ACE-inhibitory peptides and increased ACE inhibitory activity, suggesting potential cardiovascular benefit unrelated to curcumin supplementation.
- Effect
- Benefit
RCTBio-optimized Curcuma longa extract is efficient on knee osteoarthritis pain: a double-blind multicenter randomized placebo controlled three-arm study2019n=50
A manufacturer-funded study of 150 patients with moderate knee osteoarthrtitis found that Flexofytol (187 mg/day) improved self-reported knee pain and mobility. [10220]
- Effect
- Benefit
- Duration
- 90 days
- Dose
- 187 mg/day
- Population
- Healthy adults
- Participants
- 50
- Ages
- 45–80
RCTSafety and efficacy of curcumin versus diclofenac in knee osteoarthritis: a randomized open-label parallel-arm study2019n=139
An open-label study of 139 patients given 1.5 g BCM-95 or 100 mg diclofenac per day found similar benefits for pain after 28 days. Those taking curcumin also experienced reduced weight and an anti-ulcer effect. Curcumin was less likely to result in side effects (13%) vs diclofenac (38%). [10219]
- Effect
- Benefit
- Duration
- 28 days
- Dose
- 1.5 g/day
- Population
- Healthy adults
- Participants
- 139
- Ages
- 38–65
RCTA Placebo-Controlled Double-Blind Study Demonstrates the Clinical Efficacy of a Novel Herbal Formulation for Relieving Joint Discomfort in Human Subjects with Osteoarthritis of Knee2018n=105
In a 90-day double-blind RCT of 105 knee OA patients, LI73014F2 (curcuma, boswellia, and terminalia extracts) at 200 or 400 mg/day significantly improved pain, physical function, and quality of life versus placebo.
- Effect
- Benefit
- Duration
- 90 days
- Dose
- 400 mg/day
- Population
- OA patients
- Participants
- 105
RCTEfficacy and safety of curcumin and its combination with boswellic acid in osteoarthritis: a comparative, randomized, double-blind, placebo-controlled study2018n=201
A study of 201 knee osteoarthritis patients (aged 40-70 years) given either CuraMed (1.5 g/day containing 1 g curcuminoids) or CuraMin (1.5 g/day containing 1050 mg curcuminoids and 450 mg boswellic acid) found that whilst curcumin alone (CuraMed) improved physical performance vs placebo, those taking CuraMin experienced a greater reduction in pain associated with osteoarthritis of the knee. [10221]
- Effect
- Benefit
- Duration
- 12 weeks
- Dose
- 1.5 g/day
- Population
- OA patients
- Participants
- 201
- Ages
- 40–70
ObservationalPhytoproflex®: supplementary management of osteoarthrosis: a supplement registry2018n=56
A 4-week registry of 56 knee OA patients found Phytoproflex (containing curcumin, boswellic acid, and valeric acid) as add-on therapy significantly reduced pain, improved fitness, and decreased rescue medication use versus standard care alone.
- Effect
- Benefit
- Duration
- 4 weeks
- Population
- Healthy adults
- Participants
- 56
RCTCurcuma longa extract reduces inflammatory and oxidative stress biomarkers in osteoarthritis of knee: a four-month, double-blind, randomized, placebo-controlled trial2016n=160
A 4-month study of 160 patients found that 0.5 g/day curcumin was able to modestly improve knee pain and clinical outcomes. [10222]
- Effect
- Benefit
- Duration
- 4 months
- Dose
- 0.5 g/day
- Population
- Patients with knee osteoarthritis
- Participants
- 160
RCTThe efficacy and safety of a combination of glucosamine hydrochloride, chondroitin sulfate and bio-curcumin with exercise in the treatment of knee osteoarthritis: a randomized, double-blind, placebo-controlled study2016n=26
In 53 knee OA patients receiving physical therapy for 8 weeks, CartiJoint Forte (glucosamine, chondroitin, and bio-curcumin) improved pain on motion and Lequesne Index scores versus placebo, though pain at rest did not differ between groups.
- Effect
- Benefit
- Duration
- 8 weeks
- Population
- Patients with knee osteoarthritis
- Participants
- 26
ObservationalA complex of three natural anti-inflammatory agents provides relief of osteoarthritis pain2014n=42
An observational study of 42 patients with acute or chronic osteoarthritis pain treated with a turmeric, devil's claw, and bromelain complex (650–1,300 mg/day) reported clinically relevant VAS pain reductions at 15–60 days with good tolerance.
- Effect
- Benefit
- Dose
- 300 mg/day
- Population
- Women
- Participants
- 42
- Ages
- 18–65
RCTCurcuminoid treatment for knee osteoarthritis: a randomized double-blind placebo-controlled trial2014n=21
A 6-wk study of patients with mild-to-moderate osteoarthritis of the knee found that curcumin (1.5 g C3 Complex/day) improved pain and physical function but not knee stiffness and resulted in a reduced need for NSAIDs (-84%) when compared to placebo. [10223]
- Effect
- Benefit
- Duration
- 6 weeks
- Dose
- 1500 mg/day
- Population
- Healthy adults
- Participants
- 21
RCTEfficacy and safety of Curcuma domestica extracts compared with ibuprofen in patients with knee osteoarthritis: a multicenter study2014n=182
In 367 primary knee OA patients (ages 50+) over 4 weeks, Curcuma domestica extract 1,500 mg/day was noninferior to ibuprofen 1,200 mg/day for WOMAC pain and function, with fewer reports of abdominal pain.
- Effect
- Benefit
- Duration
- 4 weeks
- Dose
- 200 mg/day
- Population
- OA patients
- Participants
- 182
- Ages
- 50+
RCTShort-term effects of highly-bioavailable curcumin for treating knee osteoarthritis: a randomized, double-blind, placebo-controlled prospective study2014n=50
An 8-week manufacturer-funded study of 50 patients with knee osteoarthritis of Kellgren-Lawrence grade II or III found that 180 mg/day curcumin (Theracurmin) was able to reduce knee pain. [10224]
- Effect
- Benefit
- Duration
- 8 weeks
- Dose
- 180 mg/day
- Population
- Healthy adults
- Participants
- 50
- Ages
- 40+
RCTClinical evaluation of a formulation containing Curcuma longa and Boswellia serrata extracts in the management of knee osteoarthritis2013n=54
In 28 osteoarthritis patients, a Curcuma longa plus Boswellia serrata formulation (500 mg twice daily) outperformed celecoxib 100 mg twice daily on symptom scores and clinical examination, with no dose-related toxicity.
- Effect
- Benefit
- Dose
- 500 mg 2×/day
- Population
- OA patients
- Participants
- 54
RCTSafety and efficacy of Curcuma longa extract in the treatment of painful knee osteoarthritis: a randomized placebo-controlled trial2013n=120
In 120 knee OA patients over 42 days, NR-INF-02 (Curcuma longa extract) 500 mg twice daily significantly reduced pain (VAS), WOMAC scores, and rescue medication use versus placebo.
- Effect
- Benefit
- Duration
- 42 days
- Dose
- 1000 mg/day
- Population
- Healthy adults
- Participants
- 120
Controlled trialEfficacy and safety of Meriva®, a curcumin-phosphatidylcholine complex, during extended administration in osteoarthritis patients2010
An 8-month study including 100 osteoarthritis patients found that curcumin (Meriva) improved clinical markers of inflammation and improved walking performance. [10225]
- Effect
- Benefit
- Duration
- 8 months
- Population
- OA patients
Clinical trialProduct-evaluation registry of Meriva®, a curcumin-phosphatidylcholine complex, for the complementary management of osteoarthritis2010n=50
A registry study of 50 osteoarthritis patients given Meriva curcumin-phosphatidylcholine (200 mg/day curcumin) for 3 months reported a 58% reduction in WOMAC score, improved treadmill walking distance, and lower CRP versus controls.
- Effect
- Benefit
- Duration
- 3 months
- Dose
- 200 mg
- Population
- OA patients
- Participants
- 50
RCTEfficacy and safety of Curcuma domestica extracts in patients with knee osteoarthritis2009n=55
In 107 knee OA patients over 6 weeks, Curcuma domestica extract 2 g/day was similarly effective to ibuprofen 800 mg/day for pain reduction and functional improvement, with comparable adverse event rates.
- Effect
- Benefit
- Duration
- 6 weeks
- Dose
- 800 mg/day
- Population
- Healthy adults
- Participants
- 55
RCTA 32-week randomized, placebo-controlled clinical evaluation of RA-11, an Ayurvedic drug, on osteoarthritis of the knees2004n=358
In a 32-week double-blind RCT of 90 knee OA patients, RA-11 (an Ayurvedic formulation including Curcuma longa) significantly reduced pain VAS and improved modified WOMAC scores versus placebo.
- Effect
- Benefit
- Duration
- 32 weeks
- Population
- Healthy adults
- Participants
- 358
RCTTreatment of osteoarthritis with a herbomineral formulation: a double-blind, placebo-controlled, cross-over study1991n=42
In 42 osteoarthritis patients, herbomineral Articulin-F containing ashwagandha reduced pain and disability versus placebo over a crossover trial, without radiographic change.
- Effect
- Benefit
- Population
- OA patients
- Participants
- 42
Devil's ClawView supplement →
Consider purchase·★★★★★
How we scored this▸
- No summary is available.
Browse 7 studies
Open-labelProspective, Multicenter Evaluation of a Polyherbal Supplement alongside Standard-of-Care Treatment for Mild Knee Osteoarthritis2021n=107
In 107 adults with symptomatic mild knee osteoarthritis followed ~36 weeks, adding Tregocel® (curcumin, Boswellia, harpagophytum, celery, ginger) to standard care increased 6-minute walk distance by 26 m, improved WOMAC scores, and cut regular OA medication use from 99% to 55%.
- Effect
- Benefit
- Duration
- 36 weeks
- Population
- Women
- Participants
- 107
- Avg age
- ~60
RCTA Rosa canina - Urtica dioica - Harpagophytum procumbens/zeyheri Combination Significantly Reduces Gonarthritis Symptoms in a Randomized, Placebo-Controlled Double-Blind Study2017n=46
In 92 patients with gonarthritis over 12 weeks, daily MA212 (rosehip, nettle, and devil's claw) significantly improved WOMAC pain scores versus placebo (29.87 vs 10.23 point reduction, p < 0.001).
- Effect
- Benefit
- Duration
- 12 weeks
- Population
- Healthy adults
- Participants
- 46
ObservationalA complex of three natural anti-inflammatory agents provides relief of osteoarthritis pain2014n=42
An observational study of 42 patients with acute or chronic osteoarthritis pain treated with a turmeric, devil's claw, and bromelain complex (650–1,300 mg/day) reported clinically relevant VAS pain reductions at 15–60 days with good tolerance.
- Effect
- Benefit
- Dose
- 300 mg/day
- Population
- Women
- Participants
- 42
- Ages
- 18–65
Clinical trialTreatment of patients with arthrosis of hip or knee with an aqueous extract of devil's claw (Harpagophytum procumbens DC.)2003n=75
An open multicentre study of 75 patients with hip or knee arthrosis given aqueous devil's claw extract (50 mg harpagoside/day) for 12 weeks reported 22.9% improvement in WOMAC total score and 25.8% reduction in VAS pain.
- Effect
- Benefit
- Duration
- 12 weeks
- Dose
- 2400 mg/day
- Population
- Healthy adults
- Participants
- 75
ObservationalComparison of outcome measures during treatment with the proprietary Harpagophytum extract doloteffin in patients with pain in the lower back, knee or hip2002n=104
In a postmarketing surveillance study of 227 patients with back, knee, or hip pain taking Doloteffin (60 mg harpagoside/day) for 8 weeks, 50–70% reported benefit with few adverse effects.
- Effect
- Benefit
- Duration
- 8 weeks
- Dose
- 60 mg harpagoside/day
- Population
- Healthy adults
- Participants
- 104
RCTEfficacy and tolerance of Harpagophytum procumbens versus diacerhein in treatment of osteoarthritis2000n=122
In 122 osteoarthritis patients over 4 months, Harpadol devil's claw was comparable to diacerein 100 mg/day for pain and function, with significantly fewer adverse events (8.1% vs 26.7% diarrhea) and less rescue medication use.
- Effect
- Benefit
- Duration
- 4 months
- Dose
- 100 mg/day
- Population
- OA patients
- Participants
- 122
RCTHarpagophytum procumbens in the treatment of knee and hip osteoarthritis. Four-month results of a prospective, multicenter, double-blind trial versus diacerhein2000n=122
In 122 patients with hip and/or knee osteoarthritis over 4 months, devil's claw 2,610 mg/day was at least as effective as diacerein 100 mg/day for pain and function, with fewer analgesic needs and adverse events.
- Effect
- Benefit
- Duration
- 4 months
- Dose
- 610 mg/day
- Population
- Healthy adults
- Participants
- 122
GingerView supplement →
Consider purchase·★★★★★
How we scored this▸
- Taking ginger supplements by mouth may help reduce joint pain for people with osteoarthritis, especially in the knee or hip.
- Studies show that 500-1000 mg daily for a few weeks can slightly lessen pain and sometimes improve function.
- Applying ginger on the skin for osteoarthritis hasn’t been clearly shown to help, though some small studies found it might relieve symptoms.
- Overall, ginger is a safe natural option to try for joint pain relief.
Browse 16 studies·2 meta-analyses
RCTEffectiveness and safety of steamed ginger extract on mild osteoarthritis: a randomized, double-blind, placebo-controlled clinical trial2024n=100
In 100 adults with mild knee osteoarthritis, steamed ginger extract 1.6 g/day for 12 weeks significantly reduced pain VAS and WOMAC scores versus placebo.
- Effect
- Benefit
- Duration
- 12 weeks
- Dose
- 1.6 g/day
- Population
- Adults
- Participants
- 100
Open-labelProspective, Multicenter Evaluation of a Polyherbal Supplement alongside Standard-of-Care Treatment for Mild Knee Osteoarthritis2021n=107
In 107 adults with symptomatic mild knee osteoarthritis followed ~36 weeks, adding Tregocel® (curcumin, Boswellia, harpagophytum, celery, ginger) to standard care increased 6-minute walk distance by 26 m, improved WOMAC scores, and cut regular OA medication use from 99% to 55%.
- Effect
- Benefit
- Duration
- 36 weeks
- Population
- Women
- Participants
- 107
- Avg age
- ~60
MetaEffectiveness of Ginger on Pain and Function in Knee Osteoarthritis: A PRISMA Systematic Review and Meta-Analysis2020
A PRISMA meta-analysis found oral and topical ginger significantly reduced pain and improved knee function in osteoarthritis versus placebo across randomized trials.
- Effect
- Benefit
- Population
- Knee OA patients
RCTA Comparative of Ginger Extract in Nanostructure Lipid Carrier (NLC) and 1% Diclofenac Gel for Treatment of Knee Osteoarthritis (OA)2017n=20
In 120 knee OA patients, ginger extract in nanostructure lipid carrier for 12 weeks produced comparable WOMAC and pain improvements to 1% diclofenac gel.
- Effect
- Benefit
- Duration
- 12 weeks
- Population
- Knee OA patients
- Participants
- 20
- Ages
- 50–75
RCTEffects of Self-Knee Massage With Ginger Oil in Patients With Osteoarthritis: An Experimental Study2017n=68
In 68 knee osteoarthritis patients, self-massage with ginger oil added to standard treatment significantly reduced pain VAS and improved WOMAC scores versus standard care alone.
- Effect
- Benefit
- Population
- OA patients
- Participants
- 68
MetaEfficacy and safety of ginger in osteoarthritis patients: a meta-analysis of randomized placebo-controlled trials2015n=593
A meta-analysis of 593 osteoarthritis patients found oral ginger significantly reduced pain (SMD −0.55) versus placebo with acceptable tolerability.
- Effect
- Benefit
- Population
- OA patients
- Participants
- 593
- Ages
- >18
Improving of Knee Osteoarthritic Symptom by the Local Application of Ginger Extract Nanoparticles: A Preliminary Report with Short Term Follow-Up2015n=60
In 60 knee OA patients, topical ginger extract nanoparticles applied three times daily for 12 weeks significantly improved KOOS scores and pain versus baseline.
- Effect
- Benefit
- Duration
- 12 weeks
- Population
- Knee OA patients
- Participants
- 60
- Ages
- 50–75
RCTAyurvedic medicine offers a good alternative to glucosamine and celecoxib in the treatment of symptomatic knee osteoarthritis: a randomized, double-blind, controlled equivalence drug trial2013n=26
In 440 patients with symptomatic knee osteoarthritis over 24 weeks, Ayurvedic formulations containing Boswellia serrata were equivalent to glucosamine sulfate and celecoxib for reducing pain and improving knee function.
- Effect
- Benefit
- Duration
- 24 weeks
- Dose
- 2 g/day
- Population
- Knee OA patients
- Participants
- 26
RCTEfficacy and tolerability of ginger (Zingiber officinale) in patients of osteoarthritis of knee2013n=60
In 60 knee OA patients, ginger capsules 750 mg/day produced comparable pain relief to diclofenac 50 mg/day in an open-label randomized trial.
- Effect
- Benefit
- Duration
- 12 weeks
- Dose
- 750 mg/day
- Population
- Knee OA patients
- Participants
- 60
RCTInfluence of a specific ginger combination on gastropathy conditions in patients with osteoarthritis of the knee or hip2012n=22
In 43 OA patients on NSAIDs, ginger extract 340 mg/day for 4 weeks caused significantly fewer gastropathy symptoms than diclofenac while maintaining pain control.
- Effect
- Benefit
- Duration
- 4 weeks
- Dose
- 340 mg/day
- Population
- OA patients
- Participants
- 22
RCTThe efficacy of Plygersic gel for use in the treatment of osteoarthritis of the knee2012
In 50 knee OA patients, topical Plygersic gel (4% ginger plus plai) for 6 weeks was comparably effective to 1% diclofenac gel for pain and function outcomes.
- Effect
- Benefit
- Duration
- 6 weeks
- Population
- OA patients
RCTComparing analgesic effects of a topical herbal mixed medicine with salicylate in patients with knee osteoarthritis2011
In knee OA patients, a topical herbal ointment containing ginger, cinnamon, and sesame oil for 6 weeks reduced pain comparably to salicylate ointment versus baseline.
- Effect
- Benefit
- Duration
- 6 weeks
- Population
- OA patients
- Avg age
- ~52
RCTAn experimental study on the effectiveness of massage with aromatic ginger and orange essential oil for moderate-to-severe knee pain among the elderly in Hong Kong2008
In 59 older adults with moderate-to-severe knee pain, aromatherapy massage with ginger and orange oil for 3 weeks significantly reduced pain versus no-massage control.
- Effect
- Benefit
- Duration
- 3 weeks
- Population
- Older adults
RCTComparing the Effects of ginger (Zingiber officinale) extract and ibuprofen On patients with osteoarthritis2005
In osteoarthritis patients, ginger extract was compared with ibuprofen for pain relief in a randomized trial; no abstract was available to confirm specific outcomes.
- Effect
- Benefit
- Population
- OA patients
RCTEffects of a ginger extract on knee pain in patients with osteoarthritis2001n=59
In 261 knee OA patients, ginger extract for 6 weeks significantly reduced knee pain on standing and after walking versus placebo in a double-blind multicenter trial.
- Effect
- Benefit
- Duration
- 6 weeks
- Dose
- 2 g/day
- Population
- OA patients
- Participants
- 59
RCTA randomized, placebo-controlled, cross-over study of ginger extracts and ibuprofen in osteoarthritis2000
In hip or knee OA patients, ginger extract was comparably effective to ibuprofen for pain relief over 3 weeks in a double-blind crossover trial versus placebo.
- Effect
- Benefit
- Duration
- 3 weeks
- Population
- OA patients
SAMeView supplement →
Consider purchase·★★★★★
How we scored this▸
- Taking SAMe by mouth (400 to 1200 mg daily) can reduce pain and improve joint function in people with osteoarthritis.
- It works about as well as common pain medicines like ibuprofen or celecoxib but may take longer to start working.
- Some studies suggest that starting with an IV dose may help it work faster.
- SAMe usually causes fewer side effects and is safe to use over a long period.
Browse 12 studies·1 meta-analysis
RCTComparative clinical trial of S-adenosylmethionine versus nabumetone for the treatment of knee osteoarthritis: an 8-week, multicenter, randomized, double-blind, double-dummy, Phase IV study in Korean patients2009n=67
An 8-week RCT in 134 Korean knee osteoarthritis patients found SAMe 1200 mg/day and nabumetone 1000 mg/day reduced pain similarly, with no significant between-group differences.
- Effect
- Benefit
- Duration
- 8 weeks
- Dose
- 400 mg 3×/day
- Population
- Patients with osteoarthritis
- Participants
- 67
- Ages
- 18–65
MetaS-Adenosylmethionine for osteoarthritis of the knee or hip2009n=656
A Cochrane review of 4 RCTs in 656 knee or hip osteoarthritis patients found SAMe vs placebo showed only a small, non-significant pain benefit and inconclusive evidence overall.
- Effect
- No Benefit
- Population
- OA patients
- Participants
- 656
RCTS-adenosyl methionine (SAMe) versus celecoxib for the treatment of osteoarthritis symptoms: a double-blind cross-over trial. [ISRCTN36233495]2004n=70
A 16-week cross-over RCT in 61 adults with knee osteoarthritis found celecoxib 200 mg reduced pain faster than SAMe 1200 mg, but both were equally effective by the second month.
- Effect
- Benefit
- Duration
- 16 weeks
- Dose
- 1200 mg
- Population
- Adults
- Participants
- 70
- Ages
- 40+
S-adenosyl-L-methionine for treatment of depression, osteoarthritis, and liver disease2003
A review concluded SAMe has evidence for depression, osteoarthritis, and liver disease, though indication-specific trial quality varies.
MetaSafety and efficacy of S-adenosylmethionine (SAMe) for osteoarthritis2002
A meta-analysis of 11 osteoarthritis RCTs found SAMe comparable to NSAIDs for pain and function with fewer adverse effects; vs placebo it improved function but not pain based on two studies.
- Effect
- Benefit
- Population
- Patients with OA (effect size [ES] =
RCTA randomized, double blind, placebo controlled trial of intravenous loading with S-adenosylmethionine (SAM) followed by oral SAM therapy in patients with knee osteoarthritis1994n=81
An RCT in 81 knee osteoarthritis patients found IV SAMe 400 mg daily for 5 days followed by oral 600 mg/day for 23 days reduced overall and rest pain vs placebo at one site with milder disease.
- Effect
- Benefit
- Duration
- 5 days
- Dose
- 200 mg 3×/day
- Population
- Patients with osteoarthritis
- Participants
- 81
Clinical trialA long-term (two years) clinical trial with S-adenosylmethionine for the treatment of osteoarthritis1987n=108
A 24-month open trial in 108 osteoarthritis patients found SAMe 600 mg/day initially then 400 mg/day improved stiffness, rest pain, and movement pain from early weeks through 2 years with good tolerance.
- Effect
- Benefit
- Duration
- 24 months
- Dose
- 400 mg/day
- Population
- OA patients
- Participants
- 108
Open-labelA new medical approach to the treatment of osteoarthritis. Report of an open phase IV study with ademetionine (Gumbaral)1987n=20,641
An open phase IV trial in 20,641 osteoarthritis patients treated with ademetionine for 8 weeks reported good or very good efficacy in 71% and good or very good tolerance in 87%.
- Effect
- Benefit
- Duration
- 8 weeks
- Population
- OA patients
- Participants
- 20,641
RCTDouble-blind clinical trial of S-adenosylmethionine versus ibuprofen in the treatment of osteoarthritis1987n=36
A 4-week double-blind trial in 36 osteoarthritis patients found SAMe 1200 mg/day and ibuprofen 1200 mg/day improved total joint scores equally, with both well tolerated.
- Effect
- Benefit
- Dose
- 1200 mg/day
- Population
- OA patients
- Participants
- 36
RCTDouble-blind comparative clinical trial with S-adenosylmethionine and indomethacin in the treatment of osteoarthritis1987n=36
A 4-week double-blind trial in 36 osteoarthritis patients found SAMe 1200 mg/day and indomethacin 150 mg/day improved clinical scores similarly, with adverse effects in 2 vs 7 patients.
- Effect
- Benefit
- Dose
- 150 mg
- Population
- OA patients
- Participants
- 36
RCTDouble-blind controlled clinical trial of oral S-adenosylmethionine versus piroxicam in knee osteoarthritis1987n=45
An 84-day double-blind trial in 45 knee osteoarthritis patients found SAMe 1200 mg/day and piroxicam 20 mg/day both improved pain by day 28, with SAMe maintaining benefit longer after treatment.
- Effect
- Benefit
- Duration
- 84 days
- Dose
- 200 mg/day
- Population
- OA patients
- Participants
- 45
Controlled trialItalian double-blind multicenter study comparing S-adenosylmethionine, naproxen, and placebo in the treatment of degenerative joint disease1987n=734
A double-blind Italian multicenter trial in 734 osteoarthritis patients found SAMe 1200 mg/day matched naproxen 750 mg/day for analgesia, both beating placebo, with better SAMe tolerability than naproxen.
- Effect
- Benefit
- Dose
- 200 mg/day
- Population
- Patients with osteoarthritis
- Participants
- 734
ProbioticsView supplement →
Consider purchase·★★★★★
How we scored this▸
- Probiotics are possibly effective for Osteoarthritis.
Browse 1 study·1 meta-analysis
Systematic reviewClinical efficacy of probiotic supplementation in the treatment of knee osteoarthritis: a meta-analysis2025n=694
A meta-analysis of 5 knee osteoarthritis RCTs (n=694) found oral probiotics reduced pain VAS and WOMAC scores and hs-CRP versus control.
- Effect
- Benefit
- Population
- Patients with osteoarthritis
- Participants
- 694
Chondroitin SulfateView supplement →
Reconsider purchase·★★★★★
How we scored this▸
- Chondroitin sulfate may help reduce pain and improve function in knee osteoarthritis when taken by mouth at doses between 600 and 2000 mg daily for at least three months.
- Pharmaceutical-grade products like Chondrosulf and Structum seem to work best and may slow joint damage over time but most studies are funded by manufacturers.
- Chondroitin usually works more slowly than common arthritis medicines but its benefits last longer after stopping treatment.
- Some expert groups recommend using high-quality chondroitin supplements, while others say there isn’t enough consistent proof.
- Combining chondroitin with glucosamine might also help, especially with certain brand-name products.
- Chondroitin creams or gels have not been shown to work.
Browse 32 studies·9 meta-analyses
MetaEvaluation of efficacy and safety of glucosamine sulfate, chondroitin sulfate, and their combination regimen in the management of knee osteoarthritis: a systematic review and meta-analysis2024
A 2024 meta-analysis of 25 RCTs found chondroitin sulfate reduced pain and improved function versus placebo, glucosamine reduced joint space narrowing, and combined therapy did not significantly improve symptoms.
- Effect
- Benefit
ObservationalChondroitin sulfate and glucosamine combination in patients with knee and hip osteoarthritis: A long-term observational study in Russia2023n=1,102
In 1,102 knee and hip osteoarthritis patients followed up to 64 weeks, long-term glucosamine plus chondroitin improved pain, function, quality of life, and reduced NSAID use in routine care.
- Effect
- Benefit
- Duration
- 12 months
- Dose
- 1500 mg glucosamine + 1200 mg CS/day
- Population
- OA patients
- Participants
- 1,102
- Ages
- 45–75
Guide2019 American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee2020
The 2019 ACR/Arthritis Foundation guideline conditionally recommends chondroitin sulfate for hand osteoarthritis and advises shared decision-making for other osteoarthritis treatments.
- Effect
- Benefit
- Population
- Healthy adults
GuideAn updated algorithm recommendation for the management of knee osteoarthritis from the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO)2019
The 2019 ESCEO knee osteoarthritis algorithm recommends non-pharmacological care throughout disease management and assigns graded recommendations to available pharmacologic options.
MetaEfficacy of Chondroitin Sulfate in Patients with Knee Osteoarthritis: A Comprehensive Meta-Analysis Exploring Inconsistencies in Randomized, Placebo-Controlled Trials2019
A meta-analysis of 18 knee osteoarthritis trials found chondroitin sulfate reduced pain and improved function, with more consistent benefits in low-bias pharmaceutical-grade preparations.
- Effect
- Benefit
- Population
- Healthy adults
MetaDietary supplements for treating osteoarthritis: a systematic review and meta-analysis2018
A meta-analysis of 69 osteoarthritis supplement trials found chondroitin and glucosamine produced only small, clinically unclear pain reductions, while collagen and curcumin showed larger short-term effects.
- Effect
- No Benefit
- Population
- OA patients
MetaEffect of glucosamine and chondroitin sulfate in symptomatic knee osteoarthritis: a systematic review and meta-analysis of randomized placebo-controlled trials2018
A meta-analysis found glucosamine and chondroitin each reduced pain on visual analog scales in knee osteoarthritis, but their combination did not significantly improve WOMAC scores.
- Effect
- Benefit
MetaEffects of glucosamine in patients with osteoarthritis of the knee: a systematic review and meta-analysis2018
A meta-analysis of 18 glucosamine RCTs found marginally favorable pain effects in knee osteoarthritis, though WOMAC function improvements were small and not significant.
- Effect
- Benefit
- Population
- OA patients
RCTCombined Treatment With Chondroitin Sulfate and Glucosamine Sulfate Shows No Superiority Over Placebo for Reduction of Joint Pain and Functional Impairment in Patients With Knee Osteoarthritis: A Six-Month Multicenter, Randomized, Double-Blind, Placebo-Controlled Clinical Trial2017n=164
In 164 knee osteoarthritis patients, 6 months of combined chondroitin sulfate and glucosamine did not significantly reduce pain or functional impairment versus placebo.
- Effect
- No Benefit
- Duration
- 6 months
- Dose
- 1200 mg CS + 1500 mg GS/day
- Population
- Healthy adults
- Participants
- 164
RCTPharmaceutical-grade Chondroitin sulfate is as effective as celecoxib and superior to placebo in symptomatic knee osteoarthritis: the ChONdroitin versus CElecoxib versus Placebo Trial (CONCEPT)2017n=604
In 604 knee osteoarthritis patients over 6 months, pharmaceutical-grade chondroitin sulfate 800 mg/day was as effective as celecoxib and superior to placebo for pain and function.
- Effect
- Benefit
- Duration
- 182 days
- Dose
- 800 mg/day
- Population
- OA patients
- Participants
- 604
- Ages
- 50+
GuideA consensus statement on the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO) algorithm for the management of knee osteoarthritis-From evidence-based medicine to the real-life setting2016
An ESCEO consensus statement reviewed real-world evidence supporting pharmaceutical-grade glucosamine sulfate and chondroitin sulfate as first-line symptomatic slow-acting drugs for osteoarthritis.
- Population
- Healthy adults
RCTChondroitin sulfate efficacy versus celecoxib on knee osteoarthritis structural changes using magnetic resonance imaging: a 2-year multicentre exploratory study2016n=138
In a 24-month MRI trial of 138 knee osteoarthritis patients, chondroitin sulfate 1,200 mg/day slowed medial cartilage volume loss versus celecoxib 200 mg/day.
- Effect
- Benefit
- Duration
- 24 months
- Dose
- 200 mg/day
- Population
- Healthy adults
- Participants
- 138
RCTCombined chondroitin sulfate and glucosamine for painful knee osteoarthritis: a multicentre, randomised, double-blind, non-inferiority trial versus celecoxib2016n=606
In 606 patients with painful knee osteoarthritis, combined chondroitin and glucosamine was non-inferior to celecoxib for pain and function over 6 months.
- Effect
- Benefit
- Duration
- 6 months
- Dose
- 500 mg 3×/day
- Population
- Healthy adults
- Participants
- 606
MetaChondroitin for osteoarthritis2015n=17
A Cochrane review of 43 trials found chondroitin modestly improved osteoarthritis pain and function versus placebo, though evidence quality was often low and heterogeneous.
- Effect
- Benefit
- Population
- OA patients
- Participants
- 17
MetaEffectiveness and safety of Glucosamine, chondroitin, the two in combination, or celecoxib in the treatment of osteoarthritis of the knee2015n=16,427
A meta-analysis of 54 trials (16,427 patients) found glucosamine, chondroitin, and celecoxib each beat placebo for pain and function, with celecoxib ranking highest for symptom relief.
- Effect
- Benefit
- Population
- Healthy adults
- Participants
- 16,427
RCTGlucosamine and chondroitin for knee osteoarthritis: a double-blind randomised placebo-controlled clinical trial evaluating single and combination regimens2015n=152
In 605 knee osteoarthritis patients over 2 years, glucosamine plus chondroitin reduced joint space narrowing versus placebo, but no group showed significant symptomatic benefit over placebo.
- Effect
- No Benefit
- Duration
- 7 days
- Dose
- 1500 mg/day
- Population
- OA patients
- Participants
- 152
- Ages
- 45–75
RCTEquivalence of a single dose (1200 mg) compared to a three-time a day dose (400 mg) of chondroitin 4&6 sulfate in patients with knee osteoarthritis. Results of a randomized double blind placebo controlled study2013n=353
In 353 knee osteoarthritis patients, a single 1,200 mg daily chondroitin dose was equivalent to 400 mg three times daily and superior to placebo for symptoms over 3 months.
- Effect
- Benefit
- Duration
- 3 months
- Dose
- 200 mg/day
- Population
- Adults
- Participants
- 353
- Ages
- 45+
RCTEffect of 12 months treatment with chondroitin sulfate on cartilage volume in knee osteoarthritis patients: a randomized, double-blind, placebo-controlled pilot study using MRI2012n=21
In a 48-week pilot of 43 knee osteoarthritis patients, chondroitin sulfate showed a trend toward less cartilage volume loss on MRI versus placebo, but between-group differences were not significant.
- Effect
- No Benefit
- Duration
- 48 weeks
- Dose
- 500 mg 2×/day
- Population
- OA patients
- Participants
- 21
- Ages
- 50–75
RCTEffect of the novel low molecular weight hydrolyzed chicken sternal cartilage extract, BioCell Collagen, on improving osteoarthritis-related symptoms: a randomized, double-blind, placebo-controlled trial2012n=80
In 80 osteoarthritis patients over 70 days, BioCell Collagen 2 g/day reduced pain and improved physical function versus placebo.
- Effect
- Benefit
- Duration
- 70 days
- Dose
- 2 g/day
- Population
- OA patients
- Participants
- 80
RCTSymptom-modifying effect of chondroitin sulfate in knee osteoarthritis: a meta-analysis of randomized placebo-controlled trials performed with structum(®)2012
A meta-analysis of Structum chondroitin trials found a modest 6 mm reduction in activity pain on visual analog scales versus placebo after 3–6 months.
- Effect
- Benefit
- Duration
- 3–6 months
- Dose
- 1 g/day
- Population
- Healthy adults
RCTChondroitin sulphate reduces both cartilage volume loss and bone marrow lesions in knee osteoarthritis patients starting as early as 6 months after initiation of therapy: a randomised, double-blind, placebo-controlled pilot study using MRI2011n=69
In 69 knee osteoarthritis patients with synovitis, 800 mg/day chondroitin for 6 months reduced cartilage volume loss and bone marrow lesions versus placebo.
- Effect
- Benefit
- Duration
- 6 months
- Dose
- 800 mg/day
- Population
- OA patients
- Participants
- 69
RCTSymptomatic effects of chondroitin 4 and chondroitin 6 sulfate on hand osteoarthritis: a randomized, double-blind, placebo-controlled clinical trial at a single center2011n=82
In 162 hand osteoarthritis patients, chondroitin 4 and 6 sulfate 800 mg/day for 6 months improved hand pain and function versus placebo.
- Effect
- Benefit
- Duration
- 6 months
- Dose
- 800 mg/day
- Population
- OA patients
- Participants
- 82
MetaEffect of glucosamine or chondroitin sulfate on the osteoarthritis progression: a meta-analysis2010n=1,210
A meta-analysis of six long-term trials found glucosamine after 3 years and chondroitin after 2 years significantly slowed minimum joint space narrowing in knee osteoarthritis.
- Effect
- Benefit
- Dose
- 1500 mg/day
- Population
- Children
- Participants
- 1,210
RCTEffectiveness of chondroitin sulphate in patients with concomitant knee osteoarthritis and psoriasis: a randomized, double-blind, placebo-controlled study2010n=129
In 129 knee osteoarthritis patients with psoriasis, 800 mg/day chondroitin sulfate for 3 months improved knee pain and function versus placebo without worsening psoriasis.
- Effect
- Benefit
- Duration
- 3 months
- Dose
- 800 mg/day
- Population
- Healthy adults
- Participants
- 129
MetaStructure-modifying effects of chondroitin sulfate in knee osteoarthritis: an updated meta-analysis of randomized placebo-controlled trials of 2-year duration2010
An updated meta-analysis of three 2-year RCTs found chondroitin sulfate significantly reduced joint space narrowing rate by 0.13 mm versus placebo in knee osteoarthritis.
- Effect
- Benefit
- Population
- Healthy adults
RCTLong-term effects of chondroitins 4 and 6 sulfate on knee osteoarthritis: the study on osteoarthritis progression prevention, a two-year, randomized, double-blind, placebo-controlled trial2009n=313
In 622 knee osteoarthritis patients over 2 years, 800 mg/day chondroitin sulfate significantly slowed joint space narrowing and reduced pain faster than placebo.
- Effect
- Benefit
- Duration
- 2 years
- Dose
- 800 mg/day
- Population
- Healthy adults
- Participants
- 313
RCTGlucosamine, chondroitin sulfate, and the two in combination for painful knee osteoarthritis2006n=1,229
In 1,583 patients with knee osteoarthritis, glucosamine and chondroitin alone or combined did not beat placebo overall for pain relief; combined therapy helped in the moderate-to-severe pain subgroup.
- Effect
- No Benefit
- Duration
- 24 weeks
- Dose
- 1500 mg glucosamine + 1200 mg CS/day
- Population
- OA patients
- Participants
- 1,229
- Ages
- 18–65
RCTChondroitins 4 and 6 sulfate in osteoarthritis of the knee: a randomized, controlled trial2005n=341
In 300 knee osteoarthritis patients over 2 years, 800 mg/day chondroitin sulfate halted joint space narrowing versus progressive loss in the placebo group.
- Effect
- Benefit
- Duration
- 2 years
- Dose
- 800 mg/day
- Population
- Healthy adults
- Participants
- 341
RCTEfficacy of a combination of FCHG49 glucosamine hydrochloride, TRH122 low molecular weight sodium chondroitin sulfate and manganese ascorbate in the management of knee osteoarthritis2000n=72
In 72 patients with mild-to-moderate knee osteoarthritis, a glucosamine, chondroitin, and manganese combination improved pain and function versus placebo over 6 months.
- Effect
- Benefit
- Duration
- 6 months
- Dose
- 152 mg 2×/day
- Population
- Healthy adults
- Participants
- 72
RCTGlucosamine, chondroitin, and manganese ascorbate for degenerative joint disease of the knee or low back: a randomized, double-blind, placebo-controlled pilot study1999n=1,210
In 34 men with knee or low-back degenerative joint disease, glucosamine, chondroitin, and manganese for 16 weeks modestly relieved knee symptoms versus placebo.
- Effect
- Benefit
- Duration
- 16 weeks
- Dose
- 500 mg/day
- Population
- Children
- Participants
- 1,210
RCTChondroitin sulfate: S/DMOAD (structure/disease modifying anti-osteoarthritis drug) in the treatment of finger joint OA1998n=119
In 119 finger osteoarthritis patients, chondroitin sulfate 1,200 mg/day for up to 3 years reduced progression to erosive finger joint disease versus placebo.
- Effect
- Benefit
- Duration
- 3 years
- Dose
- 200 mg/day
- Population
- Healthy adults
- Participants
- 119
RCTComparison of the antiinflammatory efficacy of chondroitin sulfate and diclofenac sodium in patients with knee osteoarthritis1996n=146
In 146 knee osteoarthritis patients, chondroitin sulfate matched diclofenac for symptom relief over 3 months, with benefits persisting up to 3 months after stopping treatment.
- Effect
- Benefit
- Duration
- 3 months
- Dose
- 1200 mg/day
- Population
- Healthy adults
- Participants
- 146
CollagenView supplement →
Reconsider purchase·★★★★★
How we scored this▸
- Collagen supplements may help to improve knee pain in people with knee osteoarthritis and low protein intake.
- UC-II collagen was found to be around twice as effective as chondroitin and glucosamine supplements for reducing pain, stiffness and improving knee function.
Browse 2 studies
RCTA randomized controlled trial on the efficacy and safety of a food ingredient, collagen hydrolysate, for improving joint comfort2009n=250
In 250 knee osteoarthritis patients, 10 g/day collagen hydrolysate for 6 months improved knee comfort on VAS and WOMAC pain subscale, with greatest benefit in those with more joint deterioration and lower meat intake.
- Effect
- Benefit
- Duration
- 6 months
- Dose
- 10 g/day
- Population
- OA patients
- Participants
- 250
RCTSafety and efficacy of undenatured type II collagen in the treatment of osteoarthritis of the knee: a clinical trial2009n=26
In knee OA patients, 40 mg/day undenatured type II collagen for 90 days reduced WOMAC score by 33% and pain VAS by 40%, outperforming glucosamine plus chondroitin.
- Effect
- Benefit
- Duration
- 90 days
- Dose
- 40 mg/day
- Population
- RA patients
- Participants
- 26
- Ages
- 40–75
GlucosamineView supplement →
Reconsider purchase·★★★★★
How we scored this▸
- Taking glucosamine sulfate by mouth at a dose of 1500 mg daily may modestly reduce pain and improve joint function in people with knee osteoarthritis if taken for at least 4 weeks.
- Some studies show glucosamine sulfate can slow cartilage loss in the knee over several years.
- It may provide relief similar to some pain-relieving drugs like ibuprofen but takes longer to work (4–8 weeks).
- Not all glucosamine products work equally; glucosamine sulfate seems better supported by evidence than glucosamine hydrochloride, which may only help when combined with other ingredients like chondroitin.
- Benefits for osteoarthritis in the hip, spine, or hand are uncertain.
- Experts disagree about glucosamine’s effectiveness; some recommend against it, while others support pharmaceutical-grade products.
Browse 50 studies·10 meta-analyses
MetaEvaluation of efficacy and safety of glucosamine sulfate, chondroitin sulfate, and their combination regimen in the management of knee osteoarthritis: a systematic review and meta-analysis2024
A meta-analysis of 25 studies (9 Glucosamine Sulfate [GS], 13 Chondroitin Sulfate [CS], 3 GS + CS) found that chondroitin sulfate improved pain and function, and glucosamine reduced joint space narrowing. The combination treatment did not significantly improve joint space narrowing, knee pain or physical function. [10525]
- Effect
- Benefit
- Dose
- 3 g/day
ObservationalChondroitin sulfate and glucosamine combination in patients with knee and hip osteoarthritis: A long-term observational study in Russia2023n=1,102
In 1,102 knee and hip osteoarthritis patients followed up to 64 weeks, long-term glucosamine plus chondroitin improved pain, function, quality of life, and reduced NSAID use in routine care.
- Effect
- Benefit
- Duration
- 54–64 weeks
- Dose
- 1500 mg glucosamine + 1200 mg CS/day
- Population
- OA patients
- Participants
- 1,102
- Ages
- 45–75
RCTEffects of adding glucosamine or glucosamine combined with chondroitin to exercise on pain and physical function in adults with knee osteoarthritis: a systematic review and meta-analysis2023n=297
A meta-analysis of RCTs found adding glucosamine or glucosamine plus chondroitin to exercise did not significantly improve knee osteoarthritis outcomes beyond exercise alone.
- Effect
- No Benefit
- Dose
- 1500 mg/day
- Population
- Older adults
- Participants
- 297
ObservationalPrescription-grade crystalline glucosamine sulfate as an add-on therapy to conventional treatments in erosive osteoarthritis of the hand: results from a 6-month observational retrospective study2022n=123
In a 6-month observational study of 123 hand osteoarthritis patients, adding prescription glucosamine sulfate 1500 mg/day to conventional therapy improved pain and function versus usual care alone.
- Effect
- Benefit
- Duration
- 6 months
- Dose
- 1500 mg/day
- Population
- Hand OA patients
- Participants
- 123
- Ages
- 48–87
RCTEffect of celecoxib combined with glucosamine hydrochloride in promoting the functional recovery and decreasing the inflammatory factor levels in patients with knee osteoarthritis2021n=128
In an RCT of 128 knee osteoarthritis patients, celecoxib plus glucosamine hydrochloride improved pain and function scores more than celecoxib alone.
- Effect
- Benefit
- Population
- Knee OA patients
- Participants
- 128
Guide2019 American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee2019
The 2019 ACR/Arthritis Foundation guideline conditionally recommends chondroitin sulfate for hand osteoarthritis and advises shared decision-making for other osteoarthritis treatments.
- Population
- Healthy adults
GuideAn updated algorithm recommendation for the management of knee osteoarthritis from the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO)2019
The 2019 ESCEO knee osteoarthritis algorithm recommends non-pharmacological care throughout disease management and assigns graded recommendations to available pharmacologic options.
European chondroitin sulfate and glucosamine food supplements: A systematic quality and quantity assessment compared to pharmaceuticals2019
A systematic quality analysis of European glucosamine and chondroitin supplements found wide variability in labeled content and biological activity across marketed products.
MetaAssociation of Pharmacological Treatments With Long-term Pain Control in Patients With Knee Osteoarthritis: A Systematic Review and Meta-analysis2018n=37
A meta-analysis of 47 long-term randomised controlled trials (duration ≥12 months) found that glucosamine sulfate had an inconsistent effect for pain and joint space narrowing. Celecoxib and glucosamine sulfate were associated with inconsistent benefits for pain. For joint space narrowing, glucosamine had the greatest association with improvement, followed by strontium ranelate and chondroitin sulfate. [10526]
- Effect
- Benefit
- Population
- Knee OA patients
- Participants
- 37
- Ages
- 55–70
MetaEffect of glucosamine and chondroitin sulfate in symptomatic knee osteoarthritis: a systematic review and meta-analysis of randomized placebo-controlled trials2018
A meta-analysis found glucosamine and chondroitin each reduced pain on visual analog scales in knee osteoarthritis, but their combination did not significantly improve WOMAC scores.
- Effect
- Benefit
MetaEffects of glucosamine in patients with osteoarthritis of the knee: a systematic review and meta-analysis2018
A meta-analysis of 18 glucosamine RCTs found marginally favorable pain effects in knee osteoarthritis, though WOMAC function improvements were small and not significant.
- Effect
- Benefit
- Population
- OA patients
RCTCombined Treatment With Chondroitin Sulfate and Glucosamine Sulfate Shows No Superiority Over Placebo for Reduction of Joint Pain and Functional Impairment in Patients With Knee Osteoarthritis: A Six-Month Multicenter, Randomized, Double-Blind, Placebo-Controlled Clinical Trial2017n=174
A study of 174 patients with knee osteoarthritis and moderate-to-severe knee pain found that a combination of glucosamine and chondroitin sulfate was no better than placebo for reducing pain after 6 months. [10527]
- Effect
- No Benefit
- Duration
- 6 months
- Dose
- 1200 mg CS + 1500 mg GS/day
- Population
- Healthy adults
- Participants
- 174
RCTLong-term effects of a lifestyle intervention and oral glucosamine sulphate in primary care on incident knee OA in overweight women2017n=245
In a 6–7 year factorial RCT of 245 overweight women (ages 50–60), lifestyle intervention and oral glucosamine sulfate did not significantly reduce incident knee osteoarthritis versus control.
- Effect
- No Benefit
- Population
- Women
- Participants
- 245
- Ages
- 50–60
RCTCombined chondroitin sulfate and glucosamine for painful knee osteoarthritis: a multicentre, randomised, double-blind, non-inferiority trial versus celecoxib2016n=606
In 606 patients with painful knee osteoarthritis, combined chondroitin and glucosamine was non-inferior to celecoxib for pain and function over 6 months.
- Effect
- Benefit
- Duration
- 6 months
- Dose
- 500 mg 3×/day
- Population
- Healthy adults
- Participants
- 606
RCTThe role of diet and exercise and of glucosamine sulfate in the prevention of knee osteoarthritis: Further results from the PRevention of knee Osteoarthritis in Overweight Females (PROOF) study2016n=204
In the PROOF study of 407 overweight women (ages 50–60), neither diet-exercise program nor glucosamine sulfate 1500 mg/day significantly prevented radiographic knee osteoarthritis over follow-up.
- Effect
- Benefit
- Dose
- 1500 mg/day
- Population
- Women
- Participants
- 204
- Ages
- 50–60
MetaChondroitin for osteoarthritis2015n=17
A Cochrane review of 43 trials found chondroitin modestly improved osteoarthritis pain and function versus placebo, though evidence quality was often low and heterogeneous.
- Effect
- Benefit
- Population
- OA patients
- Participants
- 17
RCTCombined glucosamine and chondroitin sulfate, once or three times daily, provides clinically relevant analgesia in knee osteoarthritis2015n=1,120
In an RCT of 1120 knee OA patients over 16 weeks, glucosamine/chondroitin capsules or sachets three times daily and once daily all similarly reduced pain versus glucosamine hydrochloride/chondroitin.
- Effect
- Benefit
- Duration
- 16 weeks
- Dose
- 400 mg 3×/day
- Population
- Adults
- Participants
- 1,120
MetaEfficacy and safety of glucosamine, diacerein, and NSAIDs in osteoarthritis knee: a systematic review and network meta-analysis2015
A systematic review and network meta-analysis of 31 studies found that glucosamine was beneficial for knee pain and similarly effective to diacerein. Glucosamine carried a lower risk of adverse gastrointestinal side effects compared to diacerein. Neither treatment slowed progression of joint space narrowing in knee osteoarthritis. [10528]
- Effect
- Benefit
- Population
- Adults
RCTGlucosamine and chondroitin for knee osteoarthritis: a double-blind randomised placebo-controlled clinical trial evaluating single and combination regimens2015n=152
A 2-year study including 605 patients (36% obese) with chronic knee pain and joint space narrowing found that neither glucosamine sulfate (1500 mg/day) or chondroitin sulfate (800 mg/day) improved pain or joint space width compared to placebo after 1 year. A combination of 1500 mg/day glucosamine sulfate and 800 mg/day chondroitin sulfate reduced joint space narrowing by 50% compared to placebo after 2 years. [10529]
- Effect
- Benefit
- Duration
- 2 years
- Dose
- 1500 mg/day
- Population
- OA patients
- Participants
- 152
- Ages
- 45–75
RCTEffect of oral glucosamine on joint structure in individuals with chronic knee pain: a randomized, placebo-controlled clinical trial2014n=201
In a 24-week RCT of 201 adults with chronic knee pain, oral glucosamine did not slow MRI-measured cartilage loss versus placebo.
- Effect
- No Benefit
- Duration
- 24 weeks
- Dose
- 1500 mg/day
- Population
- Adults
- Participants
- 201
MetaRisk of bias and brand explain the observed inconsistency in trials on glucosamine for symptomatic relief of osteoarthritis: a meta-analysis of placebo-controlled trials2014n=3,458
A meta-analysis of 25 trials including 3458 participants found that glucosamine sulfate but not glucosamine hydrochloride had an inconsistent but small benefit for pain, with inconsistent benefits in part due to the use of different glucosamine brands/products. The high-quality studies in the meta-analysis with low risk of bias showed little to no benefit for pain. [10530]
- Effect
- Benefit
- Population
- Adults
- Participants
- 3,458
MetaEfficacies of different preparations of glucosamine for the treatment of osteoarthritis: a meta-analysis of randomised, double-blind, placebo-controlled trials2013n=3,159
A meta-analysis of 19 trials including 3159 participants found that glucosamine sulfate did not improve knee pain after 6 months but may improve knee function when taken for longer than 24 weeks. [10531]
- Effect
- No Benefit
- Population
- Knee OA patients
- Participants
- 3,159
RCTEffect of a dietary supplement containing glucosamine hydrochloride, chondroitin sulfate and quercetin glycosides on symptomatic knee osteoarthritis: a randomized, double-blind, placebo-controlled study2012
In a 16-week RCT of 40 Japanese adults with knee OA, a glucosamine-chondroitin-quercetin supplement did not significantly improve WOMAC pain scores versus placebo.
- Effect
- No Benefit
- Duration
- 16 weeks
- Dose
- 1200 mg/day
- Population
- Adults
RCTClinical efficacy and safety of glucosamine, chondroitin sulphate, their combination, celecoxib or placebo taken to treat osteoarthritis of the knee: 2-year results from GAIT2010n=662
In a 2-year RCT of 662 knee OA patients, glucosamine, chondroitin, and their combination did not reduce joint space narrowing or pain more than celecoxib or placebo.
- Effect
- No Benefit
- Duration
- 2 years
- Dose
- 200 mg/day
- Population
- Older adults
- Participants
- 662
RCTEffect of glucosamine on pain-related disability in patients with chronic low back pain and degenerative lumbar osteoarthritis: a randomized controlled trial2010n=125
In a double-blind RCT of 250 adults with chronic low back pain and lumbar OA, glucosamine 1500 mg/day for 6 months did not reduce pain-related disability versus placebo.
- Effect
- No Benefit
- Duration
- 6 months
- Dose
- 1500 mg/day
- Population
- Adults
- Participants
- 125
- Ages
- 25+
MetaEffect of glucosamine or chondroitin sulfate on the osteoarthritis progression: a meta-analysis2010n=1,210
A meta-analysis of 2 studies found that 1500 mg/day glucosamine sulfate had a small to moderate protective effect on joint space narrowing after 3 years but no effect after 1 year of supplementation. [10039]
- Effect
- Benefit
- Dose
- 1500 mg/day
- Population
- Children
- Participants
- 1,210
MetaEffects of glucosamine, chondroitin, or placebo in patients with osteoarthritis of hip or knee: network meta-analysis2010n=3,803
A network meta-analysis of RCTs (3803 patients) found glucosamine and chondroitin did not produce clinically meaningful pain relief in hip or knee osteoarthritis versus placebo.
- Effect
- No Benefit
- Population
- OA patients
- Participants
- 3,803
RCTEffect of glucosamine sulphate on joint space narrowing, pain and function in patients with hip osteoarthritis; subgroup analyses of a randomized controlled trial2009n=222
In a 2-year RCT of 222 hip OA patients, glucosamine sulfate 1500 mg/day did not slow joint space narrowing or improve symptoms in the overall cohort or predefined subgroups.
- Effect
- No Benefit
- Duration
- 2 years
- Dose
- 1500 mg/day
- Population
- OA patients
- Participants
- 222
RCTThe efficacy and tolerability of glucosamine sulfate in the treatment of knee osteoarthritis: A randomized, double-blind, placebo-controlled trial2009n=56
A 24-week study of 56 patients found that glucosamine sulfate (1500 mg/day for 12 weeks) improved resting knee pain at 8-16 weeks (16 weeks = 4 weeks post-treatment), reduced pain during movement at 12-16 weeks and improved physical function at weeks 8-20, but not week 24. Glucosamine sulfate consumption was associated with reduced consumption of analgesic drugs (Acetaminophen or NSAIDs). [10532]
- Effect
- Benefit
- Duration
- 24 weeks
- Dose
- 1500 mg/day
- Population
- Knee OA patients
- Participants
- 56
RCTAdditive effects of glucosamine or risedronate for the treatment of osteoarthritis of the knee combined with home exercise: a prospective randomized 18-month trial2008n=142
In an 18-month RCT of 142 women with knee OA on home exercise, adding glucosamine or risedronate did not improve pain or function beyond exercise alone.
- Effect
- No Benefit
- Duration
- 18 months
- Population
- Knee OA patients
- Participants
- 142
RCTEffect of glucosamine sulfate on hip osteoarthritis: a randomized trial2008n=20
In a 2-year RCT of 222 hip OA patients, glucosamine sulfate 1500 mg/day did not reduce symptoms or slow joint space narrowing versus placebo.
- Effect
- No Benefit
- Duration
- 24 months
- Dose
- 1500 mg/day
- Population
- Hip OA patients
- Participants
- 20
Glucosamine sulfate in osteoarthritis: the jury is still out2008
An editorial review concluded evidence remained insufficient to recommend glucosamine sulfate routinely for osteoarthritis symptom or structure modification.
RCTGlucosamine sulfate in the treatment of knee osteoarthritis symptoms: a randomized, double-blind, placebo-controlled study using acetaminophen as a side comparator2007n=108
Randomized double-blind placebo-controlled trial (with acetaminophen as side comparator) demonstrating that glucosamine sulfate significantly reduced knee osteoarthritis symptoms over placebo. A 6-month study including 318 patients with moderate knee osteoarthritis (~11 Lequesne Score) given either acetaminophen (3 g/day) or glucosamine sulfate (1500 mg/day) found that only glucosamine sulfate had a significant benefit for osteoarthritis symptoms compared to placebo treatment. Glucosamine sulfate significantly reduced Lequesne score by 3.1 points versus 1.9 with placebo. Acetaminophen reduced Lequesne score by 2.7 points but this was not statistically significant (P=0.18). [10534]
- Effect
- Benefit
- Duration
- 6 months
- Dose
- 3 g/day
- Population
- Knee OA patients
- Participants
- 108
RCTGlucosamine/chondroitin combined with exercise for the treatment of knee osteoarthritis: a preliminary study2007n=89
In a 12-month RCT of 89 older adults with knee OA, glucosamine/chondroitin 1500/1200 mg added to exercise did not improve physical function or pain beyond exercise and placebo.
- Effect
- No Benefit
- Duration
- 6 months
- Dose
- 1500 mg/day
- Population
- Older adults
- Participants
- 89
- Ages
- ≥50
RCTGlucosamine, chondroitin sulfate, and the two in combination for painful knee osteoarthritis2006n=1,229
In 1,583 patients with knee osteoarthritis, glucosamine and chondroitin alone or combined did not beat placebo overall for pain relief; combined therapy helped in the moderate-to-severe pain subgroup.
- Effect
- No Benefit
- Duration
- 24 weeks
- Dose
- 1500 mg glucosamine + 1200 mg CS/day
- Population
- OA patients
- Participants
- 1,229
- Ages
- 18–65
MetaGlucosamine long-term treatment and the progression of knee osteoarthritis: systematic review of randomized controlled trials2005n=414
A review of 2 randomised controlled studies including 414 patients with knee osteoarthritis found that 1500 mg/day glucosamine sulfate reduced disease progression (joint space narrowing) by 54% compared to placebo. Both studies lasted 3 years. [10535]
- Effect
- Benefit
- Duration
- 3 years
- Dose
- 1500 mg/day
- Population
- Knee OA patients
- Participants
- 414
MetaGlucosamine therapy for treating osteoarthritis2005n=2,570
A manufacturer-funded review of studies found that a dose of around 1,500 mg/day glucosamine sulfate taken for up to 3 years had inconsistent benefits for pain, with greater benefits found in Rotta preparation of glucosamine and no benefit from non-Rotta preparation. Rotta preparations were found in two studies to slow progression of osteoarthritis of the knee. In a total of four studies, Rotta preparation was shown to be superior to NSAIDs in two studies and equivalent in the other two. [10536]
- Effect
- No Benefit
- Dose
- 500 mg/day
- Population
- Adults
- Participants
- 2,570
RCTA randomized, double blind, placebo controlled trial of a topical cream containing glucosamine sulfate, chondroitin sulfate, and camphor for osteoarthritis of the knee2004
In a double-blind RCT, a topical cream containing glucosamine sulfate, chondroitin sulfate, and camphor did not significantly reduce knee osteoarthritis pain versus placebo.
- Effect
- No Benefit
RCTGlucosamine sulfate reduces osteoarthritis progression in postmenopausal women with knee osteoarthritis: evidence from two 3-year studies2004n=414
A combination of two independent, three-year randomised controlled studies examined the effects of glucosamine sulfate in a total of 414 patients (319 postmenopausal women). Postmenopausal women taking placebo experienced an average joint space narrowing of -0.33 mm whilst there was no change in women taking glucosamine sulfate after 3 years. [10537]
- Effect
- Benefit
- Population
- Postmenopausal women
- Participants
- 414
RCTA randomized, double blind, placebo controlled trial of a topical cream containing glucosamine sulfate, chondroitin sulfate, and camphor for osteoarthritis of the knee2003
In an 8-week double-blind RCT of 63 knee OA patients, a topical glucosamine-chondroitin preparation reduced VAS pain scores more than placebo.
- Effect
- Benefit
- Duration
- 8 weeks
- Population
- Adults
RCTA randomized, double-blind, placebo-controlled trial of glucosamine sulphate as an analgesic in osteoarthritis of the knee2002n=80
A 6-month study including 80 patients with osteoarthritis of the knee found glucosamine sulfate (1500 mg/day) did not affect global assessment of knee pain compared to placebo. [10539]
- Effect
- No Benefit
- Duration
- 6 months
- Dose
- 1500 mg/day
- Population
- OA patients
- Participants
- 80
RCTGlucosamine sulfate use and delay of progression of knee osteoarthritis: a 3-year, randomized, placebo-controlled, double-blind study2002n=202
A 3-year study of 202 patients with mild-to-moderate knee osteoarthritis (average joint space narrowing width ~ 4mm, Lequesne index score < 9 pts) found that 1500 mg/day glucosamine sulfate slowed progression of joint space narrowing and improved symptoms of pain and stiffness. Around 30% to 40% of patients took acetaminophen (500 mg) at or above the average of once every 3 days, without any effect on joint structure or osteoarthritis symptoms. [10538]
- Effect
- Benefit
- Duration
- 3 years
- Dose
- 1500 mg/day
- Population
- Knee OA patients
- Participants
- 202
RCTLong-term effects of glucosamine sulphate on osteoarthritis progression: a randomised, placebo-controlled clinical trial2001n=212
A 3-year randomized trial showing that long-term glucosamine sulfate slowed radiographic knee osteoarthritis progression and improved symptoms versus placebo. A 3-year study of 212 patients with knee osteoarthritis found that 1500 mg glucosamine sulfate per day slowed joint space narrowing compared to placebo. There was minimal joint space loss in 106 patients taking glucosamine sulfate (-0.06 mm, 95% CI -0.22 to 0.09) compared to placebo (-0.31 mm, -0.48 to -0.13) after 3 years. [10540]
- Effect
- Benefit
- Duration
- 3 years
- Dose
- 1500 mg/day
- Population
- Knee OA patients
- Participants
- 212
Analysis of glucosamine and chondroitin sulfate content in marketed products and the Caco-2 permeability of chondroitin sulfate raw materials2000
A product analysis found large variability in glucosamine and chondroitin content across marketed osteoarthritis supplements compared with pharmaceutical formulations.
RCTEfficacy of a combination of FCHG49 glucosamine hydrochloride, TRH122 low molecular weight sodium chondroitin sulfate and manganese ascorbate in the management of knee osteoarthritis2000n=72
In 72 patients with mild-to-moderate knee osteoarthritis, a glucosamine, chondroitin, and manganese combination improved pain and function versus placebo over 6 months.
- Effect
- Benefit
- Duration
- 6 months
- Dose
- 152 mg 2×/day
- Population
- Healthy adults
- Participants
- 72
RCTRandomized, controlled trial of glucosamine for treating osteoarthritis of the knee2000n=49
A 60-day study including 89 patients found that 1500 mg/day glucosamine sulfate was not significantly effective for reducing pain at rest and during walking exercise. The patients were sourced from a Veterans’ medical centre. [10541]
- Effect
- No Benefit
- Duration
- 60 days
- Dose
- 1500 mg/day
- Population
- Adults
- Participants
- 49
- Ages
- 34–81
RCTGlucosamine, chondroitin, and manganese ascorbate for degenerative joint disease of the knee or low back: a randomized, double-blind, placebo-controlled pilot study1999n=1,210
In 34 men with knee or low-back degenerative joint disease, glucosamine, chondroitin, and manganese for 16 weeks modestly relieved knee symptoms versus placebo.
- Effect
- Benefit
- Duration
- 16 weeks
- Dose
- 500 mg/day
- Population
- Children
- Participants
- 1,210
RCTEfficacy and safety of glucosamine sulfate versus ibuprofen in patients with knee osteoarthritis1998n=178
A 4-week study of 178 patients with knee osteoarthritis given either 1500 mg/day glucosamine sulfate or 1200 mg/day ibuprofen found similar reductions in pain after 2 and 4 weeks. Dropout rates were greater in the group taking ibuprofen (10%) compared to glucosamine (0%). [10542]
- Effect
- Benefit
- Duration
- 4 weeks
- Dose
- 1500 mg/day
- Population
- Knee OA patients
- Participants
- 178
RCTEfficacy and safety of intramuscular glucosamine sulfate in osteoarthritis of the knee. A randomised, placebo-controlled, double-blind study1994n=73
In a 6-week double-blind RCT of 155 knee OA outpatients, intramuscular glucosamine sulfate was at least as effective as oral glucosamine and superior to placebo for pain and function.
- Effect
- Benefit
- Duration
- 6 weeks
- Dose
- 1500 mg/day
- Population
- Knee OA patients
- Participants
- 73
RCTGlucosamine sulfate compared to ibuprofen in osteoarthritis of the knee1994n=200
A 4-week study of 200 hospitalised patients with knee osteoarthritis given either 1500 mg/day glucosamine sulfate or 1200mg/day ibuprofen found similar benefits in pain reduction after 2 weeks. However, after one week of supplementation, only around 28% of those taking glucosamine sulfate had a reduction in pain compared to 48% in those taking ibuprofen. Glucosamine sulfate was better tolerated with a 700% reduction in dropout rates and had a 500% reduction in adverse events. [10543]
- Effect
- Benefit
- Duration
- 4 weeks
- Dose
- 1500 mg/day
- Population
- Knee OA patients
- Participants
- 200
Fish OilView supplement →
Reconsider purchase·★★★★★
How we scored this▸
- Taking fish oil by mouth usually does not help with pain or joint function in osteoarthritis (OA).
- In some studies, lower doses of fish oil worked better than higher doses, possibly due to placebo effects.
- Taking fish oil with glucosamine does not give extra relief.
- One large study found no improvement in knee pain after taking fish oil for over 5 years.
- Most guidelines advise against using fish oil for OA pain in knees, hips, or hands.
- However, fish oil might help reduce joint pain in overweight older people with OA, with one study showing about 42% less pain after 16 weeks.
Browse 8 studies·1 meta-analysis
MetaEffect of omega-3 on painful symptoms of patients with osteoarthritis of the synovial joints: systematic review and meta-analysis2021n=454
A meta-analysis of 6 RCTs including 454 patients with osteoarthritis found in 4 studies that omega-3 fatty acids may reduce pain compared to placebo. [10626]
- Effect
- Benefit
- Population
- OA patients
- Participants
- 454
Guide2019 American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee2020
The American College of Rheumatology/Arthritis Foundation conditionally recommends against the use of fish oil in patients with knee, hip or hand OA. [10627]
- Population
- Healthy adults
RCTFish oil supplementation reduces osteoarthritis-specific pain in older adults with overweight/obesity2020
In 152 sedentary overweight/obese older adults over 16 weeks, fish oil 2,000 mg DHA + 400 mg EPA significantly reduced osteoarthritis-specific pain (P=0.002, d=0.56) and OA burden versus placebo.
- Effect
- Benefit
- Duration
- 16 weeks
- Dose
- 2000 mg/day
- Population
- Older adults
- Ages
- 50–80
RCTThe Effects of Vitamin D and Marine Omega-3 Fatty Acid Supplementation on Chronic Knee Pain in Older US Adults: Results From a Randomized Trial2020n=1,398
A large randomized trial found no significant benefit of vitamin D or omega-3 supplementation on chronic knee pain outcomes in older adults. A study of 1398 participants from the United States taking 1 g/day Omacor (365 mg DHA + 475 mg EPA) or placebo for an average of 5.3 years found no reductions in knee stiffness, function or pain. [10704]
- Effect
- No Benefit
- Dose
- 1 g/day
- Population
- Women
- Participants
- 1,398
- Avg age
- ~68
RCTFish oil in knee osteoarthritis: a randomised clinical trial of low dose versus high dose2016n=202
A 24-month multicentre trial of 202 patients with knee osteoarthritis and regular knee pain given either high-dose fish oil (4.5 g omega-3 fatty acids) or low-dose fish oil blend (fish oil and sunola oil; 1:9, 0.45 omega-3 fatty acids) found that the low-dose group had a greater improvement in WOMAC pain and function scores at 2 but not 1 years. There were no differences in cartilage volume loss or use of pain medication between treatment groups. [10628]
- Effect
- Benefit
- Duration
- 24 months
- Dose
- 15 mL/day
- Population
- Knee OA patients
- Participants
- 202
RCTA randomized, double-blinded, placebo-controlled study of the effect of a combination of lemon verbena extract and fish oil omega-3 fatty acid on joint management2011n=45
In 45 adults with joint discomfort over 9 weeks, a lemon verbena plus fish oil supplement significantly improved WOMAC and Lequesne pain and function scores weekly versus placebo.
- Effect
- Benefit
- Duration
- 9 weeks
- Population
- Adults
- Participants
- 45
RCTEffect of glucosamine sulfate with or without omega-3 fatty acids in patients with osteoarthritis2009n=177
A randomized trial where glucosamine plus omega-3 provided greater pain reduction than glucosamine alone in OA patients. A 6-month study including 177 patients with moderate to severe hip or knee arthritis found that a combination of fish oil and glucosamine sulfate (200 mg omega-3 fatty acids & 500 mg glucosamine sulfate 3 times per day) led to a non-significant greater reduction in morning stiffness and pain over time compared to glucosamine sulfate alone. [10629]
- Effect
- Benefit
- Duration
- 6 months
- Dose
- 1500 mg/day
- Population
- OA patients
- Participants
- 177
RCTPhytalgic, a food supplement, vs placebo in patients with osteoarthritis of the knee or hip: a randomised double-blind placebo-controlled clinical trial2009n=81
In 81 knee/hip osteoarthritis patients over 3 months, Phytalgic (fish oil, vitamin E, nettle) reduced analgesic use to 6.5 versus 16.5 paracetamol-equivalent tablets/week and lowered WOMAC dysfunction versus placebo.
- Effect
- Benefit
- Duration
- 3 months
- Population
- OA patients
- Participants
- 81
- Ages
- 40–80
ResveratrolView supplement →
Reconsider purchase·★★★★★
How we scored this▸
- It is unclear if resveratrol helps with knee osteoarthritis.
- One study found low doses of resveratrol did not improve pain or knee function.
- However, another study showed that higher doses of resveratrol combined with exercise therapy and a pain medicine (meloxicam) reduced pain and stiffness after three months.
Browse 3 studies·1 meta-analysis
RCTOral resveratrol in adults with knee osteoarthritis: A randomized placebo-controlled trial (ARTHROL)2024n=649
In knee osteoarthritis patients, oral resveratrol in a patented formulation did not significantly reduce pain versus placebo in the ARTHROL phase 3 trial.
- Effect
- No Benefit
- Duration
- 6 months
- Dose
- 40–80 mg/day resveratrol
- Population
- Women
- Participants
- 649
- Avg age
- ~61
MetaResveratrol may mildly improve renal function in the general adult population: A systematic review and meta-analysis of randomized controlled clinical trials2023
A meta-analysis found resveratrol supplementation produced small improvements in estimated glomerular filtration rate versus placebo in general adult populations.
- Effect
- Benefit
- Dose
- 500 mg/day
- Population
- Adults
RCTEfficacy and safety of co-administration of resveratrol with meloxicam in patients with knee osteoarthritis: a pilot interventional study2018n=110
In 110 knee osteoarthritis patients, resveratrol as meloxicam adjunct reduced pain and improved function versus meloxicam alone over 90 days.
- Effect
- Benefit
- Duration
- 90 days
- Dose
- 500 mg/day
- Population
- Patients with osteoarthritis
- Participants
- 110
L-CarnitineView supplement →
Reconsider purchase·★★★★★
How we scored this▸
- In women with knee osteoarthritis who were overweight or on a low-calorie diet, taking L-carnitine (1 g daily for 12 weeks) did not reduce pain, stiffness, or improve movement compared with placebo.
Browse 3 studies
RCTThe effect of L-Carnitine supplementation on clinical symptoms, C-reactive protein and malondialdehyde in obese women with knee osteoarthritis: a double blind randomized controlled trial2021n=38
In 76 obese women with knee osteoarthritis on a low-calorie diet, 12 weeks of L-carnitine 1 g/day improved BMI (−1.21 vs −0.79) but did not significantly improve WOMAC scores, CRP, or MDA versus placebo.
- Effect
- No Benefit
- Duration
- 12 weeks
- Dose
- 1 g/day
- Population
- Women
- Participants
- 38
- Ages
- 45+
RCTEffects of l-Carnitine Supplementation on Serum Inflammatory Factors and Matrix Metalloproteinase Enzymes in Females with Knee Osteoarthritis: A Randomized, Double-Blind, Placebo-Controlled Pilot Study2016n=36
In 69 women with knee osteoarthritis, 8 weeks of L-carnitine 750 mg/day significantly reduced serum IL-1β and MMP-1 and lowered VAS pain scores by 52.7% versus 21.8% with placebo.
- Effect
- Benefit
- Duration
- 8 weeks
- Dose
- 750 mg/day
- Population
- Women
- Participants
- 36
RCTEffect of l-carnitine supplementation on clinical symptoms in women with osteoarthritis of the knee: A randomized, double-blind, placebo-controlled trial2015
A randomized double-blind trial in women with knee osteoarthritis given 750 mg/day L-carnitine for 8 weeks showed improvements in WOMAC pain, stiffness, and physical function scores versus placebo.
- Duration
- 8 weeks
- Dose
- 750 mg/day
- Population
- Women
ApigeninView supplement →
Reconsider purchase·★★★★★
How we scored this▸
- Applying chamomile oil to the skin three times a day (1.5 ml each time) helped reduce pain and improve movement in people with mild to moderate knee osteoarthritis.
- It lowered the need for extra pain medicine like acetaminophen more than diclofenac or a placebo.
- Pain dropped by 25%, movement improved by 10%, and stiffness decreased by nearly 17%.
- Chamomile oil could be a helpful natural option instead of oral NSAIDs for osteoarthritis relief.
Browse 1 study
RCTEfficacy and safety of topical Matricaria chamomilla L. (chamomile) oil for knee osteoarthritis: A randomized controlled clinical trial2015
A study including 84 middle-aged or older patients with knee osteoarthritis (grade 1 to 3 Kellgren-Lawrence Grading Scale) found that topical chamomile oil (~1.5 ml 3 times per day for 3 weeks) was superior to diclofenac and placebo for reducing the use of rescue medication (500 mg acetaminophen). The chamomile group (21.00 ± 10.35) used a significantly lower number of acetaminophen tablets compared to the diclofenac group (28.14 ± 4.90) or placebo (27.46 ± 7.10) over 3-weeks. Chamomile oil led to significant improvements in pain (25.37%), physical function (10.05%) and stiffness (16.86%) and was comparable to diclofenac or placebo.
- Effect
- Benefit
- Duration
- 3 weeks
- Population
- Patients with osteoarthritis
AshwagandhaView supplement →
Reconsider purchase·★★★★★
How we scored this▸
- It is uncertain if ashwagandha helps osteoarthritis by itself.
- One study found that taking a supplement combining ashwagandha, zinc, guggul, and turmeric for 3 months reduced joint pain and swelling better than placebo.
- The study didn’t show any changes in joint X-rays, and it’s unclear which ingredient caused the benefit.
Browse 1 study
RCTTreatment of osteoarthritis with a herbomineral formulation: a double-blind, placebo-controlled, cross-over study1991n=42
In 42 osteoarthritis patients, herbomineral Articulin-F containing ashwagandha reduced pain and disability versus placebo over a crossover trial, without radiographic change.
- Effect
- Benefit
- Population
- OA patients
- Participants
- 42
Cissus QuadrangularisView supplement →
Reconsider purchase·★★★★★
How we scored this▸
- No summary is available.
Browse 1 study
RCTCissus quadrangularis reduces joint pain in exercise-trained men: a pilot study2013
In 29 exercise-trained men over 8 weeks, Cissus quadrangularis 3,200 mg/day reduced joint pain scores by about 31% on the WOMAC index.
- Effect
- Benefit
- Duration
- 8 weeks
- Dose
- 200 mg/day
- Population
- Older adults
- Ages
- 20–46
EleutheroView supplement →
Reconsider purchase·★★★★★
How we scored this▸
- In a study of people with knee osteoarthritis, taking two capsules a day (each with 400 mg of a mix of eleuthero, Panax pseudoginseng, and rehmannia) for six weeks helped improve physical function compared to a placebo.
- However, this product did not reduce knee pain or stiffness.
- It is not known if the benefit came from eleuthero, the other herbs, or the combination.
Browse 1 study
RCTEffects of AIF on Knee Osteoarthritis Patients: Double-blind, Randomized Placebo-controlled Study2009n=57
In 57 Korean knee OA patients over 6 weeks, 800 mg/day AIF (Panax notoginseng, Rehmannia, eleuthero) significantly reduced pain (VAS) and improved WOMAC physical function versus placebo.
- Effect
- Benefit
- Dose
- 800 mg/day
- Population
- OA patients
- Participants
- 57
- Ages
- 43–73
FlaxseedView supplement →
Reconsider purchase·★★★★★
How we scored this▸
- In people with hand osteoarthritis already using their regular treatments, applying a flaxseed poultice compress once a day for 7 days helped reduce pain by about two-thirds and improved hand use by a similar amount.
- Some of these benefits lasted for at least a week after stopping the compress.
Browse 1 study
RCTEffect of flaxseed poultice compress application on pain and hand functions of patients with hand osteoarthritis2019n=33
In a 7-day RCT of hand osteoarthritis patients, flaxseed poultice compress reduced pain and improved hand function versus hot compress or control, alongside routine pharmacotherapy.
- Effect
- Benefit
- Duration
- 7 days
- Population
- OA patients
- Participants
- 33
GarlicView supplement →
Reconsider purchase·★★★★★
How we scored this▸
- Taking garlic tablets twice daily for 12 weeks may help reduce knee pain in overweight or obese women with osteoarthritis.
- Garlic may work by lowering inflammation linked to joint pain.
- Studies show it can ease pain and stiffness, helping improve comfort during daily activities.
- Garlic supplements are generally safe, but more research is needed for stronger proof.
Browse 1 study
RCTThe effect of a garlic supplement on the pro-inflammatory adipocytokines, resistin and tumor necrosis factor-alpha, and on pain severity, in overweight or obese women with knee osteoarthritis2018
In 80 overweight women with knee osteoarthritis, garlic 2000 mg/day for 12 weeks reduced pain severity and serum TNF-α and resistin versus placebo.
- Effect
- Benefit
- Duration
- 12 weeks
- Dose
- 2000 mg/day
- Population
- Women
- Ages
- 50–75
NattokinaseView supplement →
Reconsider purchase·★★★★★
How we scored this▸
- There is not enough evidence to determine if nattokinase has any benefit for osteoarthritis.
Browse 1 study
RCTSoy protein may alleviate osteoarthritis symptoms2004n=71
In 135 adults with knee symptoms, 40 g/day soy protein for 3 months improved osteoarthritis range of motion and pain-related biomarkers vs milk protein, though group differences were modest.
- Effect
- Benefit
- Duration
- 3 months
- Dose
- 40 g/day
- Population
- RA patients
- Participants
- 71
Panax GinsengView supplement →
Reconsider purchase·★★★★★
How we scored this▸
- It is not clear if taking Panax ginseng helps with hand osteoarthritis.
- A small study in postmenopausal adults showed that Korean red ginseng taken three times a day for 12 weeks reduced pain and improved hand function compared to placebo.
- However, more studies are required to ensure that these findings are accurate.
Browse 1 study
RCTClinical Effects of Korean Red Ginseng in Postmenopausal Women With Hand Osteoarthritis: A Double-Blind, Randomized Controlled Trial2021n=52
In 52 postmenopausal women with hand osteoarthritis, red ginseng 3 g/day for 12 weeks improved pain and DASH scores and raised antioxidant enzyme activity versus placebo.
- Effect
- Benefit
- Duration
- 12 weeks
- Dose
- 3 g/day
- Population
- Postmenopausal women
- Participants
- 52
Vitamin DView supplement →
Reconsider purchase·★★★★★
How we scored this▸
- It is unclear if taking vitamin D helps people with osteoarthritis.
- Some studies show that taking 2000 IU daily or raising vitamin D levels for two years does not reduce knee pain or cartilage loss.
- But another study found that starting with a higher dose and then taking 60,000 IU monthly for a year slightly reduced pain and improved movement in people with low vitamin D. Because the evidence is mixed and not very strong, experts advise against using vitamin D to treat osteoarthritis.
Browse 3 studies
Guide2019 American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee2020
The 2019 ACR/Arthritis Foundation guideline conditionally recommends chondroitin sulfate for hand osteoarthritis and advises shared decision-making for other osteoarthritis treatments.
- Population
- Healthy adults
RCTDoes vitamin D improve osteoarthritis of the knee: a randomized controlled pilot trial2013n=107
In a 1-year pilot RCT of 107 knee OA patients with vitamin D insufficiency, vitamin D supplementation reduced pain and improved function versus placebo on VAS and WOMAC scores.
- Effect
- Benefit
- Duration
- 1 year
- Population
- OA patients
- Participants
- 107
RCTEffect of vitamin D supplementation on progression of knee pain and cartilage volume loss in patients with symptomatic osteoarthritis: a randomized controlled trial2013n=146
In a 2-year RCT of 146 knee osteoarthritis patients, 2,000 IU/day cholecalciferol raised 25(OH)D above 36 ng/mL but did not reduce pain or cartilage volume loss versus placebo.
- Effect
- No Benefit
- Duration
- 2 years
- Dose
- 2000 IU/day
- Population
- Women
- Participants
- 146
- Ages
- 62+
Alpha-Lipoic AcidView supplement →
Reconsider purchase·★★★★★
How we scored this▸
- It is not clear if alpha-lipoic acid helps with pain due to osteoarthritis.
- A small study found that taking 600 mg daily for 6 weeks, along with usual treatment like pain relievers, improved pain and function according to patients.
- But the results are not certain and might not be very meaningful.
Browse 1 study
Exploring the Efficacy of Alpha-Lipoic Acid in Comorbid Osteoarthritis and Type 2 Diabetes Mellitus2024n=37
In 37 patients with osteoarthritis plus type 2 diabetes, alpha-lipoic acid 600 mg/day for 6 weeks significantly improved WOMAC pain, Lequesne, and AIMS-P scores versus control.
- Effect
- Benefit
- Duration
- 6 weeks
- Dose
- 600 mg/day
- Population
- Patients with type 2 diabetes
- Participants
- 37
- Ages
- 29–78
ArnicaView supplement →
Reconsider purchase·★★★★★
How we scored this▸
- Arnica gel applied to joints may help reduce pain, stiffness, and improve function in people with mild to moderate osteoarthritis.
- Studies show that it works about as well as ibuprofen cream, although some people report skin irritation as a common side effect.
Browse 2 studies
RCTChoosing between NSAID and arnica for topical treatment of hand osteoarthritis in a randomised, double-blind study2007n=204
In 204 hand osteoarthritis patients over 21 days, topical arnica gel was not inferior to 5% ibuprofen gel for pain relief and hand function, with similar adverse event rates (~5–6%).
- Effect
- Benefit
- Duration
- 21 days
- Dose
- 50 g/day
- Population
- OA patients
- Participants
- 204
Open-labelArnica montana gel in osteoarthritis of the knee: an open, multicenter clinical trial2003n=69
An open-label trial in 79 mild-to-moderate knee OA patients found twice-daily Arnica montana gel for 6 weeks significantly improved WOMAC pain, stiffness, and function scores.
- Effect
- Benefit
- Duration
- 6 weeks
- Population
- Patients with osteoarthritis
- Participants
- 69
Vitamin EView supplement →
Do not purchase·★★★★★
How we scored this▸
- Taking 500 IU of vitamin E daily for 6 months does not lessen pain or stiffness in people with osteoarthritis.
- Studies show that taking vitamin E for up to 2 years doesn’t delay cartilage loss.
- Vitamin E supplements don’t lower the chance of getting osteoarthritis or slow disease progression if you already have it.
Browse 3 studies
RCTSupplementary vitamin E does not affect the loss of cartilage volume in knee osteoarthritis: a 2 year double blind randomized placebo controlled study2002n=136
In an RCT of 136 participants, 500 IU/day, for 2 years, there were no significant differences between the vitamin E and placebo treated groups in improvement of symptoms from baseline.
- Effect
- No Benefit
- Duration
- 2 years
- Dose
- 500 IU/day
- Population
- Women
- Participants
- 136
RCTVitamin E is ineffective for symptomatic relief of knee osteoarthritis: a six month double blind, randomised, placebo controlled study2001n=77
In an RCT of 77 participants, 500 IU/day, radiological score, exercise score, age, or antioxidant intake at baseline or six months did not differ between the groups.
- Effect
- No Benefit
- Dose
- 500 IU/day
- Population
- Patients with knee osteoarthritis
- Participants
- 77
ObservationalDo antioxidant micronutrients protect against the development and progression of knee osteoarthritis?1996n=40
In an observational study of 40 participants, odds ratios (OR) were adjusted for age, sex, body mass index, weight change, knee injury, physical activity, energy intake, and health status.
- Effect
- Benefit
- Participants
- 40
SeleniumView supplement →
Do not purchase·★★★★★
How we scored this▸
- It is not known if selenium alone helps osteoarthritis.
- One small study found that a supplement containing selenium and other ingredients did not improve arthritis symptoms better than a placebo.
Browse 1 study
Controlled trialFailure of selenium-ace to improve osteoarthritis1990
In osteoarthritis patients over 6 months, Selenium-ACE did not outperform placebo on joint symptoms, though both groups showed nonsignificant improvement trends.
- Effect
- No Benefit
- Duration
- 6 months
- Population
- OA patients
Vitamin AView supplement →
Do not purchase·★★★★★
How we scored this▸
- Vitamin A has only been tested together with other vitamins and minerals for osteoarthritis.
- One study found that a supplement with vitamin A, selenium, vitamin C, and vitamin E did not help reduce osteoarthritis symptoms compared to a placebo.
- It is unknown if vitamin A alone would be beneficial.
Browse 1 study
Controlled trialFailure of selenium-ace to improve osteoarthritis1990
In osteoarthritis patients over 6 months, Selenium-ACE did not outperform placebo on joint symptoms, though both groups showed nonsignificant improvement trends.
- Effect
- No Benefit
- Duration
- 6 months
- Population
- OA patients
Evidence visualised
Same ratings as above, aggregated so you can see coverage and imbalance.
| Supplement | DEX | Studies | Meta-analyses | Share |
|---|---|---|---|---|
| Glucosamine | ★★★★★56% | 50 | 10 | 24% |
| Curcumin | ★★★★★68% | 35 | 5 | 17% |
| Chondroitin Sulfate | ★★★★★56% | 32 | 9 | 16% |
| Boswellia | ★★★★★68% | 17 | 2 | 8% |
| Ginger | ★★★★★68% | 16 | 2 | 8% |
| SAMe | ★★★★★68% | 12 | 1 | 6% |
| Fish Oil | ★★★★★52% | 8 | 1 | 4% |
| Devil's Claw | ★★★★★68% | 7 | 0 | 3% |
| L-Carnitine | ★★★★★48% | 3 | 0 | 1% |
| Resveratrol | ★★★★★52% | 3 | 1 | 1% |
| Vitamin D | ★★★★★44% | 3 | 0 | 1% |
| Vitamin E | ★★★★★36% | 3 | 0 | 1% |
| Arnica | ★★★★★40% | 2 | 0 | <1% |
| Collagen | ★★★★★56% | 2 | 0 | <1% |
| Alpha-Lipoic Acid | ★★★★★40% | 1 | 0 | <1% |
| Apigenin | ★★★★★44% | 1 | 0 | <1% |
| Ashwagandha | ★★★★★44% | 1 | 0 | <1% |
| Cissus Quadrangularis | ★★★★★44% | 1 | 0 | <1% |
| Eleuthero | ★★★★★44% | 1 | 0 | <1% |
| Flaxseed | ★★★★★44% | 1 | 0 | <1% |
| Garlic | ★★★★★44% | 1 | 0 | <1% |
| Nattokinase | ★★★★★44% | 1 | 0 | <1% |
| Panax Ginseng | ★★★★★44% | 1 | 0 | <1% |
| Probiotics | ★★★★★64% | 1 | 1 | <1% |
| Selenium | ★★★★★28% | 1 | 0 | <1% |
| Vitamin A | ★★★★★28% | 1 | 0 | <1% |