The Arthritis Foundation says that more than 50 million adults suffer from arthritis. That’s one in five people.
No wonder arthritis is the number-one cause of disability, and it’s not getting any better. The Centers for Disease Control and Prevention (CDC) predicts that by the year 2040, about 78 million adults will have doctor-diagnosed arthritis.
Common treatments include over-the-counter pain medications, ointments, biologic drugs and corticosteroids as well as physical therapy and joint replacement surgery. Pain medications have side effects, however, and ointments can only do so much. Most want to put off surgery for as long as possible and wonder if there another alternative.
Fortunately, there are some natural supplements that have shown in scientific studies to be effective against joint pain and degradation. We’ve got the top six here.
1. Green-lipped Mussel
The green-lipped mussel is a type of shellfish from New Zealand. Shellfish, in general, are rich in omega-3 fatty acids, which help reduce inflammation. You may have heard that taking fish oil is a good idea if you have arthritis, but studies suggest that Perna canaliculus, the extract from the green-lipped mussel, may be even more effective.
In a 2011 study, for instance, researchers gave patients with arthritis fish oil or green-lipped mussel extract. Then, they gathered data after four, eight and 12 weeks of treatment. The results showed that patients treated with Perna canaliculus showed a statistically significant improvement of both pain and quality of life. Better yet, they experienced no side effects.
Patients taking the fish oil, on the other hand, showed significantly less improvement and a greater level of physical discomfort caused by side effects.
“Given the potential side effects, large dosages needed and long duration required for fish oil,” the researchers wrote, “practitioners could consider stabilized Perna canaliculus oil as a safer and faster acting first-line medication for patients who suffer from osteoarthritis.”
Other studies have shown similar results and have found that this extract can help ease stomach discomfort. This is a big plus, as many patients with arthritis take a lot of medications that can cause stomach upset.
In 2012, researchers reported that green-lipped mussel significantly improved knee joint pain, stiffness and mobility and that it also significantly improved gastrointestinal symptoms by 49 percent in arthritis patients.
Scientists aren’t sure why the extract works, but they believe that the anti-inflammatory action works to improve joint pain. The extract is also a rich source of glycosaminoglycans—including chondroitin sulfate, which has long been used in natural joint relief.
Even more good news: The New Zealand green-lipped mussel has been ranked among the top eco-friendly seafood, according to the Blue Ocean Institute.
The commonly recommended dose for easing arthritis pain is between 1,050 milligrams and 2,100 milligrams daily of the freeze-dried powder or 210 milligrams daily of the lipid extract.
2. Chondroitin Sulfate
This supplement is already included in many joint products and for good reason. It’s a natural substance that’s a major component of cartilage. It also helps build connective tissues that support joints and is involved in joint lubrication.
For supplements, chondroitin is made from either the cartilage of animals or in the laboratory. The laboratory-made version is made of chondroitin and mineral salts that help improve absorption.
As we age, the body’s production of chondroitin starts to slow, so it makes sense that replenishing it might help. Studies have found this to be true. The Mayo Clinic states that chondroitin is most often used to treat osteoarthritis, particularly of the knee. The Arthritis Foundation states that it seems to enhance the “shock-absorbing” properties of collagen and protect cartilage from breakdown. When used together with glucosamine, it may reverse cartilage loss.
The largest study on chondroitin sulfate was published in 2006 and involved 1,600 people with knee osteoarthritis. Those treated with glucosamine and chondroitin experienced significant pain relief. In a later 2010 study, the combination supplement was found to be just as effective as the prescription painkiller Celebrex (celecoxib).
The commonly recommended dose of chondroitin for joint pain is 1,200 milligrams daily, broken up into three servings of 400 milligrams each.
Often used together with chondroitin, glucosamine is another natural component of cartilage and lubricating joint fluid. Again, the idea is that by replenishing glucosamine, the joints will have the nutrients they need to stay healthy or to help repair themselves.
Glucosamine in supplements comes from either the shells of shellfish or can be man-made in the laboratory. One of the most commonly used in supplements is the laboratory form “glucosamine sulfate,” which has shown in studies to help reduce inflammation and to help regenerate cartilage.
The Mayo Clinic states that evidence supports the use of glucosamine sulfate to treat knee osteoarthritis. In 2015, for example, researchers compared a combined glucosamine and chondroitin supplement with celecoxib in about 600 patients with knee osteoarthritis. Patients received either 400 milligrams chondroitin sulfate plus 500 milligrams glucosamine three times a day or 200 milligrams celecoxib every day for six months.
At the end of the study period, researchers concluded that the two treatments were comparable in reducing pain, stiffness, joint swelling and functional limitations. A large review of 54 studies involving 16,427 people published the same year also reported that the combination supplement along with celecoxib were all more effective than placebo in relieving the pain of arthritis as well as in improving daily function.
Other studies have shown mixed results. In 2006, for example, researchers published what is referred to as the “GAIT” study, which concluded that the combination of glucosamine and chondroitin did not reduce pain effectively in patients with knee arthritis. Further analysis, however, did show that the supplement “may be effective in the subgroup of patients with moderate-to-severe knee pain.” Researchers also suggested that more research was needed since the study size was fairly small (about 1,600 participants).
A later 2010 study analysis of 10 trials, including about 3,800 patients also concluded that the two natural ingredients did not reduce joint pain.
These studies were both before the 2015 study mentioned above, however, and researchers in that study acknowledged the findings. “In recent years,” they wrote, “changes in attitudes about the use of glucosamine and chondroitin in the treatment of OA [osteoarthritis] have been witnessed … based on the research findings of the present study, we … strongly recommend that the future guidelines should reconsider the use of glucosamine and chondroitin for the treatment of knee OA.”
At this point, we still have strong evidence that these two supplements can help relieve symptoms and preserve joint function. The best joint supplement is likely to include these ingredients as well as others, like green-lipped mussel, to increase the odds of pain relief and improved function. The common dose of glucosamine is 500 milligrams three times a day.
Methylsulfonylmethane (MSM) is a chemical found in fresh raw foods like fruits, vegetables and meat. It is a good source of sulfur, a mineral that we need for a number of different bodily functions. In fact, some believe that its effectiveness in arthritis may be because it helps treat a sulfur deficiency, but it also seems to help encourage the synthesis of collagen and prevent free-radical damage.
MSM is made in the laboratory using dimethyl sulfoxide (DMSO), and DMSO is made by processing pulp, the waste product of paper-making. A number of studies on MSM have shown that it seems to decrease joint inflammation, restore collagen production and improve mobility, particularly when combined with glucosamine.
Scientists believe MSM works by reducing inflammation and providing protective antioxidant effects. Sulfur is also important in making both collagen and glucosamine, which are both critical for healthy joints.
In 2011, researchers conducted a review of three randomized-controlled trials on MSM. Two of them showed statistically significant reduction in joint pain compared with controls. The third showed no difference. An earlier 2006 study also found that arthritis patients taking MSM twice a day for 12 weeks experienced improved symptoms of pain and physical function.
We don’t have a lot of large studies on this ingredient, but what we do have shows that MSM may be helpful for some people with arthritis. The typical dose is 1,500 milligrams per day.
5. Devil’s Claw
Devil’s claw (harpagophytum procumbens) is a plant that grows in the desert with miniature claw-like hooks over its fruit. The root of the plant was used in traditional medicine to treat pain and skin problems.
Modern-day research shows that devil’s claw is a powerful anti-inflammatory as well as an analgesic (pain reliever) and, therefore, effective for all types of pain, including that caused by osteoarthritis, rheumatoid arthritis and even headaches.
According to a 2007 study review, a number of controlled trials have shown that treatment with devil’s claw relieves pain and improves mobility in people with arthritis of the knee and hip, as well as those with back pain and muscle soreness. Scientists believe that it is the compound called “harpagoside” in devil’s claw that is responsible for much of the anti-inflammatory action, but the root contains other anti-inflammatory compounds including antioxidants and antispasmodics.
Devil’s claw also seems to have a direct effect on the COX-2 enzyme, suppressing it to reduce pain and inflammation in much the same way that over-the-counter and prescription pain relievers do. A 2000 study found that devil’s claw provided pain relief of hip and knee arthritis equal to the European anti-inflammatory drug diacerein and with fewer side effects.
The most commonly recommended dose for pain is 2,000 milligrams to 2,600 milligrams (containing 50 milligrams to 60 milligrams of harpagoside) taken three times a day with meals. Since it may increase bile production, those at risk for gallstones are advised to avoid it.
Boron is a trace mineral naturally present in some foods and the environment. Plants use it to protect plant cell walls, which is why we find it in plant-based foods. It’s present in grapes, avocados, raisins, prunes, almonds and pecans. Scientists have found that boron is an essential nutrient for people, too, because it helps contribute to bone health.
We don’t need a lot of boron to be healthy but taking a bit more has shown in some studies to help ease the symptoms of arthritis. Scientists first discovered its potential when they found that areas of the world with higher levels of boron in the soil had fewer cases of arthritis than areas that had lower levels.
Boron-rich Israel, for example, was found to have only a 1 percent prevalence of arthritis, whereas the United States had a 20 percent prevalence. People who eat boron-rich diets have also been found to be less at risk for arthritis later in life.
Other studies have shown that boron can reduce inflammation in the joints. In an Australian study, 50 percent of patients with osteoarthritis who took 6 milligrams of boron a day experienced improvement, compared to only 10 percent of those taking a placebo.
In another eight-week study, patients with mild-to-medium arthritis took 6 milligrams of boron a day, while those with more severe cases took 12 milligrams a day. Average pain reduction was 62.5 percent in four weeks and 70.8 percent in eight weeks in the mild-to-medium group. By eight weeks, 67 percent had stopped using their regular pain relievers.
In the severe group, average pain reduction was 47.9 percent at four weeks and 64.5 percent at eight weeks and 75 percent quit using their medications by eight weeks.
The recommended dose is up to 6 milligrams of boron per day, with an upper daily limit of 13 milligrams.
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