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Osteoarthritis

Osteoarthritis is a problem with the joints. The flexible tissue between joints begins to wear down. This causes pain and limits movement. Other symptoms are stiffness and creaking sounds. It is managed with healthy habits and medicine. Some people may need surgery. Natural therapies have been used to ease pain and improve movement. They should not be used in place of standard care.

Natural Therapies

Likely Effective

These herbs and supplements are likely to ease pain and improve mobility:

  • Boswellia is a tree that can be taken as a supplement or applied as a cream.D20, D29, D32, D37
  • Carnitine is a nutrient that can be taken as a supplement.D32
  • Chondroitin is a compound found on the surface of joints. It is often taken with glucosamine. (Note: It should not be taken by people who take blood thinners.)D12, D13, D21, D24, D33, D34, D39
  • Ginger is a flowering plant. Its roots are used as a spice.D23
  • Green-lipped mussel is a shellfish from New Zealand.D32
  • Rose Hips come from wild rose plants and can be taken as a supplement or applied to the skin.D6, D11
  • S-Adenosylmethionine (SAMe) is a compound that the body uses to make energy. (Note: SAMe should not be taken by people who have depression.)D9

Therapies that are likely to help are:

  • Traditional Chinese exercise H1
  • Yoga I1-I4

May Be Effective

These herbs and supplements may ease pain and swelling:

  • Bitter melon is a tropical, fruit-like gourd. (Note: It should not be taken by women who are pregnant or breastfeeding.)D35
  • Capsaicin is the active ingredient in peppers. It can be applied as a gel.D14
  • Cartilage is the connective tissue on the surface of joints.D16, D25
  • Comfrey (topical) is a plant that can be taken as a supplement or applied to the skin. (Note: It should not be taken by people who have liver problems.)D17
  • Corydalis is an herb that can be taken as a supplement or made into a tea.D10, D22
  • Lavender can be massaged as an oil.D26
  • Moxibustion burns an herb called moxa on or near a person’s skin.F1-F3
  • Skullcap is a plant that may ease symptoms when taken with Acacia catechu. (Note: It should not be taken by people who have anxiety or problems with blood clotting.)D7, D19
  • Traditional Chinese medicine is the use of acupuncture, cupping, massage, herbs, and other methods to bring balance to the body.D41
  • Turmeric is a plant in the ginger family (Note: It should not be taken by people who have bone problems.)D8, D15, D40
  • Vitamin E is found in nuts and olive oil.D28

Therapies that may ease pain and improve functions are:

May Not Be Effective

Not Enough Data to Assess

Editorial process and description of evidence categories can be found at EBSCO NAT Editorial Process.

Herbs and Supplements to Be Used With Caution

Talk to your doctor about all herbs or pills you are taking. Some may get in the way of your treatment or make some health problems worse:

  • Bitter melon should not be taken by women who are pregnant or breastfeeding.
  • Chondroitin should not be taken by people who take blood thinners.
  • Comfrey should not be taken by people who have liver problems.
  • S-adenosylmethionine (SAMe) should not be taken by people who have depression. It may interact with their medicines.
  • Skullcap should not be taken by people who have anxiety or blood clotting problems. It may interact with their medicines.
  • Turmeric should not be taken by people who have bone disorders. It may interact with their medicines.
 

References

Acupuncture

A1. Manheimer E, Cheng K, et al. Acupuncture for peripheral joint osteoarthritis. Cochrane Database Syst Rev. 2010 Jan 20;(1):CD001977.

A2. Corbett MS, Rice SJ, et al. Acupuncture and other physical treatments for the relief of pain due to osteoarthritis of the knee: network meta-analysis. Osteoarthritis Cartilage. 2013 Sep;21(9):1290-1298.

A3. Manyanga T, Froese M, et al. Pain management with acupuncture in osteoarthritis: a systematic review and meta-analysis. BMC Complement Altern Med. 2014 Aug 23;14:312.

A4. Lin X, Huang K, et al. The Effects of Acupuncture on Chronic Knee Pain Due to Osteoarthritis: A Meta-Analysis. J Bone Joint Surg Am. 2016 Sep 21;98(18):1578-1585.

A5. Chen N, Wang J, et al. Electro-Acupuncture is Beneficial for Knee Osteoarthritis: The Evidence from Meta-Analysis of Randomized Controlled Trials. Am J Chin Med. 2017;45(5):965-985.

A6. Manheimer E, Cheng K, et al. Acupuncture for hip osteoarthritis. Cochrane Database Syst Rev. 2018;5:CD013010.

A7. Li J, Li YX, et al. The effectiveness and safety of acupuncture for knee osteoarthritis: An overview of systematic reviews. Medicine (Baltimore). 2019;98(28):e16301.

B. Ayurvedic Interventions

B1. Kessler CS, Pinders L, et al. Ayurvedic interventions for osteoarthritis: a systematic review and meta-analysis. Rheumatol Int. 2015 Feb;35(2):211-232.

C. Cupping Therapy

C1. Li JQ, Guo W, et al. Cupping therapy for treating knee osteoarthritis: The evidence from systematic review and meta-analysis. Complement Ther Clin Pract. 2017 Aug;28:152-160.

D. Herbs and Supplements

D1. Jonas WB, Rapoza CP, et al. The effect of niacinamide on osteoarthritis: a pilot study. Inflamm Res. 1996;45(7):330-334.

D2. Das A Jr, Hammad TA. Efficacy of a combination of FCHG49 glucosamine hydrochloride, TRH 122 low molecular weight sodium chondroitin sulfate and manganese ascorbate in the management of knee osteoarthritis. Osteoarthritis Cartilage. 2000;8(5):343-350.

D3. Hesslink R Jr, Armstrong D 3rd, et al. Cetylated fatty acids improve knee function in patients with osteoarthritis. J Rheumatol. 2002;29(8):1708-1712.

D4. Towheed TE, Maxwell L, et al. Glucosamine therapy for treating osteoarthritis. Cochrane Database Syst Rev. 2005;(2):CD002946.

D5. Cisár P, Jány R, et al. Effect of pine bark extract (Pycnogenol) on symptoms of knee osteoarthritis. Phytother Res. 2008;22(8):1087-1092.

D6. Christensen R, Bartels EM, et al. Does the hip powder of Rosa canina (rosehip) reduce pain in osteoarthritis patients?—a meta-analysis of randomized controlled trials. Osteoarthritis Cartilage. 2008;16(9):965-972.

D7. Levy RM, Saikovsky R, et al. Flavocoxid is as effective as naproxen for managing the signs and symptoms of osteoarthritis of the knee in humans: a short term randomized, double-blind pilot study. Nutr Res. 2009;29(5):298-304.

D8. Kaptniratsaikul V, Thanakhumpyorn S, et al. Efficacy and safety of Curcuma domestica extracts in patients with knee osteoarthritis. J Altern Complement Med. 2009;15(8):898-907.

D9. Rutjes AW, Nüesch E, et al. S-Adenosylmethionine for osteoarthritis of the knee or hip. Cochrane Database Syst Rev. 2009;(4):CD007321.

D10. Zuo C, Chen YT, et al. [Clinical efficacy of Corydalis composite combined with methotrexate in treating rheumatoid arthritis]. Zhongguo Zhong Xi Yi Jie He Za Zhi. 2009;29(11):1023-1025

D11. Cameron M, Gagnier JJ, et al. Evidence of effectiveness of herbal medicinal products in the treatment of arthritis. Part I: Osteoarthritis. Phytother Res. 2009;23(11):1497-1515.

D12. Lee YH, Woo JH, et al. Effect of glucosamine or chondroitin sulfate on the osteoarthritis progression: a meta-analysis. Rheumatol Int. 2010;30(3):357-363.

D13. Hochberg MC. Structure-modifying effects of chondroitin sulfate in knee osteoarthritis: an updated meta-analysis of randomized placebo-controlled trials of 2-year duration. Osteoarthritis Cartilage. 2010;1:28-31.

D14. Kosuwon W, Sirichitiwapee W, et al. Efficacy of symptomatic control of knee osteoarthritis with 0.0125% of capsaicin versus placebo. J Med Assoc Thai. 2010;93(10):1188-1195.

D15. Belcaro G, Cesarone MR, et al. Efficacy and safety of Meriva, a curcumin-phosphatidylcholine complex, during extended administration in osteoarthritis patients. Altern Med Rev. 2010;15(4):227-244.

D16. Schauss AG, Stenehjem J, et al. Effect of the novel low molecular weight hydrolyzed chicken sternal cartilage extract, BioCell Collagen, on improving osteoarthritis-related symptoms: a randomized, double-blind, placebo-controlled trial. J Agric Food Chem. 2012;60(16):4096-4101.

D17. Pabst H, Schaefer A, et al. Combination of comfrey root extract plus methyl nicotinate in patients with conditions of acute upper or low back pain: a multicenter randomized controlled trial. Phytother Red. 2013;27(6):811-817.

D18. Schumacher HR, Pullman-Mooar S, et al. Randomized double-blind crossover study of the efficacy of a tart cherry juice blend in the treatment of osteoarthritis (OA) of the knee). Osteoarthritis Cartilage. 2013;21(8):1035-1041.

D19. Arjmandi BH, Ormsbee LT, et al. A combination of Scutellaria baicalensis and Acacia catechu extracts for short-term symptomatic relief of joint discomfort associated with osteoarthritis of the knee. J Med Food. 2014;17(6):707-713.

D20. Cameron M, Chrubasik S. Oral herbal therapies for treating osteoarthritis. Cochrane Database Syst Rev. 2014;22(5):CD002947.

D21. Singh JA, Noorbaloochi S, et al. Chondroitin for osteoarthritis. Cochrane Database Syst Rev. 2015;1:CD005614.

D22. Zuo C, Yin G, et al. [Controlled clinical study on compound Decumbent Corydalis Rhizome and diclofenac in treatment of knee osteoarthritis]. Zhongguo Zhong Yao Za Zhi. 2015;40(1):149-153.

D23. Bartels EM, Folmer VN, et al. Efficacy and safety of ginger in osteoarthritis patients: a meta-analysis of randomized placebo-controlled trials. Osteoarthritis Cartilage. 2015;23(1):13-21.

D24. Zeng C, Wei J, et al. Effectiveness and safety of Glucosamine, chondroitin, the two in combination, or celecoxib in the treatment of osteoarthritis of the knee. 2015;5:16827.

D25. Lugo JP, Saiyed ZM, et al. Efficacy and tolerability of an undenatured type II collagen supplement in modulating knee osteoarthritis symptoms: a multicenter randomized, double-blind, placebo-controlled study. Nutr J. 2016;15:14.

D26. Nasiri A, Mahmodi MA, et al. Effect of aromatherapy massage with lavender essential oil on pain in patients with osteoarthritis of the knee: A randomized controlled clinical trial. Complement Ther Clin Pract. 2016;25:75-80.

D27. Harrison-Muñoz S, Rojas-Briones V, et al. Is glucosamine effective for osteoarthritis. Medwave. 2017;17(Suppl1):e6867.

D28. Tantavisut S, Tanavalee A, et al. Effect of vitamin E on oxidative stress level in blood, synovial fluid, and synovial tissue in severe knee osteoarthritis: a randomized controlled study. BMC Musculoskelet Disord. 2017;18(1):281.

D29. Karimifar M, Soltani R, et al. Evaluation of the effect of Elaeagnus angustifolia alone and combined with Boswellia thurifera compared with ibuprofen in patients with knee osteoarthritis: a randomized double-blind controlled clinical trial. Clin Rheumatol. 2017;36(8):1849-1853.

D30. Gao XR, Chen YS, et al. The effect of vitamin D supplementation on knee osteoarthritis: A meta-analysis of randomized controlled trials. Int J Surg. 2017;46:14-20.

D31. Diao N, Yang B, et al. Effect of vitamin D supplementation on knee osteoarthritis: A systematic review and meta-analysis of randomized clinical trials. Clin Biochem. 2017;50(18):1312-1316.

D32. Liu X, Machado GC, et al. Dietary supplements for treating osteoarthritis: a systematic review and meta-analysis. Br J Sports Med. 2018;52(3):167-175.

D33. Zhu X, Sang L, et al. Effectiveness and safety of glucosamine and chondroitin for the treatment of osteoarthritis: a meta-analysis of randomized controlled trials. J Orthop Surg Res. 2018;13(1):170.

D34. Simental-Mendía M, Sánchez-García A, et al. Effect of glucosamine and chondroitin sulfate in symptomatic knee osteoarthritis: a systematic review and meta-analysis of randomized placebo-controlled trials. Rheumatol Int. 2018;38(8):1413-1428.

D35. Soo May L, Sanip Z, et al. The effects of Momordica charantia (bitter melon) supplementation in patients with primary knee osteoarthritis: A single-blind, randomized controlled trial. Complement Ther Clin Pract. 2018;32:181-186.

D36. Ogata T, Ideno Y, et al. Effects of glucosamine in patients with osteoarthritis of the knee: a systematic review and meta-analysis. Clin Rheumatol. 2018;37(9):2479-2487.

D37. Bannuru RR, Osani MC, et al. Efficacy of curcumin and Boswellia for knee osteoarthritis: Systematic review and meta-analysis. Semin Arthritis Rheum. 2018;43(3):416-429.

D38. Diao N, Yang B, et al. Effect of vitamin D supplementation on knee osteoarthritis: A systematic review and meta-analysis of randomized clinical trials. Clin Biochem. 2017 Dec;50(18):1312-1316.

D39. Knapik JJ, Pope R, et al. Effects of Oral Chondroitin Sulfate on Osteoarthritis-Related Pain and Joint Structural Changes: Systematic Review and Meta-Analysis. J Spec Oper Med. Spring 2019;19(1):113-124.

D40. Daily JW, Yang M, et al. Efficacy of Turmeric Extracts and Curcumin for Alleviating the Symptoms of Joint Arthritis: A Systematic Review and Meta-Analysis of Randomized Clinical Trials. J Med Food. 2016 Aug;19(8):717-729.

D41. Chen B, Zhan H, et al. Traditional Chinese Medications for Knee Osteoarthritis Pain: A Meta-Analysis of Randomized Controlled Trials. Am J Chin Med. 2016;44(4):677-703.

E. Massage

E1. Tosun B, Unal N, et al. Effects of Self-Knee Massage With Ginger Oil in Patients With Osteoarthritis: An Experimental Study. Res Theory Nurs Pract. 2017;31(4):379-392.

E2. Zwolińska J, Weres A, et al. One-Year Follow-Up of Spa Treatment in Older Patients with Osteoarthritis: A Prospective Single Group Study. Biomed Res Int. 2018;2.

E3. Efe Arslan D, Kututürkan S, et al. The Effect of Aromatherapy Massage on Knee Pain and Functions Status in Participants with Osteoarthritis. Pain Manag Nurs. 2019;20(1):62-69.

E4. Nelson NL, Churilla JR. Massage Therapy for Pain and Function in Patients With Arthritis: A Systematic Review of Randomized Controlled Trials. Am J Phys Med Rehabil. 2017 Sep;96(9):665-672.

F. Moxibustion

G. Tai Chi

G1. Hall A, Copsey B, et al. Effectiveness of Tai Chi for Chronic Musculoskeletal Pain Conditions: Updated Systematic Review and Meta-Analysis. Phys Ther. 2017 Feb 1;97(2):227-238.

G2. Kong LJ, Lauche R, et al. Tai Chi for Chronic Pain Conditions: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Sci Rep. 2016 Apr 29;6:25325.

G3. Chen YW, Hunt MA, et al. The effect of Tai Chi on four chronic conditions-cancer, osteoarthritis, heart failure and chronic obstructive pulmonary disease: a systematic review and meta-analyses. Br J Sports Med. 2016 Apr;50(7):397-407.

G4. Lauche R, Langhorst J, et al. A systematic review and meta-analysis of Tai Chi for osteoarthritis of the knee. Complement Ther Med. 2013 Aug;21(4):396-406.

G5. Yan JH, Gu WJ, et al. Efficacy of Tai Chi on pain, stiffness and function in patients with osteoarthritis: a meta-analysis. PLoS One. 2013 Apr 19;8(4):e61672.

H. Traditional Chinese Exercise

H1. Zhang Y, Huang L, et al. The Effects of Traditional Chinese Exercise in Treating Knee Osteoarthritis: A Systematic Review and Meta-Analysis. PLoS One. 2017 Jan 25;12(1):e0170237.

I. Yoga

I1. Cheung C, Wyman JF, et al. Managing knee osteoarthritis with yoga or aerobic/strengthening exercise programs in older adults: a pilot randomized controlled trial. Rheumatol Int. 2017;37(3):389-398.

I2. Park J, McCaffrey R, et al. A Pilot Randomized Controlled Trial of the Effects of Chair Yoga on Pain and Physical Function Among Community-Dwelling Older Adults With Lower Extremity Osteoarthritis. J Am Geriatr Soc. 2017;65(3):592-597.

I3. Wang Y, Lu S, et al. Integrative effect of yoga practice in patients with knee arthritis: A PRISMA-compliant meta-analysis. Medicine (Baltimore). 2018 Aug;97(31):e11742.

I4. Ward L, Stebbings S, et al. Yoga for functional ability, pain and psychosocial outcomes in musculoskeletal conditions: a systematic review and meta-analysis. Musculoskeletal Care. 2013 Dec;11(4):203-217.

Last reviewed February 2020 by EBSCO NAT Review Board Eric Hurwitz, DC  Last Updated: 5/10/2020