by Ayotola Ogunsipe, Edited by Christopher M. Cirino, DO MPH

Introduction: Arthritis is Common

Let’s talk about arthritis. More than 54 million adults in the United States have arthritis. One in four of these adults experiencing significant joint pain, the most common symptom of the condition. As the arthritis progresses, many, especially those above 60 years of age, will have increased pain and dysfunction. The pain can increase to a point where it becomes severe. Some may eventually require joint replacement surgery. 

It’s stressful to think that arthritis can make each day challenging. More concerning is that the condition worsens over time. Fortunately, there are some options to improve the pain and stiffness. Although achieving permanent relief is not an attainable goal, there are arthritis supplements that can help to make daily life a little easier.

These supplements are available online or over the counter at your local pharmacy. You can take them instead of, or along with, commonly prescribed medications. Remember to talk to your doctor before taking these remedies. That said, let’s take a look at 5 supplements to help with your arthritis.

5 Arthritis Supplements

Curcumin

Curcumin comes from the aromatic spice turmeric and has anti-inflammatory and anti-oxidant effects . Historically, it has been used in Ayurvedic medicine to treat health problems related to pain and fatigue. It was designated a superfood in recent times because of its perceived benefit in reducing inflammation and protecting against chronic heart disease and diabetes.

Compared to diclofenac, curcumin showed similar efficacy in reducing the pain due to osteoarthritis with minimal side effects. Although the conclusions come from a single study, curcumin may benefit those looking to improve their arthritis pain, especially if they don’t tolerate the side effects of non-steroidal anti-inflammatory drugs (NSAIDS.) The prescribed dose given during the study was 500mg three times daily.

Boswellia 

Leukotrienes play an essential role in inflammation by causing the production of chemicals that trigger the inflammatory response. In inflammatory arthritis such as rheumatoid arthritis, leukotrienes initiate this response and coordinate and amplify it to lead to joint pain and swelling symptoms. 

Boswellia, an extract from the Boswellia serrata tree, may inhibit the actions of leukotrienes. Boswellic acid, a mixture isolated from the Boswellia extract, appears to be the active ingredient responsible for pain relief and improved joint function in osteoarthritis.

Supporting this is a recent systematic review that showed Boswellia and its extract may play a role in osteoarthritis symptom improvement and represents an effective and safe treatment option for people living with this condition. This study recommends a treatment period of at least four weeks for best results.

Pycnogenol

Pycnogenol is a powerful antioxidant (from its polyphenols) shown to reduce inflammation in osteoarthritis patients. This supplement is a bark extract of the French maritime pine. It may support joint health by reducing pain, swelling, and joint stiffness in patients experiencing these symptoms.

In a review where pycnogenol was studied based on its use as an adjunct supplement, it prevented the cartilage-destroying and pain-producing agents that amplify the symptoms and progression of osteoarthritis. With oral NSAIDs, side effects such as peptic ulcers and gastrointestinal bleeding may discourage long-term use; however, pycnogenol appears to give similar pain relief without these associated side effects.

Hyaluronic acid

Hyaluronic acid is a common treatment for osteoarthritis. It can be taken in people with severe knee arthritis as an injection to give acute relief from the pain and stiffness due to the condition. In a 2015 study, an oral hyaluronic acid supplement also provided relief to overweight adults with knee arthritis. There was also a 2017 review that showed similar effects. In this study, participants took an oral formulation of hyaluronan, and they reported lower pain scores than those that took a placebo.

So how does it work? Hyaluronic acid is a natural part of the viscous fluid that lubricates the joint space. Formulated for injection or oral supplementation, it can help to alleviate joint pain and reduce inflammation. If you want to take the oral form, experts recommend taking 80-200mg daily for at least two months. You may also choose to take the injection, but this may come with a higher risk of adverse effects.

Vitamin D

From the cradle to adulthood, vitamin D is considered a vital nutrient for developing and maintaining healthy bones. In children, it plays a critical role in forming healthy bones, while in adults, it can improve joint health as you grow older. Studies have often associated rheumatoid arthritis and joint pain with vitamin D deficits. Although correlation does not necessarily mean causation, the lower vitamin D levels in this form of arthritis and the associated pain might indicate that this vitamin plays a salient role in the disease. 

Furthermore, considering the odds of having an osteoporotic fracture or experiencing joint pain are significantly higher for those with RA, vitamin D supplementation can be potentially beneficial as it contributes to an increased bone mineral density and bone formation.

If you are wondering what constitutes a healthy vitamin D level, you can take a look at the NIH recommendation. If you are below 70 years old, the NIH recommends 600IU of vitamin D, and for those above 70, 800IU will do. However, if your test results show that your vitamin D level is deficient, you will need a significantly higher amount of vitamin D. In this case, if you are below 70, you are good to go with 2000IU per day. On the other hand, for those above 70, 4000IU per day should increase your vitamin D to healthy levels.

Osteoporotic Wedge Fracture

Other Supplements

In addition to the above arthritis supplements, there are glucosamine, chondroitin, methylsulfonylmethane (MSM), and fish oil. Even though widely promoted for arthritis pain, these supplements lack efficacy trials and larger, randomized studies. Although there may be some biological plausibility, these supplements showed mild, if any, improvement of pain and stiffness symptoms compared to placebo, or the studies were not large enough and powered to show a statistically significant benefit. Nevertheless, further studies could provide more information on the specific patient populations and the supplements’ dosages.

Summary: Don’t forget Lifestyle Modifications

Beyond supplements, lifestyle modification plays a crucial role in alleviating the symptoms of osteoarthritis (a topic of a future article.)

Here are a few lifestyle strategies:

1. Pain coping skills and the use of cognitive behavior therapy
2. Daily stretching and exercise regimens
3. Weight optimization
4. Quality sleep (both duration and consistency)
5. Nutritional support (anti-inflammatory foods)

In individuals overweight or obese, reducing the body weight can decrease the pressure on the joints and ease the symptoms of the condition.

Combining exercise with a healthy diet, especially foods rich in vitamin K, such as spinach and kale, may improve joint health.

One study on sleep disturbance in 112 patients with rheumatoid arthritis found a high probability of poor sleep quality, with 4 in 5 (81.5%) in this category. Lack of sleep quality is likely bidirectional: pain and dysfunction from the RA can lead to sleep problems; greater pain sensitivity, depression, and other health issues come about from poor sleep. Check out this YHF article on sleep.

Overall, a healthy diet, exercise, and a supplement trial may help manage arthritis symptoms better.