Osteoarthritis (OA)

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    Louie Neri, Gregory Lopez

    Fact-checked

    by:

    Nick Milazzo
    Last Updated: October 13, 2024

    Osteoarthritis (OA) is a joint disease involving cartilage degradation. It’s not clear what exactly causes OA, but some risk factors include joint injury, overweight or obesity, aging, misaligned joints, and family history. Lots of supplements have been studied in people with OA, as have lifestyle interventions including weight loss and exercise.

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    Osteoarthritis (OA) falls under the Pain category.

    14 references on this page
    36,097 participants in 66 trials and 19 meta-analyses

    What is osteoarthritis?

    Osteoarthritis (OA) is a joint disease and the most common type of arthritis (inflammation of the joints) whose hallmark is cartilage degradation. It most commonly affects the joints of the hand, knee, hip, neck, and lower back.[1]

    image

    What’s the difference between osteoarthritis and rheumatoid arthritis?

    What’s the difference between osteoarthritis and osteoporosis?

    What are the main signs and symptoms of osteoarthritis?

    Mild OA may not cause any noticeable symptoms. As it gets more severe, you may experience pain when moving that gets better with rest, joint stiffness after getting up from resting, poor joint range of motion, swelling after joint use, and a feeling of looseness or instability.[1]

    Does joint damage on imaging show how much osteoarthritis can affect physical function?

    How is osteoarthritis diagnosed?

    A medical provider will diagnose osteoarthritis through a combination of physical examination, discussing your symptoms, using x-ray or MRI imaging, and ruling out other causes through further testing.[1] OA is often classified on the Kellgren-Lawrence scale, which ranges from 0 (no OA) to 4 (severe OA).[2]

    What are some of the main medical treatments for osteoarthritis?

    Medical treatment is usually reserved for more severe OA, and usually starts with high-dose acetaminophen and topical creams. It can then proceed to non-steroidal antiinflammatory drugs, and possibly tramadol in severe cases. Corticosteroid injections can also be used in certain circumstances. Joint replacement is possible for people with moderate to severe disease that clearly shows up on imaging.[3]

    Have any supplements been studied for osteoarthritis?

    Many supplements have been studied for osteoarthritis. A few examples include glucosamine & chondroitin (both components of cartilage), L-carnitine, pycnogenol, and curcumin.[4]

    How could diet affect osteoarthritis?

    The most clear dietary contributor to osteoarthritis is caloric excess leading to obesity, making weight loss one of the first-line suggestions for treating knee and hip OA.[5] There’s weaker but suggestive evidence that increasing long-chain omega-3 fatty acid consumption by eating more fatty fish can also help, as could increasing vitamin K intake.[6]

    Are there any other treatments for osteoarthritis?

    Physical therapy exercises are one of the first-line treatments for OA.[5][7] Heat packs can provide relief. There are mechanistic reasons for suspecting that applying heat could also slow OA progression, although this does not have strong clinical evidence.[7] Progressive exercises of all sorts can help with osteoarthritis. Some examples include aerobic exercise, resistance training, yoga, aquatic exercise, and Tai Chi.[8]

    What causes osteoarthritis?

    It’s not clear what the mechanism is behind the development of osteoarthritis. However, some risk factors are aging, past joint injury, misaligned joints, a family history, and overweight or obesity.[1]

    Does running or resistance training cause osteoarthritis?

    Examine Database: Osteoarthritis (OA)

    Glucosamine
    Curcumin
    S-adenosylmethionine
    Boswellia
    Chondroitin
    L-Carnitine
    Rose Hip
    Ginger
    MSM
    Pycnogenol
    Resveratrol
    Krill Oil
    Stinging Nettle
    Type-II Collagen
    Ashwagandha
    Boron
    Bromelain
    Cissus Quadrangularis
    Creatine
    Devil's Claw
    Fish Oil
    Guggul
    Microlactin
    Red Light Therapy
    Vitamin D

    Research FeedRead all studies

    Frequently asked questions

    What is osteoarthritis?

    Osteoarthritis (OA) is a joint disease and the most common type of arthritis (inflammation of the joints) whose hallmark is cartilage degradation. It most commonly affects the joints of the hand, knee, hip, neck, and lower back.[1]

    image

    What’s the difference between osteoarthritis and rheumatoid arthritis?

    Osteoarthritis is caused by a progressive loss of cartilage that leads to joint inflammation via bone-on-bone rubbing, overuse, age, and trauma, whereas rheumatoid arthritis is an autoimmune inflammatory disease that targets and degrades joint tissue.

    What’s the difference between osteoarthritis and osteoporosis?

    Osteoarthritis is a progressive joint disease that is characterized by a loss of joint cartilage. On the other hand, osteoporosis describes bones that have become weak and brittle due to low bone mass. People with osteoporosis are at a higher risk of fractures, often from falls.[9]

    What are the main signs and symptoms of osteoarthritis?

    Mild OA may not cause any noticeable symptoms. As it gets more severe, you may experience pain when moving that gets better with rest, joint stiffness after getting up from resting, poor joint range of motion, swelling after joint use, and a feeling of looseness or instability.[1]

    Does joint damage on imaging show how much osteoarthritis can affect physical function?

    Although radiographic imaging may be helpful to help rule out other conditions, the relationship between joint damage found on imaging and the amount of pain one experiences can vary.[14] Imaging alone should not be used to assess severity of osteoarthritis. Rather, understanding the numerous factors that can contribute to pain and dysfunction should be used when assessing osteoarthritis.

    How is osteoarthritis diagnosed?

    A medical provider will diagnose osteoarthritis through a combination of physical examination, discussing your symptoms, using x-ray or MRI imaging, and ruling out other causes through further testing.[1] OA is often classified on the Kellgren-Lawrence scale, which ranges from 0 (no OA) to 4 (severe OA).[2]

    What are some of the main medical treatments for osteoarthritis?

    Medical treatment is usually reserved for more severe OA, and usually starts with high-dose acetaminophen and topical creams. It can then proceed to non-steroidal antiinflammatory drugs, and possibly tramadol in severe cases. Corticosteroid injections can also be used in certain circumstances. Joint replacement is possible for people with moderate to severe disease that clearly shows up on imaging.[3]

    Have any supplements been studied for osteoarthritis?

    Many supplements have been studied for osteoarthritis. A few examples include glucosamine & chondroitin (both components of cartilage), L-carnitine, pycnogenol, and curcumin.[4]

    How could diet affect osteoarthritis?

    The most clear dietary contributor to osteoarthritis is caloric excess leading to obesity, making weight loss one of the first-line suggestions for treating knee and hip OA.[5] There’s weaker but suggestive evidence that increasing long-chain omega-3 fatty acid consumption by eating more fatty fish can also help, as could increasing vitamin K intake.[6]

    Are there any other treatments for osteoarthritis?

    Physical therapy exercises are one of the first-line treatments for OA.[5][7] Heat packs can provide relief. There are mechanistic reasons for suspecting that applying heat could also slow OA progression, although this does not have strong clinical evidence.[7] Progressive exercises of all sorts can help with osteoarthritis. Some examples include aerobic exercise, resistance training, yoga, aquatic exercise, and Tai Chi.[8]

    What causes osteoarthritis?

    It’s not clear what the mechanism is behind the development of osteoarthritis. However, some risk factors are aging, past joint injury, misaligned joints, a family history, and overweight or obesity.[1]

    Does running or resistance training cause osteoarthritis?

    It’s a commonly held belief that running and resistance training can cause or worsen degenerative joint diseases such as osteoarthritis. However, there is no strong evidence that running[10] or resistance training[11] causes or worsens osteoarthritis. In fact, running[12] and resistance training[13] can improve functionality and reduce pain in people with osteoarthritis.

    The evidence that physical activity worsens osteoarthritis is weak. In many cases, physical activity may even be beneficial in reducing symptoms, which is why the American College of Rheumatology/Arthritis Foundation Guidelines strongly recommend physical activity in people with osteoarthritis.[5]

    References

    1. ^MedlinePlus: Osteoarthritis. Last updated April 20, 2016 Accessed 5/3/22.
    2. ^Mark D Kohn, Adam A Sassoon, Navin D FernandoClassifications in Brief: Kellgren-Lawrence Classification of OsteoarthritisClin Orthop Relat Res.(2016 Aug)
    3. ^Ebell MHOsteoarthritis: Rapid Evidence Review.Am Fam Physician.(2018-04-15)
    4. ^Xiaoqian Liu, Gustavo C Machado, Jillian P Eyles, Varshini Ravi, David J HunterDietary supplements for treating osteoarthritis: a systematic review and meta-analysisBr J Sports Med.(2018 Feb)
    5. ^Sharon L Kolasinski, Tuhina Neogi, Marc C Hochberg, Carol Oatis, Gordon Guyatt, Joel Block, Leigh Callahan, Cindy Copenhaver, Carole Dodge, David Felson, Kathleen Gellar, William F Harvey, Gillian Hawker, Edward Herzig, C Kent Kwoh, Amanda E Nelson, Jonathan Samuels, Carla Scanzello, Daniel White, Barton Wise, Roy D Altman, Dana DiRenzo, Joann Fontanarosa, Gina Giradi, Mariko Ishimori, Devyani Misra, Amit Aakash Shah, Anna K Shmagel, Louise M Thoma, Marat Turgunbaev, Amy S Turner, James Reston2019 American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and KneeArthritis Care Res (Hoboken).(2020 Feb)
    6. ^Thomas S, Browne H, Mobasheri A, Rayman MPWhat is the evidence for a role for diet and nutrition in osteoarthritis?Rheumatology (Oxford).(2018-05-01)
    7. ^Maqbool M, Fekadu G, Jiang X, Bekele F, Tolossa T, Turi E, Fetensa G, Fanta KAn up to date on clinical prospects and management of osteoarthritis.Ann Med Surg (Lond).(2021-Dec)
    8. ^Wellsandt E, Golightly YExercise in the management of knee and hip osteoarthritis.Curr Opin Rheumatol.(2018-03)
    9. ^Porter JL, Varacallo MOsteoporosisStatPearls.(2022-06)
    10. ^Timmins KA, Leech RD, Batt ME, Edwards KLRunning and Knee Osteoarthritis: A Systematic Review and Meta-analysis.Am J Sports Med.(2017-May)
    11. ^Bricca A, Juhl CB, Steultjens M, Wirth W, Roos EMImpact of exercise on articular cartilage in people at risk of, or with established, knee osteoarthritis: a systematic review of randomised controlled trials.Br J Sports Med.(2019-Aug)
    12. ^Lo GH, Musa SM, Driban JB, Kriska AM, McAlindon TE, Souza RB, Petersen NJ, Storti KL, Eaton CB, Hochberg MC, Jackson RD, Kwoh CK, Nevitt MC, Suarez-Almazor MERunning does not increase symptoms or structural progression in people with knee osteoarthritis: data from the osteoarthritis initiative.Clin Rheumatol.(2018-Sep)
    13. ^Turner MN, Hernandez DO, Cade W, Emerson CP, Reynolds JM, Best TMThe Role of Resistance Training Dosing on Pain and Physical Function in Individuals With Knee Osteoarthritis: A Systematic Review.Sports Health.(2020)
    14. ^Bedson J, Croft PRThe discordance between clinical and radiographic knee osteoarthritis: a systematic search and summary of the literature.BMC Musculoskelet Disord.(2008-Sep-02)

    Examine Database References

    1. Temporomandibular Disorder (TMD) Symptoms - Cahlin BJ, Dahlström LNo effect of glucosamine sulfate on osteoarthritis in the temporomandibular joints--a randomized, controlled, short-term studyOral Surg Oral Med Oral Pathol Oral Radiol Endod.(2011 Dec)
    2. Temporomandibular Disorder (TMD) Symptoms - Thie NM, Prasad NG, Major PWEvaluation of glucosamine sulfate compared to ibuprofen for the treatment of temporomandibular joint osteoarthritis: a randomized double blind controlled 3 month clinical trialJ Rheumatol.(2001 Jun)
    3. Osteoarthritis Symptoms - McAlindon T, Formica M, LaValley M, Lehmer M, Kabbara KEffectiveness of glucosamine for symptoms of knee osteoarthritis: results from an internet-based randomized double-blind controlled trialAm J Med.(2004 Nov 1)
    4. Osteoarthritis Symptoms - Towheed TE, Anastassiades TP, Shea B, Houpt J, Welch V, Hochberg MCGlucosamine therapy for treating osteoarthritisCochrane Database Syst Rev.(2001)
    5. Osteoarthritis Symptoms - Yongsak Wangroongsub, Aree Tanavalee, Vajara Wilairatana, Srihatach NgarmukosComparable clinical outcomes between glucosamine sulfate-potassium chloride and glucosamine sulfate sodium chloride in patients with mild and moderate knee osteoarthritis: a randomized, double-blind studyJ Med Assoc Thai.(2010 Jul)
    6. Osteoarthritis Symptoms - Towheed TE, Maxwell L, Anastassiades TP, Shea B, Houpt J, Robinson V, Hochberg MC, Wells GGlucosamine therapy for treating osteoarthritisCochrane Database Syst Rev.(2005 Apr 18)
    7. Osteoarthritis Symptoms - Houpt JB, McMillan R, Wein C, Paget-Dellio SDEffect of glucosamine hydrochloride in the treatment of pain of osteoarthritis of the kneeJ Rheumatol.(1999 Nov)
    8. Osteoarthritis Symptoms - Pujalte JM, Llavore EP, Ylescupidez FRDouble-blind clinical evaluation of oral glucosamine sulphate in the basic treatment of osteoarthrosisCurr Med Res Opin.(1980)
    9. Osteoarthritis Symptoms - Reginster JY, Deroisy R, Rovati LC, Lee RL, Lejeune E, Bruyere O, Giacovelli G, Henrotin Y, Dacre JE, Gossett CLong-term effects of glucosamine sulphate on osteoarthritis progression: a randomised, placebo-controlled clinical trialLancet.(2001 Jan 27)
    10. Osteoarthritis Symptoms - Rindone JP, Hiller D, Collacott E, Nordhaugen N, Arriola GRandomized, controlled trial of glucosamine for treating osteoarthritis of the kneeWest J Med.(2000 Feb)
    11. Osteoarthritis Symptoms - Clegg DO, Reda DJ, Harris CL, Klein MA, O'Dell JR, Hooper MM, Bradley JD, Bingham CO 3rd, Weisman MH, Jackson CG, Lane NE, Cush JJ, Moreland LW, Schumacher HR Jr, Oddis CV, Wolfe F, Molitor JA, Yocum DE, Schnitzer TJ, Furst DE, Sawitzke AD, Shi H, Brandt KD, Moskowitz RW, Williams HJGlucosamine, chondroitin sulfate, and the two in combination for painful knee osteoarthritisN Engl J Med.(2006 Feb 23)
    12. Osteoarthritis Symptoms - Pavelká K, Gatterová J, Olejarová M, Machacek S, Giacovelli G, Rovati LCGlucosamine sulfate use and delay of progression of knee osteoarthritis: a 3-year, randomized, placebo-controlled, double-blind studyArch Intern Med.(2002 Oct 14)
    13. Osteoarthritis Symptoms - Wandel S, Jüni P, Tendal B, Nüesch E, Villiger PM, Welton NJ, Reichenbach S, Trelle SEffects of glucosamine, chondroitin, or placebo in patients with osteoarthritis of hip or knee: network meta-analysisBMJ.(2010 Sep 16)
    14. Osteoarthritis Symptoms - Herrero-Beaumont G, Ivorra JA, Del Carmen Trabado M, Blanco FJ, Benito P, Martín-Mola E, Paulino J, Marenco JL, Porto A, Laffon A, Araújo D, Figueroa M, Branco JGlucosamine sulfate in the treatment of knee osteoarthritis symptoms: a randomized, double-blind, placebo-controlled study using acetaminophen as a side comparatorArthritis Rheum.(2007 Feb)
    15. Osteoarthritis Symptoms - Vlad SC, LaValley MP, McAlindon TE, Felson DTGlucosamine for pain in osteoarthritis: why do trial results differArthritis Rheum.(2007 Jul)
    16. Osteoarthritis Symptoms - McAlindon TE, LaValley MP, Gulin JP, Felson DTGlucosamine and chondroitin for treatment of osteoarthritis: a systematic quality assessment and meta-analysisJAMA.(2000 Mar 15)
    17. Osteoarthritis Symptoms - Chopra A, Saluja M, Tillu G, Sarmukkaddam S, Venugopalan A, Narsimulu G, Handa R, Sumantran V, Raut A, Bichile L, Joshi K, Patwardhan BAyurvedic medicine offers a good alternative to glucosamine and celecoxib in the treatment of symptomatic knee osteoarthritis: a randomized, double-blind, controlled equivalence drug trialRheumatology (Oxford).(2013 Jan 30)
    18. Osteoarthritis Symptoms - Richy F, Bruyere O, Ethgen O, Cucherat M, Henrotin Y, Reginster JYStructural and symptomatic efficacy of glucosamine and chondroitin in knee osteoarthritis: a comprehensive meta-analysisArch Intern Med.(2003 Jul 14)
    19. Osteoarthritis Symptoms - Hughes R, Carr AA randomized, double-blind, placebo-controlled trial of glucosamine sulphate as an analgesic in osteoarthritis of the kneeRheumatology (Oxford).(2002 Mar)
    20. Pain - Noack W, Fischer M, Förster KK, Rovati LC, Setnikar IGlucosamine sulfate in osteoarthritis of the kneeOsteoarthritis Cartilage.(1994 Mar)
    21. Lower Back Pain - Wilkens P, Scheel IB, Grundnes O, Hellum C, Storheim KEffect of glucosamine on pain-related disability in patients with chronic low back pain and degenerative lumbar osteoarthritis: a randomized controlled trialJAMA.(2010 Jul 7)
    22. Osteoarthritis Symptoms - Chrubasik S, Thanner J, Künzel O, Conradt C, Black A, Pollak SComparison of outcome measures during treatment with the proprietary Harpagophytum extract doloteffin in patients with pain in the lower back, knee or hipPhytomedicine.(2002 Apr)
    23. Osteoarthritis Symptoms - Caruso I, Pietrogrande VItalian double-blind multicenter study comparing S-adenosylmethionine, naproxen, and placebo in the treatment of degenerative joint diseaseAm J Med.(1987 Nov 20)
    24. Osteoarthritis Symptoms - Wadie I Najm, Sibylle Reinsch, Fred Hoehler, Jerome S Tobis, Phillip W HarveyS-adenosyl methionine (SAMe) versus celecoxib for the treatment of osteoarthritis symptoms: a double-blind cross-over trial. [ISRCTN36233495]BMC Musculoskelet Disord.(2004 Feb 26)
    25. Osteoarthritis Symptoms - Kim J, Lee EY, Koh EM, Cha HS, Yoo B, Lee CK, Lee YJ, Ryu H, Lee KH, Song YWComparative 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 patientsClin Ther.(2009 Dec)
    26. Osteoarthritis Symptoms - Soeken KL, Lee WL, Bausell RB, Agelli M, Berman BMSafety and efficacy of S-adenosylmethionine (SAMe) for osteoarthritisJ Fam Pract.(2002 May)
    27. Osteoarthritis Symptoms - Hardy ML, Coulter I, Morton SC, Favreau J, Venuturupalli S, Chiappelli F, Rossi F, Orshansky G, Jungvig LK, Roth EA, Suttorp MJ, Shekelle PS-adenosyl-L-methionine for treatment of depression, osteoarthritis, and liver disease.Evid Rep Technol Assess (Summ).(2003 Aug)
    28. Osteoarthritis Symptoms - Rutjes AW, Nüesch E, Reichenbach S, Jüni PS-Adenosylmethionine for osteoarthritis of the knee or hip.Cochrane Database Syst Rev.(2009 Oct 7)
    29. Osteoarthritis Symptoms - Panahi Y, Rahimnia AR, Sharafi M, Alishiri G, Saburi A, Sahebkar ACurcuminoid treatment for knee osteoarthritis: a randomized double-blind placebo-controlled trialPhytother Res.(2014 Nov)
    30. Osteoarthritis Symptoms - Pinsornsak P, Niempoog SThe efficacy of Curcuma Longa L. extract as an adjuvant therapy in primary knee osteoarthritis: a randomized control trialJ Med Assoc Thai.(2012 Jan)
    31. Osteoarthritis Symptoms - Srivastava S, Saksena AK, Khattri S, Kumar S, Dagur RSCurcuma longa extract reduces inflammatory and oxidative stress biomarkers in osteoarthritis of knee: a four-month, double-blind, randomized, placebo-controlled trialInflammopharmacology.(2016 Dec)
    32. Osteoarthritis Symptoms - Belcaro G, Cesarone MR, Dugall M, Pellegrini L, Ledda A, Grossi MG, Togni S, Appendino GEfficacy and safety of Meriva®, a curcumin-phosphatidylcholine complex, during extended administration in osteoarthritis patientsAltern Med Rev.(2010 Dec)
    33. Osteoarthritis Symptoms - Vilai Kuptniratsaikul, Sunee Thanakhumtorn, Pornsiri Chinswangwatanakul, Luksamee Wattanamongkonsil, Visanu ThamlikitkulEfficacy and safety of Curcuma domestica extracts in patients with knee osteoarthritisJ Altern Complement Med.(2009 Aug)
    34. Osteoarthritis Symptoms - Kuptniratsaikul V, Dajpratham P, Taechaarpornkul W, Buntragulpoontawee M, Lukkanapichonchut P, Chootip C, Saengsuwan J, Tantayakom K, Laongpech SEfficacy and safety of Curcuma domestica extracts compared with ibuprofen in patients with knee osteoarthritis: a multicenter studyClin Interv Aging.(2014 Mar 20)
    35. Osteoarthritis Symptoms - Haroyan A, Mukuchyan V, Mkrtchyan N, Minasyan N, Gasparyan S, Sargsyan A, Narimanyan M, Hovhannisyan AEfficacy and safety of curcumin and its combination with boswellic acid in osteoarthritis: a comparative, randomized, double-blind, placebo-controlled studyBMC Complement Altern Med.(2018 Jan 9)
    36. Osteoarthritis Symptoms - Shep D, Khanwelkar C, Gade P, Karad SSafety and efficacy of curcumin versus diclofenac in knee osteoarthritis: a randomized open-label parallel-arm studyTrials.(2019 Apr 11)
    37. Osteoarthritis Symptoms - Panda SK, Nirvanashetty S, Parachur VA, Mohanty N, Swain TA Randomized, Double Blind, Placebo Controlled, Parallel-Group Study to Evaluate the Safety and Efficacy of Curene® versus Placebo in Reducing Symptoms of Knee OABiomed Res Int.(2018 Oct 25)
    38. Osteoarthritis Symptoms - Nakagawa Y, Mukai S, Yamada S, Matsuoka M, Tarumi E, Hashimoto T, Tamura C, Imaizumi A, Nishihira J, Nakamura TShort-term effects of highly-bioavailable curcumin for treating knee osteoarthritis: a randomized, double-blind, placebo-controlled prospective studyJ Orthop Sci.(2014 Nov)
    39. Osteoarthritis Symptoms - Belcaro G, Cesarone MR, Dugall M, Pellegrini L, Ledda A, Grossi MG, Togni S, Appendino GProduct-evaluation registry of Meriva®, a curcumin-phosphatidylcholine complex, for the complementary management of osteoarthritisPanminerva Med.(2010 Jun)
    40. Osteoarthritis Symptoms - Madhu K, Chanda K, Saji MJSafety and efficacy of Curcuma longa extract in the treatment of painful knee osteoarthritis: a randomized placebo-controlled trialInflammopharmacology.(2013 Apr)
    41. Osteoarthritis Symptoms - Henrotin et alBio-optimized Curcuma longa extract is efficient on knee osteoarthritis pain: a double-blind multicenter randomized placebo controlled three-arm studyArthritis Res Ther.()
    42. Osteoarthritis Symptoms - Winther K, Apel K, Thamsborg GA powder made from seeds and shells of a rose-hip subspecies (Rosa canina) reduces symptoms of knee and hip osteoarthritis: a randomized, double-blind, placebo-controlled clinical trialScand J Rheumatol.(2005 Jul-Aug)
    43. Osteoarthritis Symptoms - Rein E, Kharazmi A, Winther KA herbal remedy, Hyben Vital (stand. powder of a subspecies of Rosa canina fruits), reduces pain and improves general wellbeing in patients with osteoarthritis--a double-blind, placebo-controlled, randomised trialPhytomedicine.(2004 Jul)
    44. Osteoarthritis Symptoms - Odd Warholm, Sigrun Skaar, Ewa Hedman Hanna Maria Mølmen, Liv EikThe Effects of a Standardized Herbal Remedy Made from a Subtype of Rosa canina in Patients with Osteoarthritis: A Double-Blind, Randomized, Placebo-Controlled Clinical TrialCurrent Therapeutic Research.()
    45. Pain - K Winther, E Rein, A KharazmiThe anti-inflammatory properties of rose-hipInflammopharmacology.(1999)
    46. Osteoarthritis Symptoms - Bliddal H, Rosetzsky A, Schlichting P, Weidner MS, Andersen LA, Ibfelt HH, Christensen K, Jensen ON, Barslev JA randomized, placebo-controlled, cross-over study of ginger extracts and ibuprofen in osteoarthritisOsteoarthritis Cartilage.(2000 Jan)
    47. Osteoarthritis Symptoms - Zahmatkash M, Vafaeenasab MRComparing analgesic effects of a topical herbal mixed medicine with salicylate in patients with knee osteoarthritisPak J Biol Sci.(2011 Jul 1)
    48. Joint Pain (General) - Baek HI, Shen L, Ha KC, Park YK, Kim CS, Kwon JE, Park SJEffectiveness and safety of steamed ginger extract on mild osteoarthritis: a randomized, double-blind, placebo-controlled clinical trial.Food Funct.(2024 Sep 16)
    49. Osteoarthritis Symptoms - McAlindon T, LaValley M, Schneider E, Nuite M, Lee JY, Price LL, Lo G, Dawson-Hughes BEffect of vitamin D supplementation on progression of knee pain and cartilage volume loss in patients with symptomatic osteoarthritis: a randomized controlled trialJAMA.(2013 Jan 9)
    50. Osteoarthritis Symptoms - Singh BB, Mishra LC, Vinjamury SP, Aquilina N, Singh VJ, Shepard NThe effectiveness of Commiphora mukul for osteoarthritis of the knee: an outcomes studyAltern Ther Health Med.(2003 May-Jun)
    51. Osteoarthritis Symptoms - Gupta PK, Samarakoon SM, Chandola HM, Ravishankar BClinical evaluation of Boswellia serrata (Shallaki) resin in the management of Sandhivata (osteoarthritis)Ayu.(2011 Oct)
    52. Osteoarthritis Symptoms - Sengupta K, Krishnaraju AV, Vishal AA, Mishra A, Trimurtulu G, Sarma KV, Raychaudhuri SK, Raychaudhuri SPComparative efficacy and tolerability of 5-Loxin and AflapinAgainst osteoarthritis of the knee: a double blind, randomized, placebo controlled clinical studyInt J Med Sci.(2010 Nov 1)
    53. Osteoarthritis Symptoms - Sengupta K, Alluri KV, Satish AR, Mishra S, Golakoti T, Sarma KV, Dey D, Raychaudhuri SPA double blind, randomized, placebo controlled study of the efficacy and safety of 5-Loxin for treatment of osteoarthritis of the kneeArthritis Res Ther.(2008)
    54. Osteoarthritis Symptoms - Vishal AA, Mishra A, Raychaudhuri SPA double blind, randomized, placebo controlled clinical study evaluates the early efficacy of aflapin in subjects with osteoarthritis of kneeInt J Med Sci.(2011)
    55. Osteoarthritis Symptoms - Majeed A, Majeed S, Satish G, Manjunatha R, Rabbani SN, Patil NVP, Mundkur LA standardized Boswellia serrata extract shows improvements in knee osteoarthritis within five days-a double-blind, randomized, three-arm, parallel-group, multi-center, placebo-controlled trial.Front Pharmacol.(2024)
    56. Osteoarthritis Symptoms - Keith Rayburn, Eric Fleischbein, Jessica Song, Blaine Allen, Mary Kundert, Charles Leiter, Thomas BushStinging nettle cream for osteoarthritisAltern Ther Health Med.(Jul-Aug 2009)
    57. Osteoarthritis Symptoms - Randall C, Randall H, Dobbs F, Hutton C, Sanders HRandomized controlled trial of nettle sting for treatment of base-of-thumb painJ R Soc Med.(2000 Jun)
    58. Osteoarthritis Symptoms - Brien S, Lewith G, Walker AF, Middleton R, Prescott P, Bundy RBromelain as an adjunctive treatment for moderate-to-severe osteoarthritis of the knee: a randomized placebo-controlled pilot studyQJM.(2006 Dec)
    59. Osteoarthritis Symptoms - Belcaro G, Cesarone MR, Errichi S, Zulli C, Errichi BM, Vinciguerra G, Ledda A, Di Renzo A, Stuard S, Dugall M, Pellegrini L, Errichi S, Gizzi G, Ippolito E, Ricci A, Cacchio M, Cipollone G, Ruffini I, Fano F, Hosoi M, Rohdewald PTreatment of osteoarthritis with Pycnogenol. The SVOS (San Valentino Osteo-arthrosis Study). Evaluation of signs, symptoms, physical performance and vascular aspectsPhytother Res.(2008 Apr)
    60. Osteoarthritis Symptoms - Reza Farid, Zahra Mirfeizi, Mahyar Mirheidari, Zahra Rezaieyazdi, Hassan Mansouri, Habib Esmaelli, Sherma Zibadi, Peter Rohdewald, Ronald Ross WatsonPycnogenol supplementation reduces pain and stiffness and improves physical function in adults with knee osteoarthritisNutrition Research.()
    61. C-Reactive Protein (CRP) - Omid Nikpayam, Mohammad Hossein Rouhani, Makan Pourmasoumi, Neda Roshanravan, Ehsan Ghaedi, Hamed MohammadiThe Effect of Pycnogenol Supplementation on Plasma C-Reactive Protein Concentration: a Systematic Review and Meta-AnalysisClin Nutr Res.(2018 Apr)
    62. Osteoarthritis Symptoms - Ramakanth GS, Uday Kumar C, Kishan PV, Usharani PA randomized, double blind placebo controlled study of efficacy and tolerability of Withaina somnifera extracts in knee joint painJ Ayurveda Integr Med.(2016 Jul - Sep)
    63. Osteoarthritis Symptoms - Colker CM, Swain M, Lynch L, Gingerich DAEffects of a milk-based bioactive micronutrient beverage on pain symptoms and activity of adults with osteoarthritis: a double-blind, placebo-controlled clinical evaluationNutrition.(2002 May)
    64. Osteoarthritis Symptoms - Aida Malek Mahdavi, Reza Mahdavi, Sousan KolahiEffects of l-Carnitine Supplementation on Serum Inflammatory Factors and Matrix Metalloproteinase Enzymes in Females with Knee Osteoarthritis: A Randomized, Double-Blind, Placebo-Controlled Pilot StudyJ Am Coll Nutr.(Sep-Oct 2016)
    65. Osteoarthritis Symptoms - Mahdavi R, et alL-Carnitine supplementation ameliorates serum tumor necrosis factor-alpha and matrix metalloproteinase-3 in knee osteoarthritis womenBangladesh J Pharmacol.()
    66. Osteoarthritis Symptoms - Kolahi S, et alEffect of l-carnitine supplementation on clinical symptoms in women with osteoarthritis of the knee: A randomized, double-blind, placebo-controlled trialEur J Integr Med.()
    67. Total cholesterol - Aida Malek Mahdavi, Reza Mahdavi, Sousan Kolahi, Maryam Zemestani, Amir-Mansour VatankhahL-Carnitine supplementation improved clinical status without changing oxidative stress and lipid profile in women with knee osteoarthritisNutr Res.(2015 Aug)
    68. Osteoarthritis Symptoms - Neves M Jr, Gualano B, Roschel H, Fuller R, Benatti FB, Pinto AL, Lima FR, Pereira RM, Lancha AH Jr, Bonfá EBeneficial effect of creatine supplementation in knee osteoarthritisMed Sci Sports Exerc.(2011 Aug)
    69. Osteoarthritis Symptoms - Crowley DC, Lau FC, Sharma P, Evans M, Guthrie N, Bagchi M, Bagchi D, Dey DK, Raychaudhuri SPSafety and efficacy of undenatured type II collagen in the treatment of osteoarthritis of the knee: a clinical trialInt J Med Sci.(2009 Oct 9)
    70. Osteoarthritis Symptoms - P. Benito-RuizM.M. Camacho-Zambrano, J.N. Carrillo-Arcentales, M.A. Mestanza-Peralta, C.A. Vallejo-Flores, S.V. Vargas-López, R.A. Villacís-Tamayo and L.A. Zurita-GavilanesA randomized controlled trial on the efficacy and safety of a food ingredient, collagen hydrolysate, for improving joint comfortInternational Journal of Food Sciences and Nutrition.()
    71. Osteoarthritis Symptoms - Xiaoqian Liu, Gustavo C Machado, Jillian P Eyles, Varshini Ravi, David J HunterDietary supplements for treating osteoarthritis: a systematic review and meta-analysisBr J Sports Med.(2018 Feb)
    72. Osteoarthritis Symptoms - Honvo G, Bruyère O, Geerinck A, Veronese N, Reginster JYEfficacy of Chondroitin Sulfate in Patients with Knee Osteoarthritis: A Comprehensive Meta-Analysis Exploring Inconsistencies in Randomized, Placebo-Controlled Trials.Adv Ther.(2019-May)
    73. Osteoarthritis Symptoms - Hochberg MCStructure-modifying effects of chondroitin sulfate in knee osteoarthritis: an updated meta-analysis of randomized placebo-controlled trials of 2-year duration.Osteoarthritis Cartilage.(2010-Jun)
    74. Osteoarthritis Symptoms - Lee YH, Woo JH, Choi SJ, Ji JD, Song GGEffect of glucosamine or chondroitin sulfate on the osteoarthritis progression: a meta-analysis.Rheumatol Int.(2010-Jan)
    75. Osteoarthritis Symptoms - Debbi EM, Agar G, Fichman G, Ziv YB, Kardosh R, Halperin N, Elbaz A, Beer Y, Debi REfficacy of methylsulfonylmethane supplementation on osteoarthritis of the knee: a randomized controlled studyBMC Complement Altern Med.(2011 Jun 27)
    76. Joint Pain (General) - Brien S, Prescott P, Lewith GMeta-analysis of the related nutritional supplements dimethyl sulfoxide and methylsulfonylmethane in the treatment of osteoarthritis of the knee.Evid Based Complement Alternat Med.(2011)
    77. Osteoarthritis Symptoms - Stausholm MB, Naterstad IF, Joensen J, Lopes-Martins RÁB, Sæbø H, Lund H, Fersum KV, Bjordal JMEfficacy of low-level laser therapy on pain and disability in knee osteoarthritis: systematic review and meta-analysis of randomised placebo-controlled trials.BMJ Open.(2019-Oct-28)
    78. Osteoarthritis Symptoms - Deng W, Yi Z, Yin E, Lu R, You H, Yuan XEffect of omega-3 polyunsaturated fatty acids supplementation for patients with osteoarthritis: a meta-analysis.J Orthop Surg Res.(2023-May-24)
    79. Osteoarthritis Symptoms - Nguyen C, Coudeyre E, Boutron I, Baron G, Daste C, Lefèvre-Colau MM, Sellam J, Zauderer J, Berenbaum F, Rannou FOral resveratrol in adults with knee osteoarthritis: A randomized placebo-controlled trial (ARTHROL).PLoS Med.(2024 Aug)
    80. C-Reactive Protein (CRP) - Armita Mahdavi Gorabi, Saeed Aslani, Danyal Imani, Bahman Razi, Thozhukat Sathyapalan, Amirhossein SahebkarEffect of resveratrol on C-reactive protein: An updated meta-analysis of randomized controlled trialsPhytother Res.(2021 Dec)
    81. Creatinine - Abdollahi S, Vajdi M, Meshkini F, Vasmehjani AA, Sangsefidi ZS, Clark CCT, Soltani SResveratrol may mildly improve renal function in the general adult population: A systematic review and meta-analysis of randomized controlled clinical trials.Nutr Res.(2023-May)
    82. Pain - Richard J Bloomer, Tyler M Farney, Cameron G McCarthy, Sang-Rok LeeCissus quadrangularis reduces joint pain in exercise-trained men: a pilot studyPhys Sportsmed.(2013 Sep)
    83. Functionality in Elderly or Injured - Deutsch LEvaluation of the effect of Neptune Krill Oil on chronic inflammation and arthritic symptomsJ Am Coll Nutr.(2007 Feb)
    84. C-Reactive Protein (CRP) - Laslett LL, Scheepers LEJM, Antony B, Wluka AE, Cai G, Hill CL, March L, Keen HI, Otahal P, Cicuttini FM, Jones GKrill Oil for Knee Osteoarthritis: A Randomized Clinical Trial.JAMA.(2024 Jun 18)
    85. Total cholesterol - Scorei R, Mitrut P, Petrisor I, Scorei IA double-blind, placebo-controlled pilot study to evaluate the effect of calcium fructoborate on systemic inflammation and dyslipidemia markers for middle-aged people with primary osteoarthritisBiol Trace Elem Res.(2011 Dec)