The best supplements to relieve joint pain: find out which natural remedies are sure to ease the pain of arthritis

Natural Health, Oct-Nov, 2002 by Steve Calechman

If you have osteoarthritis, the search for relief can be almost as frustrating as your condition. This degenerative disease breaks down the protective cartilage between your joints, causing pain and stiffness and limiting mobility. There are dozens of natural arthritis supplements on the market. But how do you know which are best? To answer that question, we surveyed a half-dozen joint pain specialists and combed scientific studies. The following supplements garnered the most support. Like some natural remedies, these take time to work, anywhere from one week to two months. But the payoff is worth it. They all ease pain and stiffness, and some even prevent further deterioration or rebuild cartilage. Here's what you need to know about these treatments.

Glucosamine Sulfate and Chondroitin

These two supplements work together as a powerful osteoarthritis remedy. Taken jointly, they prevent the progression of the disease, reduce inflammation, and relieve mild to severe pain. Of all the joint pain supplements on the market, glucosamine and chondroitin have the largest body of evidence behind them.

Glucosamine sulfate, a natural substance, keeps cartilage from fraying and can help you produce more cartilage, says Jason Theodosakis, M.D., a physician in Tucson, Ariz., and author of Maximizing the Arthritis Cure (St. Martin's Press, 1999). Glucosamine also relieves pain and inflammation, although how it does this is unknown. Chondroitin, a natural substance found in cartilage, helps slow cartilage breakdown, which allows you to move with less pain, says Ron Hobbs, N.D., a naturopath and professor at Bastyr University in Kenmore, Wash., and co-author of The Natural Pharmacist's Guide to Treating Arthritis (Prima Publishing, 2001).

Most of the research on glucosamine and chondroitin has focused on their ability to halt the progression of osteoarthritis. For example, in a 2001 double-blind, placebo-controlled study in Lancet, 212 patients with osteoarthritis of the knee randomly took 1,500 mg of glucosamine or a placebo daily for three years (they did not take chondroitin). At the end of the study, the placebo group showed a significant loss of cartilage, but the glucosamine patients did not. Studies also show that glucosamine and chondroitin reduce inflammation and relieve pain.

You can buy these supplements separately, but Theodosakis recommends combining them because their benefits increase when they're taken together (studies confirm this effect).

SAM-e

SAM-e is best known as a natural remedy for depression, but it can also ease the moderate pain and decreased mobility of osteoarthritis. (SAM-e stands for S-adenosylmethionine, a molecule that assists in several chemical reactions in your body.) Clinical trials on more than 22,000 patients have shown that SAM-e can relieve osteoarthritis pain, and doctors in Europe have been treating osteoarthritis and depression with it for decades. (Depression can make the symptoms of osteoarthritis more intolerable, notes Graeme Shaw, M.D., an integrative medicine physician in Los Altos, Calif.) Nearly all the experts we spoke to recommended SAM-e.

SAM-e delivers sulfur to your cartilage, where it helps build the collagen (protein fiber) bonds that strengthen your joints. The sulfur in SAM-e also helps relieve pain and inflammation, says Lisa Stein, D.C., a chiropractor in Cupertino, Calif. Experts aren't sure how SAM-e alleviates depression. Some believe that SAM-e helps produce mood-boosting chemical messengers in the brain, explains Jonathan Alpert, M.D., Ph.D., associate director of the Depression Clinical and Research Program at Massachusetts General Hospital in Boston.

A 2002 review of 11 randomized, controlled studies concluded that SAM-e is more effective in improving joint function in osteoarthritis patients than a placebo, and that it is just as effective in reducing pain and improving joint function as nonsteroidal anti-inflammatory drugs (like ibuprofen). The review was published in the Journal of Family Practice. In a 1987 double-blind study in the American Journal of Medicine, 22 people with osteoarthritis of the knee took 1,200 mg of SAM-e daily and 23 took the drug piroxicam. Both treatments significantly relieved pain and improved morning stiffness and mobility. However, patients who took SAM-e maintained these benefits longer after stopping the supplement than patients who took the conventional drug.

Turmeric

Most people know turmeric as a culinary herb (it's the spice in curry powder that makes it yellow), but it also possesses potent medicinal properties. A member of the ginger family, turmeric (Curcuma longa) treats mild osteoarthritis pain and inflammation. Only animal studies have proven its ability to reduce joint inflammation, but the herb has a centuries-long history of being used for inflammation in Ayurveda, the traditional medical system of India. Several of our experts agreed that turmeric can effectively relieve joint pain.

Doctors and researchers are unsure exactly how turmeric works, although it appears to inhibit the production of inflammatory chemicals called prostaglandins and leukotrienes, Hobbs says. A 1997 study in Molecular and Cellular Biochemistry showed that turmeric along with capsaicin (from red pepper) lowered inflammation in rats' paws. Other studies have been done on inflammation not related to joints; one of the studies involved rats, and another involved surgery patients with post-operative inflammation. Both the studies showed that turmeric reduced inflammation as powerfully as the drug phenylbutazone.