7 Best Joint Supplements for Knee Pain: Evidence Review 2024
Chronic joint pain affects almost one-quarter of people worldwide. Common joints affected include the knees, hands, elbows, shoulders, back and elsewhere. In most cases, this is caused by the most common type of arthritis, osteoarthritis. Treatments being used range from health supplements, hyaluronic acid, platelet rich plasma (PRP), stem cell therapy, to surgical methods such as minimal invasive method to joint replacement surgery (total knee replacement, total hip replacement).
Pain relievers such as acetaminophen (Tylenol or Panadol) or non-steroidal anti-inflammatory drugs, such as ibuprofen (Advil or Nurofen), are usually the first choice for joint pain relief.
Of late, there are also dozens of supplements that claim to treat joint pain, but which ones actually work? Here’s a look at the best options and what the existing research says about them.
1. Glucosamine
Glucosamine is a natural component of cartilage, a substance that prevents bones from rubbing against each other and causing pain and inflammation. It might also help prevent the cartilage breakdown that can happen with arthritis. PubMed has indexed more than 500 research studies on glucosamine and knee osteoarthritis.
Many supplements aimed at treating joint pain contain glucosamine, which is one of the most well-studied supplements for osteoarthritis. But despite this research, there are still some questions about how well it works.
Pain relievers such as acetaminophen (Tylenol or Panadol) or non-steroidal anti-inflammatory drugs, such as ibuprofen (Advil or Nurofen), are usually the first choice for joint pain relief.
Of late, there are also dozens of supplements that claim to treat joint pain, but which ones actually work? Here’s a look at the best options and what the existing research says about them.
1. Glucosamine
Glucosamine is a natural component of cartilage, a substance that prevents bones from rubbing against each other and causing pain and inflammation. It might also help prevent the cartilage breakdown that can happen with arthritis. PubMed has indexed more than 500 research studies on glucosamine and knee osteoarthritis.
Many supplements aimed at treating joint pain contain glucosamine, which is one of the most well-studied supplements for osteoarthritis. But despite this research, there are still some questions about how well it works.
In a 2022 meta-analysis of 8 randomized controlled trials, that included more than 3,700 patients; confirmed that the combination of glucosamine and chondroitin is effective and superior to other treatments in knee osteoarthritis to a certain extent.
There are two types of glucosamine found in supplements: glucosamine hydrochloride and glucosamine sulfate.
One meta-analysis found that products containing glucosamine hydrochloride don’t do much to improve joint pain caused by osteoarthritis. Another study shows that glucosamine sulfate does improve these symptoms, so it may be a better option that glucosamine hydrochloride.
When taken over a long period of time, glucosamine sulfate may also help to slow down the progression of osteoarthritis. Studies suggest that it slows down narrowing of the joint space, a marker of the condition getting worse, when taken for up to three years.
Try it: Glucosamine sulfate is typically taken once daily in a dose of 1,500 milligrams (mg). If this upsets your stomach, try spreading it out over three doses of 500 mg each.
One meta-analysis found that products containing glucosamine hydrochloride don’t do much to improve joint pain caused by osteoarthritis. Another study shows that glucosamine sulfate does improve these symptoms, so it may be a better option that glucosamine hydrochloride.
When taken over a long period of time, glucosamine sulfate may also help to slow down the progression of osteoarthritis. Studies suggest that it slows down narrowing of the joint space, a marker of the condition getting worse, when taken for up to three years.
Try it: Glucosamine sulfate is typically taken once daily in a dose of 1,500 milligrams (mg). If this upsets your stomach, try spreading it out over three doses of 500 mg each.
You can find glucosamine sulfate supplements on Amazon.
2. Chondroitin
Like glucosamine, chondroitin is a building block of cartilage. It may also help prevent cartilage breakdown from osteoarthritis. PubMed has indexed more than 500 research studies on chondroitin and knee osteoarthritis.
Many clinical studies have found that chondroitin can reduce joint pain and stiffness in people with osteoarthritis. About 53 percent of people who take chondroitin have a 20 percent or greater improvement in knee pain.
Chondroitin sulfate may also slow down the progression of osteoarthritis when taken long-term. Studies show that it slows down narrowing of the joint space when taken for up to 2 years.
Joint supplements often combine chondroitin with glucosamine. In a 2022 meta-analysis of 8 randomized controlled trials, that included more than 3,700 patients; confirmed that the combination of glucosamine and chondroitin is effective and superior to other treatments in knee osteoarthritis to a certain extent.
Try it: Chondroitin is typically taken in a dose of 400 to 800 mg two or three times per day.
EPA and DHA are predominantly found in animal foods like fatty fish, while ALA is mostly found in plants.
However, ALA isn’t biologically active and needs to be converted to EPA and DHA to be used for something other than just stored energy like other types of fat (Trusted Source).
While ALA is still an essential fatty acid, EPA and DHA are linked to many more health benefits (Trusted Source). Additionally, the conversion process from ALA to EPA and DHA is quite inefficient in humans (Trusted Source). For example, one study found that only 5% of ALA is converted to EPA and less than 0.5% of ALA is converted to DHA in adults (Trusted Source).
EPA and DHA can reduce inflammation, which causes swelling and pain. Research has indicated that both acids might suppress the body’s immune system. However, a 2016 study suggests that DHA might enhance immune function instead. DHA is more effective at reducing inflammation than EPA, but both have a role.
All of these effects makes fish oil potentially beneficial for people with arthritis.
EPA and DHA come with other health benefits: They can help prevent heart attacks by making it harder for blood to clot. They help lower blood triglyceride levels and blood pressure. As well, EPA taken with statin medication is more effective in reducing the inflammation of arteriosclerosis than medication alone.
For the omega-3 fatty acids in fish oil to work against arthritis, it’s necessary to consume a fairly large quantity of it each day. Fish oil — or cod liver oil — enclosed in capsules makes this fairly easy.
On the other hand, because cod liver oil contains very high amounts of vitamin A and vitamin D, taking too much can be toxic. For the purpose of treating arthritis, fish oil is the safer choice.
In a 2020 randomized controlled trial, mineral rich algae with pine bark improved pain, physical function and analgesic use in mild-knee joint osteoarthritis, compared to Glucosamine.
Sources of resveratrol include:
They took this combination alongside a 15-gram dose of the NSAID meloxicam every day for 90 days.
People who took resveratrol found that their pain levels dropped significantly, compared with those who took the placebo.
More research is needed to confirm that resveratrol can benefit people with OA.
However, if you’re already taking another NSAID and it doesn’t reduce your pain as much as you’d like, the research suggests resveratrol may be a useful add-on.
However, not all supplements are equally effective, and it’s essential to learn how to safely use them.
Before taking any supplements:
Related:
2. Chondroitin
Like glucosamine, chondroitin is a building block of cartilage. It may also help prevent cartilage breakdown from osteoarthritis. PubMed has indexed more than 500 research studies on chondroitin and knee osteoarthritis.
Many clinical studies have found that chondroitin can reduce joint pain and stiffness in people with osteoarthritis. About 53 percent of people who take chondroitin have a 20 percent or greater improvement in knee pain.
Chondroitin sulfate may also slow down the progression of osteoarthritis when taken long-term. Studies show that it slows down narrowing of the joint space when taken for up to 2 years.
Joint supplements often combine chondroitin with glucosamine. In a 2022 meta-analysis of 8 randomized controlled trials, that included more than 3,700 patients; confirmed that the combination of glucosamine and chondroitin is effective and superior to other treatments in knee osteoarthritis to a certain extent.
Try it: Chondroitin is typically taken in a dose of 400 to 800 mg two or three times per day.
You can find chondroitin supplements on Amazon.
3. Methylsulfonylmethane (MSM)
Methylsulfonylmethane (MSM) is another common ingredient in supplements said to help with joint pain. One of the most popular uses of MSM is to decrease joint or muscle pain. It has been shown to benefit those with joint degeneration, a common cause of pain in the knees, back, hands and hips.
In one randomised controlled study, MSM improved pain and functioning compared to a placebo in people with osteoarthritis.
A study in 100 people over the age of 50 found that treatment with a supplement containing 1,200 mg of MSM for 12 weeks decreased pain, stiffness and swelling in the joints, compared to a placebo (Int J Biomed Sci. 2015).
The group receiving the supplement also reported improved overall quality of life and less difficulty walking and getting out of bed (Int J Biomed Sci. 2015).
Another study in 32 people with lower back pain found that taking a glucosamine supplement containing MSM significantly reduced lumbar stiffness and pain upon movement, plus greatly increased quality of life (Curr Ther Res Clin Exp. 2005).
Try it: Typical MSM doses range from 1,500 to 6,000 grams per day, sometimes divided into two doses.
3. Methylsulfonylmethane (MSM)
Methylsulfonylmethane (MSM) is another common ingredient in supplements said to help with joint pain. One of the most popular uses of MSM is to decrease joint or muscle pain. It has been shown to benefit those with joint degeneration, a common cause of pain in the knees, back, hands and hips.
In one randomised controlled study, MSM improved pain and functioning compared to a placebo in people with osteoarthritis.
A study in 100 people over the age of 50 found that treatment with a supplement containing 1,200 mg of MSM for 12 weeks decreased pain, stiffness and swelling in the joints, compared to a placebo (Int J Biomed Sci. 2015).
The group receiving the supplement also reported improved overall quality of life and less difficulty walking and getting out of bed (Int J Biomed Sci. 2015).
Another study in 32 people with lower back pain found that taking a glucosamine supplement containing MSM significantly reduced lumbar stiffness and pain upon movement, plus greatly increased quality of life (Curr Ther Res Clin Exp. 2005).
Try it: Typical MSM doses range from 1,500 to 6,000 grams per day, sometimes divided into two doses.
You can find MSM supplements on Amazon.
4. Omega-3s and Fish Oil
Omega-3 fatty acids are essential fats, meaning you must get them from the food you eat, as your body can’t make them. PubMed has indexed more than 30 research studies on omega-3 and knee pain.
They’ve been associated with numerous health benefits, such as a reduced risk of heart disease, reduced inflammation, and improved mood (Source, Source, Source).
Fish oil and flaxseed oil each contain an impressive amount of omega-3 fatty acids.
The main types of omega-3s in fish oil are eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) (Trusted Source).
On the other hand, flaxseed oil contains the omega-3 fatty acid known as alpha-linoleic acid (ALA) (Trusted Source). Flaxseed oil also contains linoleic acid, an omega-6 fatty acid.
4. Omega-3s and Fish Oil
Omega-3 fatty acids are essential fats, meaning you must get them from the food you eat, as your body can’t make them. PubMed has indexed more than 30 research studies on omega-3 and knee pain.
They’ve been associated with numerous health benefits, such as a reduced risk of heart disease, reduced inflammation, and improved mood (Source, Source, Source).
Fish oil and flaxseed oil each contain an impressive amount of omega-3 fatty acids.
The main types of omega-3s in fish oil are eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) (Trusted Source).
On the other hand, flaxseed oil contains the omega-3 fatty acid known as alpha-linoleic acid (ALA) (Trusted Source). Flaxseed oil also contains linoleic acid, an omega-6 fatty acid.
EPA and DHA are predominantly found in animal foods like fatty fish, while ALA is mostly found in plants.
However, ALA isn’t biologically active and needs to be converted to EPA and DHA to be used for something other than just stored energy like other types of fat (Trusted Source).
While ALA is still an essential fatty acid, EPA and DHA are linked to many more health benefits (Trusted Source). Additionally, the conversion process from ALA to EPA and DHA is quite inefficient in humans (Trusted Source). For example, one study found that only 5% of ALA is converted to EPA and less than 0.5% of ALA is converted to DHA in adults (Trusted Source).
EPA and DHA can reduce inflammation, which causes swelling and pain. Research has indicated that both acids might suppress the body’s immune system. However, a 2016 study suggests that DHA might enhance immune function instead. DHA is more effective at reducing inflammation than EPA, but both have a role.
All of these effects makes fish oil potentially beneficial for people with arthritis.
EPA and DHA come with other health benefits: They can help prevent heart attacks by making it harder for blood to clot. They help lower blood triglyceride levels and blood pressure. As well, EPA taken with statin medication is more effective in reducing the inflammation of arteriosclerosis than medication alone.
For the omega-3 fatty acids in fish oil to work against arthritis, it’s necessary to consume a fairly large quantity of it each day. Fish oil — or cod liver oil — enclosed in capsules makes this fairly easy.
On the other hand, because cod liver oil contains very high amounts of vitamin A and vitamin D, taking too much can be toxic. For the purpose of treating arthritis, fish oil is the safer choice.
Shop for fish oil supplement.
5. Curcumin
Curcumin is an antioxidant that may offer a variety of anti-inflammatory benefits. PubMed has indexed more than 40 research studies on curcumin and knee pain.It’s present in turmeric, a mild spice that can add color and flavor to sweet and savory dishes, as well as teas. It’s also available as a supplement.
Curcumin, present in turmeric, has long played a role in Chinese and Ayurvedic medicine, due to its anti-inflammatory properties.
In 2019, some researchers found that curcumin capsules had a similar effect on the symptoms of knee osteoarthritis as diclofenac, an NSAID.
In the study, 139 people with OA of the knee took either a 50-milligram tablet of diclofenac twice a day for 28 days or a 500-milligram curcumin capsule three times a day.
Both groups said their pain levels improved, but those who took curcumin had fewer negative effects. The research suggested that people who can’t take NSAIDs may be able to use curcumin instead.
Curcumin, present in turmeric, has long played a role in Chinese and Ayurvedic medicine, due to its anti-inflammatory properties.
In 2019, some researchers found that curcumin capsules had a similar effect on the symptoms of knee osteoarthritis as diclofenac, an NSAID.
In the study, 139 people with OA of the knee took either a 50-milligram tablet of diclofenac twice a day for 28 days or a 500-milligram curcumin capsule three times a day.
Both groups said their pain levels improved, but those who took curcumin had fewer negative effects. The research suggested that people who can’t take NSAIDs may be able to use curcumin instead.
Shop for curcumin supplements on Amazon.
6. Pine Bark Extract (Pycnogenol)
This is a relatively new entrant in this space.
Pine bark acts as a local anti-inflammatory in synovial
fluid (R) and three publications have shown it to improve KOA (knee osteoarthritis) pain and stiffness, NSAID (non steroidal anti inflammatory drug) use, physical and emotional well-being (R, R, R). Pine bark preparations have recently been “strongly recommended” to
the rheumatology community as early and additive treatment for OA,
likely based on the following meta-analysis (R, R).
7. Resveratrol
Resveratrol is another nutrient that has antioxidant and anti-inflammatory properties.Sources of resveratrol include:
- grapes
- tomatoes
- red wine
- peanuts
- soy
- some teas
They took this combination alongside a 15-gram dose of the NSAID meloxicam every day for 90 days.
People who took resveratrol found that their pain levels dropped significantly, compared with those who took the placebo.
More research is needed to confirm that resveratrol can benefit people with OA.
However, if you’re already taking another NSAID and it doesn’t reduce your pain as much as you’d like, the research suggests resveratrol may be a useful add-on.
You can find resveratrol supplements on Amazon.
Conclusion
Your doctor will likely recommend non-drug treatments if you have joint pain, and these recommendations may include supplements.However, not all supplements are equally effective, and it’s essential to learn how to safely use them.
Before taking any supplements:
- check first with your doctor that they are safe for you to use
- get your supplements from a reputable source
- follow the instructions provided
- trying to follow a healthy, balanced, and nutrient-dense diet
- if you are over-weight, strive to loss weight
- find out the underlying cause of the joint pain. Could be from poor sitting or standing position.
- physical therapy
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