osteoarthritis solutions

Osteoarthritis: micronutritional and phytotherapeutic solutions

Although the damage to cartilage caused by osteoarthritis is irreversible, it is nonetheless possible to relieve the pain during the chronic, less intense phases of the condition and to delay the progression of the disease. This article reviews the dietary and phytotherapeutic solutions available.

Although osteoarthritis cannot be cured, it can be treated. To relieve the pain and discomfort of osteoarthritis, action can be taken on two levels : 

  • reduce the pain during the chronic, less intense phases of the condition
  • slow the progression of the disease.

Reducing inflammation using natural solutions

Anti-inflammatory action of omega-3 

Omega-3 EPA and DHA polyunsaturated fatty acids offer a number of recognised beneficial effects, including anti-inflammatory properties. Since the joint degeneration process involves local inflammation, an adequate nutritional intake of these fatty acids appears to be beneficial1,2.
The intake of these fatty acids can be increased by consuming more oily fish (salmon, sardine, tuna, mackerel, etc.) as well as rapeseed, walnut and camelina oils.

Plants to combat inflammation

Turmeric (Curcuma longa L)

Curcuma Longa L., a plant that is native to south Asia, is rich in curcumin. In-vitro studies have shown that curcumin appears to inhibit inflammatory cytokines. In humans, studies have shown that curcumin offers significant relief from joint pain for treated subjects3.

Boswellia

Boswellia serrata is a tree that is native to India. Its resin, obtained by making incisions in the bark, is used in Ayurvedic medicine. Boswellic acids inhibit the activity of inflammatory cytokines and of enzymes associated with inflammation (in-vitro study)4. Its extracts reduce pain levels in patients with osteoarthritis5.

Devil’s claw

Harpagophytum procumbens DC is a plant from Namibia which is used in South Africa to relieve pain caused by rheumatism, fevers, etc. The plant is acknowledged to have analgesic and anti-inflammatory properties6,7. ESCOP (European Scientific Cooperative on Phytotherapy) recognises the use of the secondary roots of Devil’s claw for the symptomatic treatment of painful joint symptoms, lower back pain, loss of appetite and dyspepsia. EMA (European Medicines Agency) recognises its traditional use for joint pain. 

Willow

Willow (Salix), is a tree that is rich in salicylic acid (the ancestor of aspirin) and has been used for thousands of years to relieve joint pain and treat fever. According to the French medicines agency’s reference guide (Médicaments à base de plantes, 1998), willow bark is traditionally used orally “as an analgesic (headache, toothache) and orally and topically “for the symptomatic treatment of minor painful joint symptoms”.
Its bark does, in fact, have a very high content of salicylate derivatives which are metabolised into salicylic acid and give willow its analgesic and anti-inflammatory properties that are indicated for osteoarticular disorders8.

A clinical study was conducted on subjects with osteoarthritis. In this study, taking 350 mg of turmeric extract and 150 mg of boswellia extract twice a day for 12 weeks reduced pain levels13.

Slowing the progression of osteoarthritis

Cruciferous vegetables, a source of sulphoraphane

Vegetables belonging to the crucifer family (all cabbages, turnip, watercress, broccoli…) have been found to be beneficial due to their high sulphoraphane content. Indeed, according to a study published in Arthritis and Rheumatism9, sulphoraphane, released after the consumption of cruciferous vegetables (e.g. broccoli), appears to slow down the destruction of cartilage in joints. 

Specific micronutrients: Glucosamine and Chondroitin

Glucosamine

This substance is naturally present in the body, and is formed from glucose and glutamine. It is mainly found in the cartilage and performs an important maintenance role. The research work carried out on this substance has been motivated by the idea that the intake of this precursor might stimulate the synthesis of the cartilage matrix. Studies have shown that a 4 to 8-week ingestion of glucosamine10-17: 

  • improves the symptoms (pain and functional disability in particular), 
  • slows down the loss of cartilage, 
  • reduces the amount of analgesics consumed and/or improves quality of life.

Glucosamine can be ingested orally since it is a derivative of chitin, present in the shells of crustaceans (e.g. Dublin Bay prawns (langoustines)).

Chondroitin

This compound is also manufactured by the body and its production reduces with age. It helps to reduce symptoms by alleviating the stiffness of the joint. Chondroitin sulphate is found in shark or ray cartilage which means that it is unlikely to be consumed in a normal western diet. In western countries, chondroitin and glucosamine compounds are available as food supplements.

For optimal efficacy and to avoid all adverse reactions, it is advisable to consult a healthcare professional.   

Who can give you advice ?

Who can give you advice ?

Find a healthcare professional near you, to advise you. Get advice

Key points

  • The consumption of crucifers (cabbages, turnip, watercress, broccoli) is recommended to slow down the destruction of cartilage9.
  • The consumption of oily fish (salmon, sardine, tuna, mackerel, etc.) and of rapeseed, walnut and camelina oils, which are rich in omega-3 is valuable since they have anti-inflammatory properties.
  • Studies have also demonstrated the beneficial effects of glucosamine and chondroitin in halting or slowing down the progression of the disease17.
  • With regard to plants, turmeric combined with boswellia improves the pain associated with osteoarthritis. They may be combined with Devil's claw6,7 and willow8 which offer anti-inflammatory properties.

Find a healthcare professional near you, to advise you.

Get advice

Our references

  1. Curtis CL, Rees SG, Little CB, Flannery CR, Hugues CE, Wilson C, et al. Pathologic indicators of degradation and inflammation in human osteoarthritic cartilage are abrogated by exposure to n-3 fatty acids. Athritis Rheum 2002 Jun;46(6):1544-53.
  2. Curtis CL, Rees SG, Little CB, Flannery CR, Hugues CE, Wilson C, et al. Effects of n-3 fatty acids on cartilage metabolism. Proc Nutr Soc 2002 Aug;61(3):381-9.
  3. Belcaro G, Cesarone MR, Dugall M, Pellegrini L, Ledda A, Grossi MG, et al. Product-evaluation registry of Meriva(R), a curcumin-phosphatidylcholine complex, for the complementary management of osteoarthritis. Panminerva Med 2010 Jun;52(2 Suppl 1):55-62 
  4. Abdel-Tawab M, Werz O, Schubert-Zsilavecz M. Boswellia serrata: an overall assessment of in vitro, preclinical, pharmacokinetic and clinical data. Clin Pharmacokinet 2011 Jun;50(6):349-69
  5. Sengupta K, Krishnaraju AV, Vishal AA, Mishra A, Trimurtulu G, Sarma KV, et al. Comparative efficacy and tolerability of 5-Loxin and Aflapin against osteoarthritis of the knee: a double blind, randomized, placebo controlled clinical study. Int J Med Sci 2010;7(6):366-77
  6. Natural Standard. Devil’s claw, Professional Monograph. 2011. 
  7. Chrubasik JE, Roufogalis BD, Chrubasik S. Evidence of effectiveness of herbal antiinflammatory drugs in the treatment of painful osteoarthritis and chronic low back pain. Phytother Res 2007 Jul;21(7):675-83. 
  8. CHRUBASIK S et al. Treatment of low back pain exacerbations with willow bark extract: a randomized double-blind study. Am J Med. 2000 ; 109(1): 9-14.
  9. Sulforaphane represses matrix-degrading proteases and protects cartilage from destruction in vitro and in vivo, Arthritis and Rheumatism, 2013. Le Sulforaphame permettrait de bloquer les enzymes responsables de la destruction des articulations en inhibant une protéine responsable elle-même de l’inflammation.
  10. Pavelka K, Gatterova J, Olejarova M, Machacek S, Giacovelli G, Rovati LC. Glucosamine sulfate use and delay of progression of knee osteoarthritis: a 3-year, randomized, placebo-controlled, double-blind study. Arch Intern Med 2002 Oct 14;162(18):2113-23. 
  11. Reginster JY, Deroisy R, Rovati LC, Lee RL, Lejeune E, Bruyere O, et al. Long-term effects of glucosamine sulphate on osteoarthritis progression: a randomised, placebo-controlled clinical trial. Lancet 2001 Jan 27 ;357(9252):251-6.
  12. Anderson JW, Nicolosi RJ, Borzelleca JF. Glucosamine effects in humans: a review of effects on glucose metabolism, side effects, safety considerations and efficacy. Food Chem Toxicol 2005 ;43(2):187-201.
  13. Braham R, Dawson B, Goodman C. The effect of glucosamine supplementation on people experiencing regular knee pain. Br J Sports Med 2003 ;37(1):45-9.
  14. Gaby AR. Natural treatments for osteoarthritis. Altern Med Rev 1999 ;4(5):330-41.
  15. McAlindon TE, LaValley MP, Gulin JP, Felson DT. Glucosamine and chondroitin for treatment of osteoarthritis: a systematic quality assessment and meta-analysis. Jama 2000; 283(11):1469-75.
  16. McAlindon TE, Biggee BA. Nutritional factors and osteoarthritis: recent developments. Curr Opin Rheumatol 2005 ;17(5):647-52.
  17. Richy F, Bruyere O, Ethgen O, Cucherat M, Henrotin Y, Reginster JY. Structural and symptomatic efficacy of glucosamine and chondroitin in knee osteoarthritis: a comprehensive meta-analysis. Arch Intern Med 2003 ;163(13):1514-22. 30. Towheed T. Glucosamine therapy for treating osteoarthritis. Cochrane Database of systematic reviews 2004.

To go further

Les Echos de la micronutrition n°51: Arthrose, adieu douleurs, bonjour bonheur !, http://www.iedm.asso.fr/IMG/pdf/echos-51_11-2016.pdf

These items may also interest you...