Chronic joint pain can affect knees, hands, elbows, shoulders, and hips. Anywhere where bones meet with cartilage in between can be a hotspot for inflammation, swelling, reduced mobility, and pain. Although there are over 100 types of arthritis, the most common type of arthritis, osteoarthritis (OA), affects about half of those over 65 in at least one joint .
Doctors often recommend pain relievers such as acetaminophen (Tylenol) or nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil), to treat joint pain. Unfortunately, these drugs do not support healing or address the problems causing joint pain. Fortunately, research has shown that several natural supplements can work just as well, if not better, to promote comfort while also supporting healing in the joints.
Four powerful nutrients available to support joint health are glucosamine, chondroitin, curcumin (from turmeric), and SAMe. Let us share a little more about the science behind these supplemental nutrients so you (with the help of your doctor) can make the best decision for your individual needs.
Glucosamine is a natural component of cartilage, an amino sugar that helps to maintain the strength and structure of cartilage, contributing to both its resiliency and shock-absorption properties. Glucosamine is involved both in the structural matrix of cartilage and in drawing hydration to the joint as a rate-limiting factor in hyaluronic acid synthesis . When taken as a nutritional supplement, glucosamine may also help prevent some cartilage breakdown and the subsequent progression of osteoarthritis .
There are no natural, human food sources of glucosamine, but it can be isolated from the shells of shellfish for supplementation. While natural in its origin, it may not be an appropriate supplement for those with shellfish allergies or those choosing a vegan lifestyle.
Like glucosamine, chondroitin is a building block of cartilage. Chondroitin is a gel-forming polysaccharide macromolecule that contributes to the cushion-like characteristics of cartilage. It may also help prevent cartilage breakdown for osteoarthritis. Research has shown that chondroitin can reduce joint pain and stiffness in people with osteoarthritis . One specific study found that short-term chondroitin supplementation improved arthritic knee pain by more than 20% . In the long term, chondroitin supplementation helped to slow the narrowing of joint space, a measure of cartilage breakdown in arthritis .
Again, there are no common food sources of chondroitin. You can get some from the gristle (which is cartilage) between animal bones, but it is not typically a palatable food choice, making supplementation an easier option, but not a vegan one. Supplemental chondroitin is typically isolated from animal sources.
Glucosamine and Chondroitin…together
Glucosamine and chondroitin are often found combined in supplements as it seems their activities in joint support are somewhat synergistic. Glucosamine and chondroitin are considered long-term structure-modifying agents as they have been shown to have a beneficial effect of delaying long-term knee OA cartilage loss , in addition to reducing pain, stiffness, functional limitations, and joint swelling [7,8].
In subjects with knee pain, glucosamine and chondroitin supplementation has demonstrated support for both pain management and locomotor functions . Some of this effect may be credited to the fact that these nutrients contribute to further production of hyaluronic acid for joint lubrication, and they are building materials for cartilage. Aside from these structural functions, glucosamine and chondroitin have anti-inflammatory properties . This anti-inflammatory action may delay inflammation-induced breakdown of the cartilage, while the building-block functions may help to support the joint structure and keep the joint lubricated. Together, these effects may lead to more comfort and increased mobility of the affected joint. In fact, clinical trials involving highly arthritic patients have demonstrated equal pain relief between glucosamine/chondroitin and NSAID anti-inflammatory drugs .
Metabolic Maintenance offers a Glucosamine/Chondroitin supplement with added hyaluronic acid. Supplemental hyaluronic acid has also been shown to support tissue hydration and joint lubrication .
Perhaps a better option for those on a vegan diet is a supplement with curcumin. Curcumin is a naturally occurring substance, isolated from turmeric, a spice commonly used in Indian cuisines. Curcumin gives turmeric its anti-inflammatory and antioxidant effects that are thought to benefit cardiovascular health, brain function, mood, and a host of other conditions – one of which being arthritis.
A recent study conducted on people with symptoms of knee osteoarthritis showed that curcumin supplementation elicited a similar response to daily NSAID (diclofenac) treatment: nearly all patients in both treatment groups reported at least 50% improvement in their arthritis symptoms . In addition, people taking curcumin lost an average of 2% of their body weight and experienced few side effects that were common with diclofenac .
Although this was only one study, curcumin is a potent anti-inflammatory compound, so it follows that this nutrient likely supports healthy joints. Several other studies involving curcumin have reported similar results, showing no difference between curcumin and pain medication for joint comfort, and a link between curcumin supplementation, improved mobility, and decreased inflammation [11,12].
In a study of people with rheumatoid arthritis (an autoimmune arthritic condition), curcumin supplementation led to more antiarthritic activity than an anti-inflammatory drug .
Curcumin may not be an appropriate choice for those on blood-thinning medication (anticoagulants) as it has some natural blood-thinning properties. It also may be inappropriate for those with gallbladder issues or diabetes as it can amplify problems in the gallbladder and cause a decrease in blood sugar. Please talk to your doctor about whether curcumin is the right choice for joint support in your body.
SAMe (S-Adenosyl-L-methionine) was initially touted as a supplement that promotes a positive mood and emotional balance. However, scientists studying its effects on mood also noted that SAMe treatments led to improvements in arthritis symptoms as a side effect. Now SAMe is commonly marketed as a supplement to promote joint health, comfort, and mobility . And, yet again, SAMe supplementation has been shown to be about as effective as standard anti-inflammatory drugs in easing the symptoms of osteoarthritis [15,16]. The long-lasting response to SAMe suggests that SAMe also has a protective effect against further damage to cartilage .
If you are taking selective serotonin reuptake inhibitors (SSRIs; or any medication to treat a mood disorder) do not take SAMe without first discussing it with your psychiatrist. This is especially important for patients with bipolar disorder. As SAMe plays a role in neurotransmitter synthesis, it can have a positive effect on mood, but can also change the effect of mood-related medications. Your doctor can help you decide whether to make an adjustment to your medication or whether you should choose a different supplement for joint support.
- Jerosch, Jörg. “Effects of glucosamine and chondroitin sulfate on cartilage metabolism in OA: outlook on other nutrient partners especially omega-3 fatty acids.” International journal of rheumatology 2011 (2011).
- Uitterlinden, E. J., et al. “Glucosamine increases hyaluronic acid production in human osteoarthritic synovium explants.” BMC Musculoskeletal Disorders 9.1 (2008): 120.
- Pavelká, Karel, et al. “Glucosamine sulfate use and delay of progression of knee osteoarthritis: a 3-year, randomized, placebo-controlled, double-blind study.” Archives of internal medicine 162.18 (2002): 2113-2123.
- Singh, Jasvinder A., et al. “Chondroitin for osteoarthritis.” Cochrane Database of Systematic Reviews 1 (2015).
- Brief, Andrew A., Stephen G. Maurer, and Paul E. Di Cesare. “Use of Glucosamine and Chondroitin Sulfatein the Management of Osteoarthritis.” JAAOS-Journal of the American Academy of Orthopaedic Surgeons 9.2 (2001): 71-78.
- Raynauld, Jean‐Pierre, et al. “Long‐Term Effects of Glucosamine and Chondroitin Sulfate on the Progression of Structural Changes in Knee Osteoarthritis: Six‐Year Followup Data From the Osteoarthritis Initiative.” Arthritis care & research 68.10 (2016): 1560-1566.
- Hochberg, Marc C., et al. “Combined chondroitin sulfate and glucosamine for painful knee osteoarthritis: a multicentre, randomised, double-blind, non-inferiority trial versus celecoxib.” Annals of the rheumatic diseases (2015): annrheumdis-2014.
- Zeng, Chao, et al. “Effectiveness and safety of Glucosamine, chondroitin, the two in combination, or celecoxib in the treatment of osteoarthritis of the knee.” Scientific Reports 5 (2015): 16827.
- Kanzaki, Noriyuki, et al. “Glucosamine-containing supplement improves locomotor functions in subjects with knee pain: a randomized, double-blind, placebo-controlled study.” Clinical interventions in aging 10 (2015): 1743.
- Shep, Dhaneshwar, et al. “Safety and efficacy of curcumin versus diclofenac in knee osteoarthritis: a randomized open-label parallel-arm study.” Trials 20.1 (2019): 214.
- Belcaro, Gianni, et al. “Product-evaluation registry of Meriva®, a curcumin-phosphatidylcholine complex, for the complementary management of osteoarthritis.” Panminerva Med 52.2 Suppl 1 (2010): 55-62.
- Daily, James W., Mini Yang, and Sunmin Park. “Efficacy of turmeric extracts and curcumin for alleviating the symptoms of joint arthritis: a systematic review and meta-analysis of randomized clinical trials.” Journal of medicinal food 19.8 (2016): 717-729.
- Chandran, Binu, and Ajay Goel. “A randomized, pilot study to assess the efficacy and safety of curcumin in patients with active rheumatoid arthritis.” Phytotherapy research 26.11 (2012): 1719-1725.
- Soeken, Karen L., et al. “Safety and efficacy of S-adenosylmethionine (SAMe) for osteoarthritis.” J Fam Pract 51.5 (2002): 425-30.
- Kalbhen DA, Jansen G. Pharmacological studies on the anti-degenerative effect of ademetionine in experimental osteoarthritis [in German]. Arzneimittelforschung. 1990;40:1017-1021.
- Muller-Fassbender H. Double-blind clinical trial of S-adenosylmethionine versus ibuprofen in the treatment of osteoarthritis. Am J Med. 1987;83:81-83.