Providing Options for Knee Osteoarthritis

With the nation’s rate of obesity approaching 40% comes the direct effect of more weight on the joints, and in particular the knees.1 Painful knees and symptoms of osteoarthritis in the knee are increasing, affecting 25% of adults by limiting function and mobility.1 Additionally, osteoarthritis is the most common cause of knee pain in those over 50, and a major indicator for knee replacement.1 Alternative solutions may be ideal for certain patients who want to approach their knee pain without surgery via a regimen utilizing supplements shown to reduce inflammation.


There are several nutrients that have been documented in clinical studies to effect anti-inflammatory responses in the body, including the knees. One or more of the following supplements may be considered to support patients with knee pain due to osteoarthritis:



Methylsulfonylmethane (MSM)

An organosulfur compound, MSM is used as a supplement for inflammatory conditions that include osteoarthritis. By inhibiting the proinflammatory signaling pathway, MSM has been shown to decrease the release of proinflammatory cytokines, as well as alleviate markers of oxidative stress and muscle damage.2 In an analysis of 69 randomized placebo-controlled clinical trials, it was determined that MSM revealed statistically significant improvements in pain at short term, including physical function and stiffness.2 MSM is considered a safe supplement as it is on the GRAS list (Generally Recognized As Safe). 



One of the better known, most-studied supplements for osteoarthritis, glucosamine is an amino sugar that occurs in connective tissue, and is used to relieve the pain of osteoarthritis.3 In a meta-analysis of long-term pharmacologic treatments for knee osteoarthritis, it was determined that a small but statistically and clinically significant benefit was seen from prescription-grade glucosamine sulfate,4 which was associated with pain improvement, as well as improvement in the secondary outcomes of physical function and joint structure.4



Made primarily from chondroitin sulfate, chondroitin works by stopping the degradation of cartilage, as well as restoring lost cartilage. The supplement is also comprised of sulfur-containing amino acids.5 In an analysis of 43 randomized controlled trials, participants treated with chondroitin achieved statistically significant and clinically meaningful better pain scores in studies less than 6 months than those given placebo.5 Additionally, a comparison of chondroitin alone or in combination with glucosamine or another supplement demonstrated a significant reduction in pain when compared with placebo or an active control.5



Curcumin is an active constituent derived from the rhizome of turmeric. Its anti-inflammatory effects are the result of inhibiting pro-inflammatory signals that include prostaglandins, leukotrienes, and cyclooxygenase-2.6 In a randomized, open-label, parallel, active controlled clinical study, participants randomly received either curcumin or control for 28 days. At days 14 and 28, patients receiving curcumin showed similar improvement in severity of pain when compared with control; curcumin may provide an alternative treatment option for patients with knee osteoarthritis who are intolerant to the side effects of prescription medication.6


The resulting effects of each supplement are promising as an alternative or adjunctive regimen to traditional osteoarthritis treatments of the knee.



1. van der Merwe M, Bloomer RJ. The Influence of Methylsulfonylmethane on Inflammation-Associated Cytokine Release before and following Strenuous Exercise. J Sports Med (Hindawi Publ Corp). 2016;2016:7498359.

2. Nguyen US, Zhang Y, Zhu Y, Niu J, Zhang B, Felson DT. Increasing prevalence of knee pain and symptomatic knee osteoarthritis: survey and cohort data. Ann Intern Med. 2011;155(11):725–732. 

3. Zhu X, Sang L, Wu D, Rong J, Jiang L. Effectiveness and safety of glucosamine and chondroitin for the treatment of osteoarthritis: a meta-analysis of randomized controlled trials. J Orthop Surg Res. 2018;13(1):170. Published 2018 Jul 6. 

4. Gregori D, Giacovelli G, Minto C, et al. Association of Pharmacological Treatments With Long-term Pain Control in Patients With Knee Osteoarthritis: A Systematic Review and Meta-analysis. JAMA. 2018;320(24):2564–2579. 

5. Singh JA, Noorbaloochi S, MacDonald R, Maxwell LJ. Chondroitin for osteoarthritis. Cochrane Database Syst Rev. 2015;1:CD005614. Published 2015 Jan 28. 

6. Shep, D., Khanwelkar, C., Gade, P. et al. Safety and efficacy of curcumin versus diclofenac in knee osteoarthritis: a randomized open-label parallel-arm study. Trials 20, 214 (2019).