Cayenne (Capsicum frutescens). The US Food and Drug Administration (FDA) has approved the use of creams, lotions, and ointments made with capsaicin (or capsicin), the active compound in cayenne, to relieve pain caused byOsteoarthritis. International recommendations recommend the local use of capsaicin⁵, especially for osteoarthritis of the knee.

Dosage

Apply to affected areas, up to 4 times a day, a cream, lotion or ointment containing 0,025% to 0,075% capsaicin. It often takes up to 14 days of treatment before the full therapeutic effect is felt. Be careful, a burning sensation may be felt during the application.

Glucosamine

Glucosamine plays an important role in maintaining the integrity of the cartilage of all joints. The body produces it naturally. The vast majority of studies have been conducted with glucosamine sulfates.

 Relieve joint pain (mild or moderate osteoarthritis). Despite some controversy, the majority of research to date shows that glucosamine relieves, at least slightly, the symptoms of mild or moderate osteoarthritis (see our glucosamine fact sheet). The vast majority of studies have focused onknee osteoarthritis, some on thehip osteoarthritis.

 Slow the progression of osteoarthritis. The conclusions of 2 long-term clinical trials (3 years each, 414 subjects in all)^13-16 indicate that the action of glucosamine, in addition to its effects on symptoms, may help to slow the progression of the disease. An advantage over NSAIDs, which tend to accelerate the progression of osteoarthritis.

Dosage. Take 1 mg se glucosamine sulfates, in one or more doses, while eating. Allow 2 to 6 weeks for the supplement to show its full effects.

 Chondroitin. Like glucosamine, chondroitin is an essential component of cartilage and it is naturally produced by the body. Most of the studies have been done with highly purified patented products (Condrosulf®, Structum®, for example). Several meta-analyzes, reviews and clinical trials conclude that it is effective for relieve symptoms mild to moderate osteoarthritis and slow down its evolution. As with glucosamine, this is an advantage over NSAIDs, which tend to accelerate the progression of osteoarthritis. Chondroitin is also the subject of some controversy. Consult our Chondroitin file to learn more about the studies carried out and the choice between glucosamine and chondroitin.

Dosage

Take 800 mg to 1 mg per day of chondroitin, in one or more doses. It takes 200 to 2 weeks for the full effect to be felt.

 SAMe. SAMe (for S-Adenosyl-L-Methionine) is synthesized by the body from proteins in food. Used as a supplement, it has been proven to treat osteoarthritis²⁷. The results of the studies showed that it was as effective as conventional anti-inflammatory drugs without having the side effects and being safe.^28-31 .

However, a meta-analysis published in 2009 brings down the efficacy and safety of S-adenosylmethionine. According to its authors, several studies have methodological weaknesses and an insufficient number of participants. They conclude that the analgesic effect of SAMe (1 mg per day) is modest⁸⁰.

Dosage

Take 400 mg 3 times a day for 3 weeks then reduce the daily dose to 200 mg 2 times a day.

Remark

Although it may take a few days to show benefits, it can take up to 5 weeks for treatment to take full effect. Consult our SAMe file for more details.

 Devil’s claw (Harpagophytum procumbens). Devil’s claw root has been shown to reduce inflammation. Despite reservations about the methodology of certain studies⁷⁹, the results of several clinical trials, with or without a placebo group, indicate that devil’s claw root can improve mobility and significantly relieve pain^{35, 36,81-83}.

Dosage

Dosages may vary depending on the type of extract. Follow the manufacturer’s instructions. It is recommended to follow the treatment for at least 2 or 3 months in order to take full advantage of its effects.

 Phytodolor®. This standardized herbal medicine, marketed in Europe as a tincture to be taken internally, consists of trembling aspen (populus), European ash (Fraxinus excelsior) and goldenrod (Solidago virgaurea) with a 3: 1: 1 ratio. This product would be more effective than a placebo in reducing pain, increasing mobility and reducing the consumption of non-steroidal anti-inflammatory drugs.^32-34 .

 Acupuncture. Several clinical trials have evaluated the effectiveness of acupuncture on pain associated with osteoarthritis. A meta-analysis published in 2007 and involving more than 1 people concluded that acupuncture may reduce pain and disability associated with osteoarthritis⁵⁹. However, some trials have shown that sham acupuncture can also be effective. Anyway, the international recommendations on the management of osteoarthritis of the knee and hip⁵ recognize acupuncture as a potentially effective pain relief tool.

 Hydrotherapy. The results of various clinical trials show that hydrotherapy treatments in different forms (spa, baths using different kinds of water, etc.) could improve the quality of life of people with osteoarthritis, by increasing the range of motion. and reducing pain^49-54 . A systematic review published in 2009, grouping together 9 trials and nearly 500 patients, concludes that balneotherapy is effective in the short and long term on pain associated with osteoarthritis of the knee.⁴⁵.

 Homeopathy. A few studies have been published on the effectiveness of homeopathy in reducing pain and symptoms of osteoarthritis. The authors of a systematic review believe that homeopathy could be a useful treatment for osteoarthritis but that more studies are needed to make sure.⁴⁸. See the Homeopathy sheet.

 Avocado and soya unsaponifiables. Substances extracted from avocado and soy – the unsaponifiable fraction of their oils – may be beneficial for people with osteoarthritis of the knee or hip. Based on 4 clinical studies with placebo^37-41 , these substances help to improve the function of the joints and to decrease the pain and the need for anti-inflammatory drugs, without side effects. Currently, avocado and soy unsaponifiables are marketed in France but not in Canada.

 Magnetotherapy. Several studies have evaluated the effects of magnetotherapy, applied using static magnets or devices emitting electromagnetic fields (EMF), in the treatment of osteoarthritis and especially that of the knee.^65-68 . Magnetotherapy would reduce the pain in a modest way. In 2009, a review including 9 studies and 483 patients with osteoarthritis of the knee concluded that magnetotherapy was an interesting complementary approach to improve the functional ability and facilitate activities daily⁵⁸.

 Leeches. A pilot study⁵⁵ and 2 randomized clinical trials^56,57 conducted in Germany indicate that applying leeches to a knee with osteoarthritis can relieve pain, counter stiffness and decrease other symptoms. Leeches have traditionally been used in the treatment of pain since Antiquity and then abandoned in the mid-XNUMXth century.^e century. However, they are still commonly used in traditional medicines in Asia, Africa and Arab countries.

 White willow (Salix alba). White willow bark extracts are said to be more effective than a placebo in reducing joint pain caused by osteoarthritis. However, in a trial of 127 participants with osteoarthritis of the knee or hip, these extracts were significantly less effective than an anti-inflammatory drug (diclofenac).⁷⁴.

 Yoga. Results from clinical trials in healthy subjects and people with various musculoskeletal disorders^69,70 reveal that the practice of yoga can help improve several aspects of these conditions, including osteoarthritis of the hands⁷¹ and knees⁷² and rheumatoid arthritis⁷³.

 Transcutaneous electrical stimulation (TENS). This technique uses a device that generates an electric current of low intensity, transmitted to the nerves by electrodes placed on the skin. A review of studies published in 2000 suggested that transcutaneous electrical neurostimulation could lead to reduced pain in knee osteoarthritis.⁴⁴. However, in 2009, an update published by the same group of researchers, including new trials, concluded that the effectiveness of this technique could not be confirmed for osteoarthritis of the knee.⁴⁷.

 Bore. Epidemiological data indicate that in places where boron intake is 1 mg or less per day, the frequency of arthritis problems is significantly higher (20% to 70%) than in areas where the daily intake is is between 3 mg and 10 mg per day (0% to 10%)³. A single clinical study dating from 1990 and involving 20 subjects has been published on the effect of boron on osteoarthritis: participants noted a slight improvement in their condition after taking 6 mg per day of boron, for 8 weeks⁴.

 Boswellie (Boswellia serrata). Boswellia, whose anti-inflammatory properties have been shown in vitro and in animals, may help in the treatment of osteoarthritis. Indeed, several studies of patients with osteoarthritis of the knee have shown positive results.^42,43,61. However, there are still too few data to suggest a dosage.

 Collagen. Collagen ensures the cohesion, elasticity and regeneration of several tissues (tendons, connective tissues, ligaments, etc.). Studies that have assessed the effectiveness of collagen supplements for relieving osteoarthritis have not been conclusive^75-77 . Most recent study found slight pain relief⁷⁸. In vitro data suggests that taking such supplements may help the affected joint by stimulating collagen production.

Notes. Most researchers have used a dosage of 10 g of collagen hydrolyzate per day. The commercially available capsules and tablets instead offer 1g to 2g per day.

 Tai chi. A clinical trial was conducted on 43 women over 55 with osteoarthritis⁶³. They practiced tai chi weekly for 12 weeks, or were part of the control group. There have been positive changes in the perception of pain, joint stiffness, balance and strength of the abdominal muscles in women who practice tai chi. According to a systematic review published in 2008, the results are promising but further clinical trials will be needed to verify the effectiveness of tai chi⁶⁰.

 Cassis (Ribes nigrum). ESCOP recognizes the medicinal use of blackcurrant leaves (psn) as an adjuvant treatment for rheumatic disorders. The organization has identified a fairly large number of studies in vivo showing the anti-inflammatory properties of the leaves to officially recognize this use established by tradition.

Dosage

Infuse 5 g to 12 g of dried leaves in 250 ml of boiling water for 15 minutes. Take 2 cups a day of this infusion, or take 5 ml of fluid extract (1: 1), 2 times a day, before meals.

 Various plants have been used traditionally to treat people with osteoarthritis: turmeric (psn) (Curcuma longa), ginger rhizomes (psn) (Zinziber officinalis) and feverfew (Tanacetum parthenium).

 Massage Therapy. Massotherapy sessions contribute to the state of general well-being and to muscle and nervous relaxation. It also promotes blood and lymphatic circulation. This is why some specialists recommend its use by people with osteoarthritis⁶⁴.