The joints in your body are where two bones meet and enable you to move. The hips, shoulders, elbows, knees, wrists, and ankles are where the main joints located in your body. Hence, activities like walking up and down the stairs, running, jumping, extending, and bending your limbs are all required helps from joints.
The surfaces of the two connecting bones in your joint are cover with a layer called cartilage. Intact cartilage enables movement without friction and prevents the two bones from rubbing against each other. The cartilage also passes the pressure in the joint on to the bones, thereby sharing the burden of your body weight.1 Synovial fluid, a clear and thick fluid in the joint lubricates the cartilage and acts as a shock absorber in reducing the pressure exerted on the joint.
Osteoarthritis (or degenerative arthritis) and rheumatoid arthritis are the two most commonly seen joint conditions. The degenerative joint happens when the cartilage has begun to wear and tear, causes the bones to rub together, and eventually leads to bone damage. Frequent crackling sound from the joint accompanied by pain or swelling and limited motion may be the early signs of worn cartilage. On the other hand, rheumatoid arthritis is an autoimmune disease that happens when the body’s immune system mistakenly attacks the healthy joint tissues and leads to inflammation with symptoms such as joint pain, stiffness, and swelling.2
Medications have been the first choice of treatment for relieving joint pain. However, supplements have also supported by clinical researches in reducing joint pain and preventing cartilage breakdown. Read on to learn more about the clinical evidence of these alternative supplements in treating arthritis.
Glucosamine is one of the most widely used supplements for the management of osteoarthritis. It is a natural compound found in your joints area and acts as a building block for the cartilage by stimulates the formation and prevents its degradation.3
A meta-analysis analysed eighteen articles written between 2003 and 2016, found a favourable effect of glucosamine in alleviating knee osteoarthritis symptoms. Majority of the studies demonstrated the effective dose of glucosamine at 1,500mg/day.4 The intake of glucosamine was also found to be effective in improving knee flexion and extension among athletes after an acute knee injury.5
Loss of cartilage causes the narrowing of space between the ends of the bones in joint. This condition is common in arthritis patients where it eventually leads to pain, stiffness and limited movement of the joint. Long-term treatment with glucosamine can help to slow down the narrowing of joints space in patients with knee osteoarthritis.6,7
The term ‘collagen’ refers to a group of structural proteins arranged in a fibre-like strand present within all tissues and organs.8 It is found abundantly in the skin, bone, tendon, muscle, cartilage and vessel wall. Similar to glucosamine, collagen is also one of the components in the matrix of joint structures.
The hydrolyzed collagen is also known as collagen peptide or collagen hydrolysate. It is commonly used collagen in dietary supplements. This form of collagen undergoes the hydrolysis process that further enhances its absorption rate and bioavailability.9 Numerous studies have demonstrated that oral consumption of collagen peptides helps reduce joint pain and improves joint mobility.10,11 The beneficial effects are associates with collagen peptides’ ability in reducing inflammation and improving the thickness of articular cartilage in osteoarthritis.12,13 In the skeleton, collagen peptides have also shown to increase bone mass density and limit bone loss in postmenopausal women.14
The ingredient, hyaluronic acid is not unfamiliar to fellow skin-care lovers. It possesses a unique characteristic in binding and retaining water molecule underneath the skin, thus an excellent choice for dry and wrinkling skins. Various human tissues include the eyes, connective tissues, synovial fluid and the cartilage contain this naturally occurring component.15 In osteoarthritis, the viscosity of the synovial fluid is low. It is due to the decreasing concentration and molecular size of the hyaluronic acid. Synovial fluid also turns out to be less effective in lubricates the joints and triggers inflammation effect.15
Oral intake of hyaluronic acid is non-invasive, safe and effective management for joint pain. A study recruited 78 subjects between the age of 19 and 70 found that oral consumption of hyaluronic acid for 4 weeks reduced joint pain and the used of pain medication.16 Similarly, a 12 months study showed an improvement in osteoarthritis symptoms when combined with the quadriceps strengthening exercise.17 Hyaluronic acid also helps support joint health through anti-inflammation, cartilage lubrication, antioxidative and cartilage repair effects.18
Turmeric, a vibrant yellow spice with a long history of use as food and traditional medicine is known for its antioxidative and anti-inflammatory properties. The beneficial effects of turmeric are due to the yellow pigment bioactive compound known as curcumin.
Several studies highlighted the effectiveness of curcumin in alleviating arthritis symptoms. In one pilot study, 45 patients diagnosed with rheumatoid arthritis took curcumin and diclofenac sodium (a non-steroidal anti-inflammatory drug for reducing pain and inflammation in the body) alone, or their combination for 8 weeks. The result has found better improvement in symptoms and without adverse events in the group that took curcumin alone.19 Similarly, curcumin is also as effective as ibuprofen (a commonly used non-steroidal anti-inflammatory drug) for the treatment of knee osteoarthritis with fewer side effects.20 All in all, curcumin is a promising alternative treatment for those seeking for joint pain relief with a safer profile.
Take Home Messages
The commonly used oral medication for joint pain, such as non-steroidal anti-inflammatory drugs is merely focusing on alleviate pain and reduce inflammation. Reported side effects from these medications such as bloating, heartburn, stomach discomfort, nausea and vomiting are not uncommon. Thus, supplementation is an excellent choice for long-term maintenance of joint health. Apart from minimizing joint pain, supplements such as glucosamine, collagen peptide and hyaluronic acid are also supplying the essential nutrients to the cartilage and synovial fluid to reduce the breakdown of worn cartilage.
If you’re looking for better and faster joint pain relief options, try supplementation along with some lifestyle modifications.
1. Watch Your Body Weight – Being overweight or obese is equivalent to putting more stress on your already degenerated joints. You’ll feel the difference, the moment you successfully shed off a few pounds.
2. Exercise As Much As You Can – Low impact exercises like walking, yoga, swimming and cycling can strengthen your muscle to have better support for your joint. It can also reduce joint stiffness and manage your body weight.
3. Eat Healthier – Adding more fruits and vegetables in your daily meals will promote overall health, including your joint. Cut down processed foods that are high in sugar, saturated fats, trans fat and food additives that can trigger inflammation.
- InformedHealth.org[Internet].Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. How do joints work? 2009 Dec 30 [Updated 2018 Jul 12]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK279363/
- Senthelal S, Li J, Goyal A, et al. Arthritis. [Updated 2020 Aug 10]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK518992/
- Williams C, Ampat G. Glucosamine Sulfate. [Updated 2020 Jun 25]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK558930/
- Ogata T, Ideno Y, Akai M, Seichi A, Hagino H, Iwaya T, et al. Effects of glucosamine in patients with osteoarthritis of the knee: a systematic review and meta-analysis. Clin Rheumatol. 2018;37(9):2479-2487.
- Ostojic SM, Arsic M, Prodanovic S, Vukovic J, Zlatanovic. Glucosamine administration in athletes: effects on recovery of acute knee injury. Res Sports Med. 2007;15(2):113-124.
- 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;357(9252):251-256.
- Pavelka K, Gatterova J, Olejarova M, Machacek S, Giacovelli G, Rovati LC. Glucosamine sulphate use and delay of progression of knee osteoarthritis: a 3-year, randomized, placebo-controlled, double-blind study. Arch Intern Med. 2002;162(18):2119-2123.
- Van Der Rest M. Collagen family of proteins. The FASEB Journal. 1991;5(13):2814-2823.
- Skov K, Oxfeldt M, Thogersen R, Hansen M, Bertram HC. Enzymatic hydrolysis of a collagen hydrolysate enhances postprandial absorption rate – a randomized controlled trial. Nutrients. 2009;11(5):1064.
- Clark KL, Sebastianelli W, Flechsenhar KR, Aukermann DF, Meza F, Millard RL, et al. 24-week study on the use of collagen hydrolysate as a dietary supplement in athletes with activity-related joint pain. Curr Med Res Opin. 2008;24(5):1485-1496.
- Jiang JX, Yu S, Huang QR, Zhang XL, Zhang CQ, Zhou JL, et al. Collagen peptides improve knee osteoarthritis in elderly women: a 6-month randomized, double-blind, placebo-controlled study. Agro Food Industry Hi Tech. 2014;25(2):19-22.
- McAlindon TE, Nuite M, Krishnan N, Ruthazer R, Price LL, Burstein D, et al. Change in knee osteoarthritis cartilage detected by delayed gadolinium enhanced magnetic resonance imaging following treatment with collagen hydrolysate: a pilot randomized controlled trial. Osteoarthritis Cartilage. 2011;19(4):399-405.
- Dar QA, Schott EM, Catheline SE, Maynard RD, Liu ZY, Kamal F, et al. Daily oral consumption of hydrolysed type 1 collagen is chondroprotective and anti-inflammatory in murine posttraumatic osteoarthritis. PLoS One. 2017;12(4):e0174705.
- Konig D, Oesser S, Scharla S, Zdzieblik D, Gollhofer A. Specific collagen peptides improve bone mineral density and bone markers in postmenopausal women – a randomized controlled study. Nutrients;10(1):97 doi: 3390/nu10010097
- Walker K, Basehore BM, Goyal A, et al. Hyaluronic Acid. [Updated 2020 Sep 29]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482440/
- Jensen GS, Attridge VL, Lenninger MR, Benson KF. Oral intake of a liquid high-molecular-weight hyaluronan associated with relief of chronic pain and reduced use of pain medication results of a randomized, placebo-controlled double-blind pilot study. J Med Food. 2015;18(1):95-101.
- Tashiro T, Seino S, Sato T, Matsuoka R, Masuda Y, Fukui N. Oral administration of polymer hyaluronic acid alleviates symptoms of knee osteoarthritis: a double-blind, placebo-controlled study over a 12-month period. 2012;2012:167928. doi: 10.1100/2012/167928. Epub 2012 Nov 20. PMID: 23226979; PMCID: PMC3512263.
- Gupta RC, Lall R, Srivastava A, Sinha A. Hyaluronic acid: molecular mechanisms and therapeutic trajectory. Front Vet Sci. 2019;6:192 doi: 3389/fvets.2019.00192
- Chandran B, Goel A. A randomized, pilot study to assess the efficacy and safety of curcumin in patients with active rheumatoid arthritis. Phytother Res. 2012;26(11):1719-1725.
- Kuptniratsaikul V, Dajpratham P, Taechaarpornkul W, Buntragulpoontawee M, Lukkanapichonchut P, Chootip C, et al. Efficacy and safety of curcuma domestica extracts compared with ibuprofen in patients with knee osteoarthritis: a multicentre study. Clin Interv Aging. 2014;9:451-458.