8 Supplements That Can Help Joint Pain
By: Holly L. Thacker, MD • Posted on September 27, 2018
What Can I Do For My Joint Pain?
This is a common question I hear almost every day. Osteoarthritis, also known as degenerative joint disease, is very common in people especially over the age of 30.
The joints that are most commonly affected include the ones that take the most weight bearing and abuse such as the following:
- big toe
- hip joint
This is also called “wear and tear arthritis.”
People who have sustained sports injuries are at greater risk of degeneration of the joint. Common every day activities do produce some wear and tear on the joints particularly if the body weight is increased. Even a 5 pound weight gain transmits five times which would equal 25 extra pounds of pressure to the lower body joints, so maintaining a normal body weight is very important.
Stretching and strengthening exercises are very important as they stabilize the joints. Since the tendons, joints and cartilage do not have any direct blood vessels, movement In the form of activity, specifically aerobic exercise that gets the heart rate up is important for diffusing both oxygen and nutrients into the joints.
Supplements and Medications To Help Joint Pain
1. Vitamin D
The number one supplement I recommend for joint health and overall musculoskeletal health is vitamin D3. Vitamin D is not a vitamin, but it is a pro steroid hormone. Humans can make vitamin D if they are exposed to the right ultraviolet light. However, most of my patients over age 50 are low in vitamin D (on blood testing with a 25-hydroxy vitamin D test). If you have joint pain consider starting 1,000 to 2,000 units of vitamin D per day and/or have your physician check your level.
Estrogen is important for musculoskeletal health, including joint health. There are estrogen receptors and cartilage and tendons. Postmenopausal women with low estrogen state may complain of joint pain and stiffness as their primary menopausal symptoms.
Low estrogen states can exacerbate tendinitis. Estrogen therapy is generally not given specifically for joint pain unless the woman is suffering from additional menopausal symptoms. There’s also evidence that women who undergo total joint replacements who are on post-menopausal estrogen do better than those not on hormone therapy. Talk to your women's health physician to see if estrogen is right for you.
3. Glucosamine and Chondroitin Sulfate
Glucosamine and chondroitin sulfate are one of the most common combination supplements that I recommend to women with joint pain, especially knee pain. Glucosamine has shown some protective benefit for knee arthritis in up to 70% of persons in divided doses of 1,000 to 1,500 mg per day.
The first time, I recommended the supplement several years ago I had a woman exclaimed, “That is what my veterinarian has me give my dog!” Dogs like other mammals do suffer from degenerative joint disease with aging.
Some studies have shown no benefit with glucosamine while others have shown reductions in joint pain - particularly the glucosamine sulfate salt. Various studies have shown the benefit of both glucosamine and chondrointin sulfate showing less pain and swelling and joint space narrowing, in doses of 800 to 1200 mg per day.
Glucosamine and Chrondroitin Sulfate Dosage
- Glucosamine is frequently added with chondroitin sulfate in doses of 500–400 mg three times per day and needs to be taken for at least 2 months for effect.
- If adults have reduction in joint pain, I recommend continuing on a maintenance dose of at least one tablet daily.
- If there is no benefit, I recommend after 2 to 3 months to stop taking the glucosamine and chrondroitin sulfate supplement.
Glucosamine and Chrondroitin Sulfate Allergy Warnings
- It’s important to note that this supplement is usually derived from shellfish so persons with a shellfish allergy should NOT take glucosamine and chondroitin sulfate. For those with shellfish allergies and our vegan friends, there are vegan sourced glucosamine derived from corn.
- There is some small amount of sugar in glucosamine and this can elevate blood sugar so patients with diabetes need to be aware of this.
Methylsulfonlymethane (MSM) in doses of up to 6 g per day orally have been shown to reduce pain, improve function and reduce some stiffness. Long term studies aren’t available.
Turmeric is a spice containing curcumin, and taking 500 mg orally up to twice daily has been shown to have some anti-inflammatory, anti-oxidant, anti-cancer and perhaps anti-atherosclerotic effects. A side effect of turmeric can be increasing bleeding time, so patients on blood thinners and Coumadin need to be aware as well as some people who have G.I. distress.
6. Omega 3
Omega 3 fatty acids in doses of 2 to 4 g has been shown to reduce pain from:
- rheumatoid arthritis inflammatory joint pain
- chronic spinal pain auto immune disease
- neuropathic pain
- menstrual cramps
In general, I recommend that people ingest omega 3s via their diet as opposed to taking a supplement. I have seen breast tenderness and breast cysts in women on high doses of oral omega 3s. The benefit of ingesting omega 3 in the diet in terms of reducing joint pain is likely related to the anti-inflammatory effects of a heart, healthy Mediterranean-type diet.
Mediterranean Diet Foods
- olive oil
Omega 3 Foods
- seeds such as Chia seeds and flax seeds
Keep a Food Diary
It’s helpful for people to keep a dietary log of what they eat because many people find out what foods are more associated with joint pain such as gluten, red meat, trans fats and highly processed foods. There are many reasons to follow anti-inflammatory diet even if you don’t have joint pain, but if you do have joint pain it is critical that you follow an anti-inflammatory diet.
Ginger is an herb that has anti-inflammatory, anti-cancer and anti-atherosclerotic effects and can be ingested, 3 g per day. Ginger is also used to treat nausea.
- S-adenosyl-L-methionine (SAMe) is a compound found naturally in the body.
- A supplement form of SAMe has been used to help the liver, reduce joint pain and even elevate the mood.
- Doses start at 400 up to 1200 mg per day and this supplement can be pricey.
- Any persons with mania or schizophrenia should avoid this supplement.
With aging most of us will experience wear and tear on joints, tendons, cartilage and muscle. However, with a healthy, anti-inflammatory diet and appropriate vitamins and supplements, pain and stiffness can be reduced. Because the supplements can interact with other medications it is important to let your physician know all the things that you are taking.
Be Strong. Be Healthy. Be in Charge!
-Holly L Thacker, MD
Holly L. Thacker, MD, FACP is nationally known for her leadership in women’s health. She is the founder of the Cleveland Clinic Specialized Women’s Health Fellowship and is currently the Professor and Director of the Center for Specialized Women’s Health at Cleveland Clinic and Lerner College of Medicine at Case Western Reserve University. Dr. Thacker is also the Executive Director of Speaking of Women’s Health and the author of The Cleveland Clinic Guide to Menopause. Her special interests and areas of research including menopause and related medical problems including osteoporosis, hormone therapy, breast cancer risk assessment, menstrual disorders, female sexual dysfunction and interdisciplinary women’s health.