A 6-week, double-blind, placebo-controlled study of 247 individuals with osteoarthritis of the knee evaluated a combination herbal product containing
and the Asian spice galanga (
The results showed that participants in the ginger/galanga group improved to a significantly greater extent than those receiving placebo. However, despite news reports claiming that this study proves ginger effective for osteoarthritis, it only provides information on the effectiveness of the herbal combination. The two double-blind studies performed on ginger alone were small and produced contradictory results.
Furthermore, another study found that massage combined with the topical application of
made from ginger and orange was no better than massage plus olive oil in patients with osteoarthritis of the knee.
A 3-week double-blind study of 220 people with osteoarthritis of the knee found that use of a cream containing the herb
reduced symptoms significantly more than a placebo cream.
contains the aspirin-like substance salicin. A 2-week, double-blind, placebo-controlled trial of 78 individuals with arthritis found evidence that willow extracts can relieve osteoarthritis pain.
However, another double-blind study enrolling 127 people with osteoarthritis found white willow less effective than a standard anti-inflammatory drug and no more effective than placebo.
Again, the likely explanation for these contradictory results is that white willow at usual doses provides relatively modest benefits.
As noted above, the supplement
methyl sulfonyl methane
has shown promise for osteoarthritis when taken along with glucosamine.
Besides that study, benefits were also seen in a 12-week, double-blind, placebo-controlled trial of 50 people with osteoarthritis, utilizing MSM at a dose of 3 g twice daily.
However, in a comprehensive review of 6 studies involving 681 patients with osteoarthritis of knee, researchers concluded it is not yet possible to convincingly determine whether or not either DSMO or MSM is beneficial.
A randomized trial with 200 patients found collagen hydrolysate significantly reduced joint pain when compared to placebo. Patients, who were followed for 6 months, were over 50 years old with hip, knee, elbow, shoulder or lumbar spine pain.
Other treatments with incomplete supporting evidence from double-blind trials include
Ayurvedic herbal combination therapy
a proprietary complex of minerals with or without cat's claw,
The therapeutic effects of boswellia were evaluated in a review of 4 randomized trials. It was associated with significant pain reduction and improved physical function.211
Traditional Chinese herbal medicine
has also shown some promise for osteoarthritis. However, one study that compared a commonly used Chinese herbal product (Duhuo Jisheng Wan) to the drug diclofenac found that the herb worked more slowly than the drug, yet produced about an equal rate of side effects.
In a randomized trial, GCSB-5 (a combination of 6 dried herbs) was as safe and effective as a prescription nonsteroidal anti-inflammatory drug (celecoxib) in treating knee osteoarthritis.210
Growing but definitive evidence suggests that the natural substance hyaluronic acid may help reduce osteoarthritis symptoms when it is injected directly into an affected joint.
However, there is absolutely no reason to believe that
hyaluronic acid should help, and one study failed to show any significant benefit.
Incomplete and inconsistent evidence from human and animal studies only weakly suggests that
might alleviate osteoarthritis symptoms.
A badly designed human study hints that
might be helpful as well.
One double blind study involving dogs found some evidence of benefit with
elk velvet antler
Numerous other herbs and supplements sometimes recommended for osteoarthritis include:
. However, there is little to no evidence as yet that these treatments are effective.
Other studies provide limited evidence that certain supplements proposed for osteoarthritis do
work. For example, a 2-year, double-blind study of 136 people with knee arthritis found
ineffective for either reducing symptoms or slowing the progression of the disease.
In addition, a 6-month, double-blind, placebo-controlled trial of 77 people with osteoarthritis failed to find any symptomatic benefit with vitamin E.
Similarly, in a large (almost 400-participant) 5-year, double-blind, placebo-controlled study, use of injected
failed to slow the progression of osteoarthritis.
A fairly small study failed to find the enzyme
helpful for reducing symptoms.
is a special form of injection therapy that is popular among some alternative practitioners. A double-blind, placebo-controlled study evaluated the effects of 3 prolotherapy injections (using a 10% dextrose solution) at 2-month intervals in 68 people with osteoarthritis of the knee.
At 6-month follow-up, participants who had received prolotherapy showed significant improvements in pain at rest and while walking, reduction in swelling, episodes of "buckling," and range of flexion, as compared to those who had received placebo treatment. The same research group performed a similar double-blind trial of 27 individuals with osteoarthritis in the hands.
The results at 6-month follow-up showed that range of motion and pain with movement improved significantly in the treated group as compared to the placebo group.
Several double-blind, placebo-controlled studies suggest that pulsed electromagnetic field therapy, a special form of
, can improve symptoms of osteoarthritis.
One small study provides extremely weak supporting evidence for the more ordinary form of magnet therapy: static magnets.
A subsequent much larger study of static magnets failed to find real magnets more effective than placebo magnets, but a manufacturing error may have obscured genuine benefits (some people in the placebo group were accidentally given active magnets).
In yet another placebo-controlled trial, the use of a magnetic knee wrap for 12 weeks was associated with a significant increase in quadriceps (thigh muscle) strength in patients with knee osteoarthritis.
Limited evidence supports the use of bee venom injections for osteoarthritis.
Hot water therapy (
176-180, 186relaxation therapies
and various forms of
have also all shown some promise.
However, for none of these therapies is the supporting evidence convincing.
In a 2011 review of the literature, researchers analyzed 4 studies investigating the benefits of manual therapy (including massage therapy, joint mobilization, and
) for osteoarthritis of the hip or knee.
The results were inconclusive. Although one of the studies (involving 68 people) did find that massage therapy helped to improve pain and function, it was compared to no intervention rather than another treatment or a placebo.
(OPCs) are chemicals derived from pine bark extract. Three trials, which were part of a larger systematic review, hinted at the possible effectiveness of OPCs in treating osteoarthritis of the knee.
Leech saliva has anesthetizing, anti-inflammatory, and vasodilating properties. In a randomized crossover trial of 52 patients with knee osteoarthritis, one application of leech therapy was associated with improvements in pain, function and overall symptoms compared to one-time transcutaneous electrical nerve stimulation. Patients switched therapies after 42 days and were followed for an additional 21 days after the second treatment. Only about three-quarters of the patients completed the study.
For a discussion of homeopathic approaches to osteoarthritis, see the