The Best and Worst Supplements for Joint Health

Eastern Idaho Regional Medical Center - September 08, 2017
5 min Read Time

Rows upon rows of supplements at the pharmacy or vitamin shop are enough to overwhelm even the most health-savvy customer. Every bottle, ad and banner claims it’s the number one brand to help ease your joint pain. But with so many products competing for your attention—and cash—how do you know which is right for you? Are any of them even based on science?

“The thing with supplements is they’re not regulated in the same way over-the-counter medications like ibuprofen are,” says Robyn Hakanson, MD, a practicing adult reconstructive orthopedic surgeon from LewisGale Medical Center in Salem, Virginia. “In fact, they’re not regulated by the Food and Drug Administration before hitting the market. You never really know if the bottle contains the dose it claims to, and there’s no quality control other than what the company chooses to do.”With those limitations in mind, Dr. Hakanson explains how four popular joint supplements stack up against the hype.

Glucosamine and Chondroitin

Glucosamine and chondroitin are popular joint supplements, often taken for pain related to osteoarthritis (OA). They're typically used together, though they can be taken separately if necessary for medical reasons, like a drug allergy.

Some large studies have shown glucosamine and chondroitin can slightly delay the progression of OA when used for at least two years. A few studies suggest they can help with pain relief too, but that may be due, at least in part, to the placebo effect.

While study results are mixed, glucosamine and chondroitin aren’t usually recommended in clinical settings. But if people take them and feel less pain, healthcare providers often don’t object, unless they interfere with another prescription or medical condition. “When people ask, I tell them, ‘I can’t give you studies to prove this will help you, but I don’t know that it will hurt you either,” says Hakanson.

As with any new supplement, talk to your doctor before using glucosamine and chondroitin to make sure they’re safe for you. They may not be right for people on warfarin, a blood thinner, for example. Those with diabetes might need to avoid this supplement, as well, since glucosamine can interfere with blood sugar control.

Omega-3 Oil

Omega-3 oil, which can be found in fish oil, is probably the joint supplement with the most research behind it, says Hakanson. Studies have found it to have anti-inflammatory properties that might reduce joint pain, but the most positive evidence has been for rheumatoid arthritis, rather than OA. And again, more research is needed to confirm these findings.

When it comes to fish oil specifically, higher doses (greater than 2 grams per day) may be necessary to reduce inflammation. Even then, pain relief isn’t guaranteed and the risks could outweigh the benefits. Possible side effects include:

Decreased blood sugar control
Low blood pressure
Abnormal heart rhythms
Acid reflux and bad breath
Increased bleeding risk (particularly at doses of 3 grams per day or greater)

According to some research, a higher risk of prostate cancer is another potential downside of taking omega-3s in the form of fish oil, Hakanson adds. Evidence on how fish oil affects prostate cancer risk has been mixed overall, with some studies suggesting it offers protection and others finding it raises risk. This may be related to dose differences, but more studies are needed to determine the exact relationship between fish oil and prostate cancer.

To avoid potential side effects, try getting omega-3s from your diet instead of a supplement. Good sources include fatty fish like salmon, chia seeds, flax seeds and walnuts.

Capsaicin

Capsaicin is a compound that comes from chili peppers. It’s available in a variety of forms, including gels, creams, patches and pills. When applied to the skin, it can relieve OA pain in some joints, like the knees. It can also help ease nerve pain associated with shingles.

There haven’t been many strong studies on capsaicin, but most existing research has found it to be more effective than a placebo. For example, in one study, capsaicin cream reduced pain in 81 percent of people who used it for four-to-twelve weeks, compared to 54 percent of people who used a placebo cream.

Just heed stern warnings to wash your hands after using capsaicin cream—especially before touching your eyes, mouth or genital areas. “It can be just as ‘spicy,’ or burn just as much, as putting hot pepper in your eyes,” Hakanson warns. Other possible side effects include burning, itching or redness in the area where you apply the cream, but these effects often go away after using it for a few weeks. Capsaicin may also cause coughing, shortness of breath, chest tightness or a sore throat, though these are less common.

Curcumin

Curcumin is the active ingredient in turmeric. It’s what gives the spice its yellow color. Small studies have found curcumin supplements to relieve joint pain associated with OA and rheumatoid arthritis, but more research is needed to confirm this.

“People have been using turmeric in their food for centuries,” says Hakanson. “I’m not sure I’d take big spoonful of it every day, but choosing recipes with turmeric is a simple way to get curcumin from your diet, rather than a pill.”

The body tends to inactivate curcumin quickly, but the chemical piperine in black pepper may slow this down and allow curcumin to work better. The next time you make a savory turmeric-based dish, add black pepper; even a small amount can do the trick.

Before you take curcumin supplements or any of the others listed here, talk to your doctor. They can weigh in on exactly how much and how often you should use them. They can also confirm the supplement you’re considering won’t interfere with your other medications or worsen any of your medical conditions.