Condition
Osteoarthritis (OA)
Osteoarthritis is a joint condition in which the cartilage cushioning your joints slowly breaks down, causing pain, stiffness and less mobility. Trials found systemic enzymes eased knee pain about as well as an anti-inflammatory drug, and chondroitin and glucosamine each improved pain, with moderate evidence. Still, the pain gains with chondroitin and glucosamine were small, so the differences were modest.
Sources: PMID 30879253; PMID 11548224
- Supplements studied
- 32
- Medicines and peptides
- 1
- Graded outcomes
- 41
- Trials
- 67
- People studied
- 44,117
Evidence by supplement
- Strong
- Moderate
- Limited
- Very limited
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Knee Osteoarthritis Pain (vs NSAID) Individual patient-level meta-analysis (6 RCTs, n=697, 2016): OEC (bromelain/trypsin/rutoside) showed equivalent efficacy to diclofenac for Lequesne Algofunctional Index improvement. RCT (n=150, 12 weeks): Wobenzym comparable to diclofenac; both superior to placebo (P<0.05). | Improves (the measure goes down) | Moderate effect | ||||
| Joint Function in Osteoarthritis Pooled analysis (6 RCTs): Significant improvement in joint function comparable to diclofenac. Narrative review (9 RCTs): OEC consistently improved Lequesne scores. Reduces reliance on rescue analgesic medication. | Improves (the measure goes up) | Moderate effect | ||||
| Safety vs NSAIDs RCT (n=150): Adverse events similar to placebo (7.2% vs 9.1%) and lower than diclofenac (15.6%). Meta-analysis: Better GI safety profile than NSAIDs. Appropriate for long-term use in patients who cannot tolerate NSAIDs. | Improves (the measure goes up) | Moderate effect |
Avocado/Soybean Unsaponifiables
- Osteoarthritis Symptoms: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Osteoarthritis Symptoms Small Improvement | Improves (the measure goes down) | Small effect | 1 study | 1,095 people | ||
Chondroitin
- Pain: improves
- Osteoarthritis Symptoms: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Pain Small Improvement | Improves (the measure goes down) | Small effect | 1 study | 3,791 people | ||
| Osteoarthritis Symptoms Small Improvement | Improves (the measure goes down) | Small effect | 1,822 people | |||
Pycnogenol
- Osteoarthritis Symptoms: improves
- Pain: changes; see studies
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Osteoarthritis Symptoms Moderate Improvement | Improves (the measure goes down) | Moderate effect | 1 study | 191 people | ||
Studies that measured osteoarthritis symptoms | ||||||
| Pain | Changes; see studies | 35 people | ||||
Devil's Claw (Harpagophytum procumbens)
- Osteoarthritis Pain (vs NSAID): improves
- Joint Function (WOMAC): improves
- Safety vs NSAIDs/DMOADs: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Osteoarthritis Pain (vs NSAID) RCT (n=122, 4 months): Harpagophytum 2610mg/day equivalent to diacerhein 100mg/day for hip/knee OA. No significant difference in pain, disability, or Lequesne score. Significantly reduced need for analgesic and NSAID co-medication. | Improves (the measure goes up) | Moderate effect | ||||
| Joint Function (WOMAC) Observational study (n=75, 12 weeks, 50mg harpagoside/day): WOMAC subscale improvements - pain 23.8%, stiffness 22.2%, physical function 23.1%. Consistent improvement across all domains. | Improves (the measure goes up) | Moderate effect | ||||
| Safety vs NSAIDs/DMOADs RCT vs diacerhein: Significantly lower adverse event rate. Diarrhea in 8.1% (Devil's Claw) vs 26.7% (diacerhein). Cochrane: Low to moderate quality evidence shows few side effects. Better GI safety profile than NSAIDs. | Improves (the measure goes up) | Moderate effect | ||||
| Rescue Medication Reduction Cochrane review: Devil's Claw may reduce use of rescue medication compared to placebo. RCT vs diacerhein: Significantly reduced need for analgesic (acetaminophen-caffeine) and NSAID (diclofenac) co-medication. | Improves (the measure goes up) | Moderate effect | ||||
| Osteoarthritis Symptoms | Changes; see studies | 227 people |
Resveratrol
- Blood Urea Nitrogen (BUN): improves
- Kidney Function: improves
- Pain: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Blood Urea Nitrogen (BUN) Small Decrease | Improves (the measure goes down) | Small effect | 894 people | |||
| Kidney Function | Improves (the measure goes up) | 2 studies | 135 people | |||
Studies that measured kidney function | ||||||
| Pain | Improves (the measure goes down) | 1 study | 142 people | |||
Studies that measured pain | ||||||
| Osteoarthritis Symptoms | Improves (the measure goes down) | 142 people | ||||
| Serum Albumin | Improves (the measure goes up) | 516 people | ||||
| Uric Acid | Improves (the measure goes down) | 353 people | ||||
Curcumin
- C-Reactive Protein (CRP): improves
- Bilirubin
- Pain: improves
Boron
- C-Reactive Protein (CRP): improves
- Total cholesterol: changes; see studies
- Erythrocyte Sedimentation Rate: changes; see studies
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| C-Reactive Protein (CRP) Moderate Decrease | Improves (the measure goes down) | Moderate effect | 3 studies | 72 people | ||
Studies that measured c-reactive protein (crp)
| ||||||
| Total cholesterol | Changes; see studies | 1 study | 72 people | |||
| Erythrocyte Sedimentation Rate | Changes; see studies | 72 people | ||||
| Fibrinogen | Improves (the measure goes up) | 72 people | ||||
| High-density lipoprotein (HDL) | Improves (the measure goes up) | 72 people | ||||
| Low-density lipoprotein (LDL) | Changes; see studies | 72 people | ||||
Boswellia
- Asthma Symptoms: improves
- C-Reactive Protein (CRP)
- Osteoarthritis Symptoms: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Asthma Symptoms Small Improvement | Improves (the measure goes down) | Small effect | 2 studies | 1,879 people | ||
| C-Reactive Protein (CRP) No effect | NoneNo effect | 98 people | ||||
| Osteoarthritis Symptoms Improvement | Improves (the measure goes down) | 11 studies | 186 people | |||
Studies that measured osteoarthritis symptoms
| ||||||
| Pain Improvement | Improves (the measure goes down) | 186 people | ||||
| Interleukin 6 | Changes; see studies | 98 people | ||||
| Subjective Well-Being | Improves (the measure goes up) | 47 people | ||||
Krill Oil
- C-Reactive Protein (CRP): improves
- Arthritis (In General): improves
- Functionality in Elderly or Injured: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| C-Reactive Protein (CRP) Moderate Decrease | Improves (the measure goes down) | Moderate effect | 2 studies | 352 people | ||
| Arthritis (In General) Moderate Improvement | Improves (the measure goes up) | Moderate effect | 1 study | 90 people | ||
Studies that measured arthritis (in general) | ||||||
| Functionality in Elderly or Injured | Improves (the measure goes up) | 90 people | ||||
| Pain | Improves (the measure goes down) | 262 people | ||||
| Quality of Life | Improves (the measure goes up) | 262 people | ||||
Microlactin
- Osteoarthritis Symptoms: improves
- Pain: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Osteoarthritis Symptoms Small Improvement | Improves (the measure goes down) | Small effect | 1 study | 31 people | ||
Studies that measured osteoarthritis symptoms | ||||||
| Pain | Improves (the measure goes down) | 31 people | ||||
L-Carnitine
- C-Reactive Protein (CRP): improves
- High-density lipoprotein (HDL): improves
- Total cholesterol: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| C-Reactive Protein (CRP) Moderate Decrease | Improves (the measure goes down) | Moderate effect | 1 study | 72 people | ||
| High-density lipoprotein (HDL) | Improves (the measure goes up) | 12 studies | 72 people | |||
| Total cholesterol | Improves (the measure goes down) | 6 studies | 72 people | |||
| Oxidative Stress Biomarkers | Improves (the measure goes down) | 3 studies | 72 people | |||
| TNF-Alpha | Improves (the measure goes down) | 2 studies | 72 people | |||
| Matrix Metalloproteinase 13 | Improves (the measure goes up) | 1 study | 72 people | |||
| Interleukin 1-beta | Improves (the measure goes down) | 72 people | ||||
| Low-density lipoprotein (LDL) | Improves (the measure goes down) | 72 people | ||||
| Matrix Metalloproteinase 1 | Improves (the measure goes up) | 72 people | ||||
| Matrix Metalloproteinase 3 | Improves (the measure goes up) | 72 people | ||||
| Osteoarthritis Symptoms | Improves (the measure goes down) | 216 people | ||||
| Pain | Improves (the measure goes down) | 144 people | ||||
| Total Antioxidant Capacity (TAC) | Improves (the measure goes up) | 72 people |
MSM
- Osteoarthritis Symptoms: improves
- Pain: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Osteoarthritis Symptoms Small Improvement | Improves (the measure goes down) | Small effect | 1 study | 148 people | ||
| Pain | Improves (the measure goes down) | 50 people |
Ginger (Zingiber officinale)
- Inflammation: improves
- Osteoarthritis Symptoms: changes; see studies
- Pain: changes; see studies
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Inflammation Small Decrease | Improves (the measure goes down) | Small effect | 1 study | 92 people | ||
| Osteoarthritis Symptoms | Changes; see studies | 1 study | 167 people | |||
| Pain | Changes; see studies | 1 study | 100 people |
Rose Hip
- Chemotaxis: improves
- C-Reactive Protein (CRP)
- Pain: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Chemotaxis Small Decrease | Improves (the measure goes down) | Small effect | 8 people | |||
| C-Reactive Protein (CRP) No effect | NoneNo effect | 3 studies | 8 people | |||
| Pain | Improves (the measure goes down) | 2 studies | 93 people | |||
| Osteoarthritis Symptoms | Improves (the measure goes down) | 1 study | 261 people |
Ashwagandha
- Osteoarthritis Symptoms: improves
- Pain: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Osteoarthritis Symptoms Moderate Improvement | Improves (the measure goes down) | Moderate effect | 60 people | |||
| Pain | Improves (the measure goes down) | 1 study | 60 people |
Arnica
- Pain/Function: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Pain/Function Topical gel (50% tincture) effective for OA symptoms | Improves (the measure goes down) | Moderate effect | 80 people |
Artemisia annua
- Long-term Safety/Efficacy: changes; see studies
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Long-term Safety/Efficacy 6-month open-label extension showed maintained benefits with continued safety | Changes; see studies | Moderate effect | 42 people |
Manganese
- Joint Pain: improves
- Cartilage Health: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Joint Pain Small Decrease | Improves (the measure goes down) | Small effect | 200 people | |||
| Cartilage Health Small Increase | Improves (the measure goes up) | Small effect | 120 people |
Creatine
- Body Fat: improves
- Power Output: improves
- Muscle Mass: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Body Fat Small Decrease | Improves (the measure goes down) | Small effect | 24 people | |||
| Power Output | Improves (the measure goes up) | 44 studies | 24 people | |||
| Muscle Mass | Improves (the measure goes up) | 5 studies | 24 people | |||
| Subjective Well-Being | Improves (the measure goes up) | 3 studies | 24 people | |||
| Osteoarthritis Symptoms | Improves (the measure goes down) | 24 people |
Type-II Collagen
- Osteoarthritis Symptoms: improves
- Pain: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Osteoarthritis Symptoms Small Improvement | Improves (the measure goes down) | Small effect | 259 people | |||
| Pain | Improves (the measure goes down) | 2 studies | 259 people |
Stinging Nettle
- Osteoarthritis Symptoms
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Osteoarthritis Symptoms No effect | NoneNo effect | 3 studies | 50 people |
S-adenosylmethionine
- Bilirubin
- Depression Symptoms: improves
- Osteoarthritis Symptoms: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Bilirubin No effect | NoneNo effect | 1 study | 1,558 people | |||
| Depression Symptoms | Improves (the measure goes down) | 6 studies | 1,558 people | |||
| Osteoarthritis Symptoms | Improves (the measure goes down) | 6 studies | 1,219 people | |||
| Functionality in Elderly or Injured | Improves (the measure goes up) | 1,021 people | ||||
| Itching | Improves (the measure goes up) | 1,558 people | ||||
| Pain | Improves (the measure goes down) | 795 people |
Cissus Quadrangularis
- Blood Pressure
- Functionality in Elderly or Injured: improves
- Pain: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Blood Pressure No effect | NoneNo effect | 1 study | 29 people | |||
| Functionality in Elderly or Injured | Improves (the measure goes up) | 29 people | ||||
| Pain | Improves (the measure goes down) | 29 people |
Probiotics
- Body Mass Index (BMI)
- C-Reactive Protein (CRP): improves
- Osteoarthritis Symptoms: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Body Mass Index (BMI) No effect | NoneNo effect | 129 people | ||||
| C-Reactive Protein (CRP) | Improves (the measure goes down) | 2 studies | 563 people | |||
| Osteoarthritis Symptoms | Improves (the measure goes down) | 1 study | 627 people | |||
| Pain | Improves (the measure goes down) | 562 people |
Fisetin
- Joint Pain: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Joint Pain Preliminary pain reduction observed | Improves (the measure goes down) | Small effect | 30 people |
Vitamin D
- Collagen Content
- Pain: improves
- Osteoarthritis Symptoms: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Collagen Content No effect | NoneNo effect | 146 people | ||||
| Pain | Improves (the measure goes down) | 2 studies | 146 people | |||
| Osteoarthritis Symptoms | Improves (the measure goes down) | 146 people |
Devil's Claw
- Osteoarthritis Symptoms: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Osteoarthritis Symptoms | Improves (the measure goes down) | 3 studies | 227 people |
Collagen Peptides
- Osteoarthritis Symptoms: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Osteoarthritis Symptoms | Improves (the measure goes down) | 1 study | 870 people |
Bromelain
- Osteoarthritis Symptoms: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Osteoarthritis Symptoms Improvement | Improves (the measure goes down) | 1 study | 47 people |
Guggul
- Osteoarthritis Symptoms: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Osteoarthritis Symptoms | Improves (the measure goes down) | 1 study | 30 people |
Prescription medicines and peptides studied, for context
Retatrutide (GLP-3 Triple Agonist)
- Osteoarthritis Pain: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Osteoarthritis Pain Phase 3 TRIUMPH-4: WOMAC pain score reduced by 4.5 points (75.8%) at 68 weeks. 12% of patients on 12mg achieved complete pain freedom vs 4.2% placebo. Likely secondary to weight loss reducing joint stress. | Improves (the measure goes down) | Large effect | 15 studies |
What the published studies found
8 automated readings
Chondroitin: joint pain
A Cochrane review (2015, 43 studies, 4,962 people) found an improvement in joint pain. That review studied adults with osteoarthritis. 6 of the 9 studies read agree; 3 found no clear difference. The evidence is limited.
9 studies counted of 10 read: 9 reviews.
- Meta-analysis, 2015; 43 studies, 4,962 people; adults with osteoarthritis: improves (the review the verdict rests on).
statistically significantly and clinically meaningful better pain scores
Chondroitin for osteoarthritis - Meta-analysis, 2023; 6 studies, 297 people; adults with knee osteoarthritis: no clear difference.
effect of G, or G and C, in combination with exercise is not significant
Effects of adding glucosamine or glucosamine combined with chondroitin to exercise on pain and physical function in adults with knee osteoarthritis: a systematic review and meta-analysis - Meta-analysis, 2019; 18 studies; people with osteoarthritis: improves.
SMD -0.41, 95% confidence interval (95% CI) -0.57 to -0.25
Effects of Oral Chondroitin Sulfate on Osteoarthritis-Related Pain and Joint Structural Changes: Systematic Review and Meta-Analysis - Meta-analysis, 2018: improves. Effect of glucosamine and chondroitin sulfate in symptomatic knee osteoarthritis: a systematic review and meta-analysis of randomized placebo-controlled trials
- Meta-analysis, 2018; 30 studies: improves.
chondroitin could alleviate pain symptoms and improve function
Effectiveness and safety of glucosamine and chondroitin for the treatment of osteoarthritis: a meta-analysis of randomized controlled trials - Systematic review, 2010; 10 studies, 3,803 people; patients with osteoarthritis of hip or knee: no clear difference.
for chondroitin, and -0.5 cm (-0.9 to 0.0 cm)
Effects of glucosamine, chondroitin, or placebo in patients with osteoarthritis of hip or knee: network meta-analysis - Meta-analysis, 2007; 20 studies, 3,846 people; patients with osteoarthritis of the knee or hip: no clear difference. Meta-analysis: chondroitin for osteoarthritis of the knee or hip
- Meta-analysis, 2003: improves.
effective on Lequesne Index, visual analog scale pain
Structural and symptomatic efficacy of glucosamine and chondroitin in knee osteoarthritis: a comprehensive meta-analysis - Meta-analysis, 2000; 7 studies, 372 people; patients with osteoarthritis: improves.
significantly superior to placebo with respect to the Lequesne index and pain VAS
A metaanalysis of chondroitin sulfate in the treatment of osteoarthritis
- Meta-analysis, 2015; 43 studies, 4,962 people; adults with osteoarthritis: improves (the review the verdict rests on).
Collagen Peptides: joint pain
The best available review (2021, 15 studies) found an improvement in joint pain. That review studied recreational athletes, elderly, untrained pre-menopausal women. All 8 studies read agree. The evidence is moderate.
8 studies counted of 9 read: 1 review and 7 trials (553 people in the trials).
- Systematic review, 2021; 15 studies; recreational athletes, elderly, untrained pre-menopausal women: improves (the review the verdict rests on).
COL is most beneficial in improving joint functionality and reducing joint pain
The effects of collagen peptide supplementation on body composition, collagen synthesis, and recovery from joint injury and exercise: a systematic review - Randomised trial, 2025; 160 people; adult patients with osteoarthritis: improves.
WOMAC scores were significantly lower in comparing HCP and placebo
Evaluation of the Efficacy and Safety of CollaSel PRO® Type I and Type III Hydrolyzed Collagen Peptides in the Treatment of Osteoarthritis: A Double-Blind, Placebo-Controlled, Randomized Clinical Trial - Randomised trial, 2025; 80 people; adults with knee osteoarthritis: improves.
significantly reduced WOMAC pain compared to the placebo
Efficacy and safety of low-molecular-weight collagen peptides in knee osteoarthritis: a randomized, double-blind, placebo-controlled trial - Randomised trial, 2025; 31 people; patients with Grade 2-3 osteoarthritis: improves.
notable enhancements across all osteoarthritis-related pain
Effect of supplementation with type 1 and type 3 collagen peptide and type 2 hydrolyzed collagen on osteoarthritis-related pain, quality of life, and physical function: A double-blind, randomized, placebo-controlled study - Randomised trial, 2025; adults with grade II or III knee osteoarthritis: improves.
significant reductions in VAS pain scores
Oral administration of hydrolyzed collagen alleviates pain and enhances functionality in knee osteoarthritis: Results from a randomized, double-blind, placebo-controlled study - Randomised trial, 2024; 182 people; healthy adults with functional knee and hip pain: improves.
significantly reduced pain at rest (p = 0.018)
Impact of Specific Bioactive Collagen Peptides on Joint Discomforts in the Lower Extremity during Daily Activities: A Randomized Controlled Trial - Randomised trial, 2024; 100 people; adults with knee joint osteoarthritis: improves. Management and Amelioration of Knee Joint Osteoarthritis in Adults Using a Novel High-Functional Bovine Collagen Peptide as a Nutritional Therapy: A Double-Blind, Prospective, Multicentric, Randomized, Active and Placebo Controlled, Five-Arm, Clinical Study to Evaluate the Efficacy, Safety, and Tolerability
- Randomised trial, 2023; middle-aged active adults: improves.
pain only improved in high frequency exercisers
Collagen peptides supplementation improves function, pain, and physical and mental outcomes in active adults
- Systematic review, 2021; 15 studies; recreational athletes, elderly, untrained pre-menopausal women: improves (the review the verdict rests on).
Collagen Peptides: knee pain
The best available review (2023, 4 studies, 507 people) found a moderate improvement in knee pain. That review studied patients with knee osteoarthritis. 7 of the 8 studies read agree; 1 found no clear difference. The evidence is moderate.
8 studies counted of 8 read: 1 review and 7 trials (697 people in the trials).
- Meta-analysis, 2023; 4 studies, 507 people; patients with knee osteoarthritis: improves (the review the verdict rests on).
significant difference in pain relief between the collagen peptide group and the placebo group
Analgesic efficacy of collagen peptide in knee osteoarthritis: a meta-analysis of randomized controlled trials - Randomised trial, 2025; 80 people; adults with knee osteoarthritis: improves.
significantly reduced WOMAC pain compared to the placebo
Efficacy and safety of low-molecular-weight collagen peptides in knee osteoarthritis: a randomized, double-blind, placebo-controlled trial - Randomised trial, 2025; 31 people; patients with Grade 2-3 osteoarthritis: improves.
yielded notable enhancements across all osteoarthritis-related pain
Effect of supplementation with type 1 and type 3 collagen peptide and type 2 hydrolyzed collagen on osteoarthritis-related pain, quality of life, and physical function: A double-blind, randomized, placebo-controlled study - Randomised trial, 2025; adults with grade II or III knee osteoarthritis: improves.
significant reductions in VAS pain scores
Oral administration of hydrolyzed collagen alleviates pain and enhances functionality in knee osteoarthritis: Results from a randomized, double-blind, placebo-controlled study - Randomised trial, 2024; 100 people; adults with knee joint osteoarthritis: improves. Management and Amelioration of Knee Joint Osteoarthritis in Adults Using a Novel High-Functional Bovine Collagen Peptide as a Nutritional Therapy: A Double-Blind, Prospective, Multicentric, Randomized, Active and Placebo Controlled, Five-Arm, Clinical Study to Evaluate the Efficacy, Safety, and Tolerability
- Randomised trial, 2021; 180 people; young physically active adults with exercise-related knee pain: improves.
significantly (p = 0.024) higher reduction of exercise-induced knee pain
The Influence of Specific Bioactive Collagen Peptides on Knee Joint Discomfort in Young Physically Active Adults: A Randomized Controlled Trial - Randomised trial, 2020; 167 people; healthy physically active individuals with self-reported knee pain: no clear difference.
similar decrease in VAS was observed after supplementation
Effectiveness of collagen supplementation on pain scores in healthy individuals with self-reported knee pain: a randomized controlled trial - Randomised trial, 2017; 139 people; athletes with functional knee problems: improves.
statistically significant improvement in activity-related pain intensity
Improvement of activity-related knee joint discomfort following supplementation of specific collagen peptides
- Meta-analysis, 2023; 4 studies, 507 people; patients with knee osteoarthritis: improves (the review the verdict rests on).
Curcumin: joint pain
The best available review (2025, 10 studies, 786 people) found an improvement in joint pain. All 10 studies read agree. The evidence is moderate.
10 studies counted of 10 read: 6 reviews and 4 trials (421 people in the trials).
- Meta-analysis, 2025; 10 studies, 786 people: improves (the review the verdict rests on).
significantly improved VAS for pain than placebo
Efficacy of Curcuma longa in relieving pain symptoms of knee osteoarthritis patients: a systematic review and meta-analysis of clinical trials - Meta-analysis, 2024; 11 studies: improves. The efficacy of curcumin in relieving osteoarthritis: A meta-analysis of meta-analyses
- Meta-analysis, 2022; 29 studies, 2,396 people; patients with arthritis: improves.
improved the severity of inflammation and pain levels
Efficacy and Safety of Curcumin and Curcuma longa Extract in the Treatment of Arthritis: A Systematic Review and Meta-Analysis of Randomized Controlled Trial - Systematic review, 2021; 51 studies: improves.
curcumin significantly improved morning stiffness, walking time and joint swelling
Curcumin and rheumatoid arthritis: A systematic review of literature - Systematic review, 2021; 17 studies; patients with osteoarthritis, especially knee osteoarthritis: improves.
significant improvement in VAS and overall WOMAC scores
A Systematic Review of the Clinical Use of Curcumin for the Treatment of Osteoarthritis - Meta-analysis, 2017; 7 studies, 797 people; adults with primarily knee osteoarthritis: improves.
Compared with placebo, curcuminoids significantly reduced knee pain (visual analogue scale): (standardized mean difference: -3.45; …
Effectiveness of curcuminoids in the treatment of knee osteoarthritis: a systematic review and meta-analysis of randomized clinical trials - Randomised trial, 2024; 48 people; women with rheumatoid arthritis: improves.
it decreased tender joint counts, swollen joint counts, visual analog scale (VAS) for pain, and …
The efficacy of curcumin supplementation on serum total antioxidant capacity, malondialdehyde, and disease activity in women with rheumatoid arthritis: A randomized, double-blind, placebo-controlled clinical trial - Randomised trial, 2020; 72 people; older adults with knee osteoarthritis: improves.
significantly lower in the intervention group
The effect of curcumin ointment on knee pain in older adults with osteoarthritis: a randomized placebo trial - Randomised trial, 2018; 201 people; 40- to 70-year-old patients with osteoarthritis: improves.
significant effect of Curamin® compared to placebo
Efficacy and safety of curcumin and its combination with boswellic acid in osteoarthritis: a comparative, randomized, double-blind, placebo-controlled study - Randomised trial, 2010; 100 people: improves.
Significant improvements of both the clinical
Efficacy and safety of Meriva®, a curcumin-phosphatidylcholine complex, during extended administration in osteoarthritis patients
- Meta-analysis, 2025; 10 studies, 786 people: improves (the review the verdict rests on).
Curcumin: knee pain
The best available review (2025, 10 studies, 786 people) found an improvement in knee pain. All 10 studies read agree. The evidence is moderate.
10 studies counted of 11 read: 6 reviews and 4 trials (263 people in the trials).
- Meta-analysis, 2025; 10 studies, 786 people: improves (the review the verdict rests on). Efficacy of Curcuma longa in relieving pain symptoms of knee osteoarthritis patients: a systematic review and meta-analysis of clinical trials
- Meta-analysis, 2024; 11 studies; patients with osteoarthritis: improves. The efficacy of curcumin in relieving osteoarthritis: A meta-analysis of meta-analyses
- Meta-analysis, 2022; 12 studies, 1,438 people; patients with knee osteoarthritis: improves.
improvement was significant with regard to pain
A Meta-Analysis of the Impact of Nutritional Supplementation on Osteoarthritis Symptoms - Systematic review, 2021; 10 studies; individuals with knee osteoarthritis: improves.
All 10 studies showed improvement in pain
Therapeutic effects of turmeric or curcumin extract on pain and function for individuals with knee osteoarthritis: a systematic review - Systematic review, 2021; 17 studies; patients with knee osteoarthritis: improves.
significant improvement in VAS and overall WOMAC scores
A Systematic Review of the Clinical Use of Curcumin for the Treatment of Osteoarthritis - Meta-analysis, 2017; 7 studies, 797 people; adults with primarily knee osteoarthritis: improves.
Compared with placebo, curcuminoids significantly reduced knee pain (visual analogue scale): (standardized mean difference: -3.45; …
Effectiveness of curcuminoids in the treatment of knee osteoarthritis: a systematic review and meta-analysis of randomized clinical trials - Randomised trial, 2021; 101 people; adults with knee osteoarthritis: improves.
curcumin significantly reduced the KOOS knee pain score
An Investigation into the Effects of a Curcumin Extract (Curcugen®) on Osteoarthritis Pain of the Knee: A Randomised, Double-Blind, Placebo-Controlled Study - Randomised trial, 2020; 72 people; older adults with knee osteoarthritis: improves.
absolute difference of 1.133 (i.e. 11.33 mm) score
The effect of curcumin ointment on knee pain in older adults with osteoarthritis: a randomized placebo trial - Randomised trial, 2014; 50 people; patients with knee osteoarthritis: improves. Short-term effects of highly-bioavailable curcumin for treating knee osteoarthritis: a randomized, double-blind, placebo-controlled prospective study
- Randomised trial, 2014; 40 people; patients with mild-to-moderate knee osteoarthritis: improves.
significant improvements in the pain and physical function scores
Curcuminoid treatment for knee osteoarthritis: a randomized double-blind placebo-controlled trial
Fish Oil: joint pain
The studies disagree. A Cochrane review (2022, 17 studies, 2,034 people) did not settle it for joint pain, while 4 of the 8 studies read found an improvement. The evidence is very weak.
8 studies counted of 11 read: 7 reviews and 1 trial (23 people in the trials).
- Meta-analysis, 2022; 17 studies, 2,034 people; women with early breast cancer taking aromatase inhibitors: unclear: evidence too weak to tell (the review the verdict rests on).
evidence is very uncertain about the effect
Systemic therapies for preventing or treating aromatase inhibitor-induced musculoskeletal symptoms in early breast cancer - Meta-analysis, 2024; 23 studies; patients with rheumatoid arthritis: unclear: evidence too weak to tell.
small effect in reducing pain [standardized mean difference (SMD): -0.16
Efficacy of n-3 fatty acid supplementation on rheumatoid arthritis' disease activity indicators: a systematic review and meta-analysis of randomized placebo-controlled trials - Meta-analysis, 2023; 9 studies, 2,070 people; patients with osteoarthritis: improves.
significantly relieve the arthritis pain as compared to placebo
Effect of omega-3 polyunsaturated fatty acids supplementation for patients with osteoarthritis: a meta-analysis - Systematic review, 2017; 18 studies, 1,143 people; patients with rheumatoid arthritis: mixed results.
reduction in patient or physician assessment of pain
Effect of ω-3 polyunsaturated fatty acids on arthritic pain: A systematic review - Meta-analysis, 2017; 42 studies: improves. Marine Oil Supplements for Arthritis Pain: A Systematic Review and Meta-Analysis of Randomized Trials
- Systematic review, 2012; 23 studies; patients with rheumatoid arthritis: improves.
consistent, but modest, benefit of marine n-3 PUFAs on joint swelling and pain
Influence of marine n-3 polyunsaturated fatty acids on immune function and a systematic review of their effects on clinical outcomes in rheumatoid arthritis - Meta-analysis, 2007; 17 studies; patients with rheumatoid arthritis, inflammatory bowel disease, dysmenorrhea: improves.
reduces patient reported joint pain intensity
A meta-analysis of the analgesic effects of omega-3 polyunsaturated fatty acid supplementation for inflammatory joint pain - Randomised trial, 2010; 23 people; patients with moderate to severe rheumatoid arthritis: no clear difference.
tended to be lower in the omega-3 FA group
omega-3 Fatty acids infusions as adjuvant therapy in rheumatoid arthritis
- Meta-analysis, 2022; 17 studies, 2,034 people; women with early breast cancer taking aromatase inhibitors: unclear: evidence too weak to tell (the review the verdict rests on).
Ginger (Zingiber officinale): joint pain
The best available review (2022, 24 studies) found an improvement in joint pain. That review studied humans with various health conditions. 6 of the 8 studies read agree; 1 found no clear difference, 1 found no clear answer. The evidence is strong.
8 studies counted of 11 read: 5 reviews and 3 trials (190 people in the trials).
- Systematic review, 2022; 24 studies; humans with various health conditions: improves (the review the verdict rests on). Orally consumed ginger and human health: an umbrella review
- Systematic review, 2025; 39 studies, 4,599 people; adults with knee osteoarthritis: improves.
ginger, and krill oil also demonstrated benefits
Comparative Effectiveness of Nutritional Supplements in the Treatment of Knee Osteoarthritis: A Network Meta-Analysis - Meta-analysis, 2020; 4 studies; patients with knee osteoarthritis: unclear: evidence too weak to tell.
mean difference for pain was -7.88 mm
Effectiveness of Ginger on Pain and Function in Knee Osteoarthritis: A PRISMA Systematic Review and Meta-Analysis - Meta-analysis, 2015; 5 studies, 593 people; osteoarthritis patients aged over 18 years: improves.
statistically significant pain reduction SMD = -0.30
Efficacy and safety of ginger in osteoarthritis patients: a meta-analysis of randomized placebo-controlled trials - Systematic review, 2015; 7 studies; athletes and untrained individuals: improves.
modestly reduce muscle pain stemming from eccentric resistance exercise
Ginger (Zingiber officinale) as an Analgesic and Ergogenic Aid in Sport: A Systemic Review - Randomised trial, 2025; 30 people; men and women with mild to moderate joint pain: improves.
improved ratings of pain, stiffness, and functional capacity
Effects of Ginger Supplementation on Markers of Inflammation and Functional Capacity in Individuals with Mild to Moderate Joint Pain - Randomised trial, 2024; 100 people: improves.
pain visual analog scale (VAS) Korean-Western Ontario and McMaster University Osteoarthritis Index (K-WOMAC; total scores, …
Effectiveness and safety of steamed ginger extract on mild osteoarthritis: a randomized, double-blind, placebo-controlled clinical trial - Randomised trial, 2012; 60 people; patients with osteoarthritic knees: no clear difference. The efficacy of powdered ginger in osteoarthritis of the knee
Glucosamine: joint pain
The studies disagree. The best available review (2013, 3 studies, 309 people) did not settle it for joint pain, while 4 of the 7 studies read found an improvement. The evidence is very weak.
7 studies counted of 10 read: 7 reviews.
- Systematic review, 2013; 3 studies, 309 people; chronic low back pain with spinal osteoarthritis: unclear: evidence too weak to tell (the review the verdict rests on).
Conflicting evidence was demonstrated with pain scores
The use of glucosamine for chronic low back pain: a systematic review of randomised control trials - Systematic review, 2025; 146 studies; humans with osteoarthritis and joint pain: improves. The Safety and Efficacy of Glucosamine and/or Chondroitin in Humans: A Systematic Review
- Meta-analysis, 2023; 6 studies, 297 people; adults with knee osteoarthritis: no clear difference.
effect of G, or G and C, in combination with exercise is not significant
Effects of adding glucosamine or glucosamine combined with chondroitin to exercise on pain and physical function in adults with knee osteoarthritis: a systematic review and meta-analysis - Meta-analysis, 2018; 18 studies; patients with osteoarthritis of the knee: improves.
marginally favorable effect of glucosamine on VAS pain scores
Effects of glucosamine in patients with osteoarthritis of the knee: a systematic review and meta-analysis - Meta-analysis, 2018: improves.
Treatments with glucosamine and chondroitin were found to significantly reduce pain in VAS [weighted mean …
Effect of glucosamine and chondroitin sulfate in symptomatic knee osteoarthritis: a systematic review and meta-analysis of randomized placebo-controlled trials - Meta-analysis, 2018; 17 studies; people with osteoarthritis: improves.
summary SMD was -0.35, with a 95% confidence interval (95% CI) = -0.54 to -0.16
Effects of Oral Glucosamine Sulfate on Osteoarthritis-Related Pain and Joint-Space Changes: Systematic Review and Meta-Analysis - Meta-analysis, 2017; 5 studies, 1,625 people; people with hip or knee osteoarthritis: no clear difference.
Glucosamine was no better than placebo for pain
Subgroup analyses of the effectiveness of oral glucosamine for knee and hip osteoarthritis: a systematic review and individual patient data meta-analysis from the OA trial bank
- Systematic review, 2013; 3 studies, 309 people; chronic low back pain with spinal osteoarthritis: unclear: evidence too weak to tell (the review the verdict rests on).
Key findings
- Knee Osteoarthritis Pain (vs NSAID)Improves (the measure goes down)
- Joint Function in OsteoarthritisImproves (the measure goes up)
- Safety vs NSAIDsImproves (the measure goes up)
Safety notes in the studies
- RCT (n=150): Adverse events similar to placebo (7.2% vs 9.1%) and lower than diclofenac (15.6%).
- RCT vs diacerhein: Significantly lower adverse event rate.
The Osteoarthritis (OA) protocol
2 primary supplements · 5 supporting supplements
- Glucosamine + Chondroitin1,500 mg glucosamine + 1,200 mg chondroitin daily
- Curcumin500–1,000 mg daily (enhanced absorption formula)
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Studies cited
2 studies from PubMed
- Efficacy of low-level laser therapy on pain and disability in knee osteoarthritis: systematic review and meta-analysis of randomised placebo-controlled trials.
- The effects of cognitive behavioural therapy delivered by physical therapists in knee osteoarthritis pain: A systematic review and meta-analysis of randomized controlled trials