Glucosamine and chondroitin may get all the press (
45), but there are other natural remedies that can help alleviate joint stiffness and pain. And because they carry less risk of harmful side effects than traditional treatments like nonsteroidal anti-inflammatory drugs (NSAIDs) and COX-2 inhibitors (48), these supplements might just deserve a spot in your medicine cabinet.
Short for S-adenosylmethionine, SAM-e occurs naturally in cells. Your body produces less of it as you get older, which caused researchers to wonder if supplementing could help conditions like osteoarthritis (OA) and other joint pain. Scientists suspect that SAM-e relieves pain by calming inflammation, and it may help keep cell walls flexible and allow for better cell communication as well. SAM-e also spurs production of the antioxidant glutathione, quelling free radicals. Lab and animal studies have shown SAM-e can stimulate the production of cartilage, but more research is needed to see if it can do the same in humans.
Studies show SAM-e can reduce joint pain and stiffness seemingly as well as traditional pain relievers like NSAIDs and COX-2 inhibitors. For example, researchers at the University of California, Irvine, compared SAM-e (1,200 milligrams) with celecoxib (Celebrex 200 milligrams) for sixteen weeks to see how they reduced pain associated with knee OA. The researchers found that after two months, both treatments improved pain and joint function equally, although SAM-e took longer to take effect.
It’s expensive to take the full recommended dose of SAM-e, although many people find that after an initial period of high dosing they can maintain the effects with a smaller amount. Start with 400 milligrams three times a day for two weeks, then decrease to 200 milligrams twice a day thereafter. People taking SAM-e seem to tolerate it well and are less likely to report problems than people using NSAIDs, but SAM-e can have side effects at the high dose, such as mild digestive distress (though it doesn’t damage your stomach, like NSAIDs can do). Choose enteric-coated products labeled “butanedisulfonate,” which is the most stable form. Some research suggests SAM-e also has an antidepressant effect, so unless your doctor says it’s okay, you shouldn’t use it if you are taking antidepressant medications to avoid interactions.
Researchers believe pycnogenol, the patented name for a French maritime pine bark extract, helps OA by fighting free radicals (it contains potent antioxidant compounds called bioflavonoids) and calming inflammation. A 2008 study in the journal Phytotherapy Research found that OA sufferers who took 100 milligrams of pycnogenol daily for three months had significantly reduced pain and stiffness and better joint function, and could walk much farther on a treadmill test compared to those given a placebo. What’s more, pycnogenol takers were able to cut back on other pain-relieving medications such as NSAIDs and COX-2 inhibitors by 58 percent (and had 63 percent fewer gastrointestinal side effects as a result!). In a similar study published later that year, patients with mild to moderate OA took 150 milligrams of pycnogenol daily and also experienced pain relief significant enough to allow them to reduce NSAID use.
Pycnogenol seems to be safe and well tolerated, but talk to your doctor if you’d like to try it, since it also has cardiovascular effects and could reduce your need for hypertension drugs. It may affect your blood sugar levels as well. Take 50 milligrams two or three times daily with meals.
A handful of small studies indicate that extracts of Boswellia serrata (frankincense), an anti-inflammatory herb, help calm inflammation and improve OA symptoms such as pain, swelling, and joint function. A 2007 study in the Indian Journal of Pharmacology, for example, compared boswellia extract (1,000 milligrams daily, divided into three doses) with a COX-2 inhibitor and found that, while boswellia didn’t take effect as quickly, within two months both treatments had similar benefits on OA symptoms. And the people who took boswellia continued to notice improvements for up to a month after stopping the treatment, whereas the COX-2 inhibitor’s effects dwindled as soon as that group stopped taking the drug. A recent lab study also showed boswellia prevented cartilage degradation. But more and better-designed studies in humans are needed to gauge the herb’s benefit. As a 2008 review of studies in the British Medical Journal noted, “The evidence for the effectiveness of Boswellia serrata extracts is encouraging but not compelling.”