7 Best Supplements for Knee Pain​ 2022

Chronic joint pain affects almost one-quarter of people worldwide. Common joints affected include the knees, hands, elbows, shoulders, back and elsewhere. In most cases, this is caused by the most common type of arthritis, osteoarthritis. 

What causes chronic knee pain?

Temporary knee pain is different from chronic knee pain. Many people experience temporary knee pain as a result of an injury or accident. 

Chronic knee pain rarely goes away without treatment, and it isn’t always attributable to one incident. It’s most often the result of several causes or conditions.

Step 1 in dealing with a chronic knee pain is to know the cause or 'diagnosis', a term used by medical doctors. Treatment is step 2. This may appear logical but many people jump into various kind of treatments without even knowing the cause of the knee pain. Thus, wasting their hard-earned money in none effective treatments.

Physical conditions or diseases can cause knee pain. These include:
  • osteoarthritis: pain, inflammation, and joint destruction caused by degeneration and deterioration of the joint
  • tendinitis: pain in the front of the knee that is made worse when climbing, taking stairs, or walking up an incline
  • bursitis: inflammation caused by repeated overuse or injury of the knee
  • chondromalacia patella: damaged cartilage under the knee cap
  • gout: arthritis caused by the buildup of uric acid
  • Baker’s cyst: a buildup of synovial fluid (fluid that lubricates the joint) behind the knee
  • rheumatoid arthritis (RA): a chronic autoimmune inflammatory disorder that causes painful swelling and can eventually cause joint deformity and bone erosion
  • dislocation: dislocation of the kneecap most often the result of trauma
  • meniscus tear: a rupture in one or more of the cartilage in the knee
  • torn ligament: tear in one of the four ligaments in the knee — the most commonly injured ligament is the anterior cruciate ligament (ACL)
  • bone tumors: osteosarcoma (second most prevalent bone cancer), most commonly occurs in the knee
As you can see from the above, there are many causes of knee pain. That's why you need to understand the importance of 'diagnosis' or finding the cause of the knee pain. Knee pain due to gout or rheumatoid arthritis has to be treated differently from knee osteoarthritis. A mis-diagnosis will lead to a mis-treatment.

Best Supplements for Knee Pain 2022

Treatments being used range from health supplements, hyaluronic acid, platelet rich plasma (PRP), stem cell therapy, to surgical methods such as minimal invasive method to joint replacement surgery (total knee replacement, total hip replacement). However, when it comes to joint pain supplements, the recommendations are mixed. 

On one side are experts and even guidelines telling you that supplements don't work, there's very little research and you should avoid them and just rely on wholesome foods. On the other, are experts telling you to take all kinds of supplements that will help with you joint problem. 

Do they actually work? Are they safe? Some supplements do have evidence more than others and some don't. This guide is based on various references to scientific literature and hopefully, can help you make sense of the options and to separate the facts from fiction.

best joint pain supplements

Pain relievers such as acetaminophen (Tylenol or Panadol) or non-steroidal anti-inflammatory drugs, such as ibuprofen (Advil or Nurofen), are usually the first choice for joint pain relief. However, you need to be under medical supervision if you intend to take these medications on a long term basis.

Of late, there are also dozens of supplements and ways that claim to treat joint pain, but which ones actually work? Here’s a look at the best options and what the existing research says about them.

1. Glucosamine

Glucosamine is a natural component of cartilage, a substance that prevents bones from rubbing against each other and causing pain and inflammation. It might also help prevent the cartilage breakdown that can happen with arthritis.

Many supplements aimed at treating joint pain contain glucosamine, which is one of the most well-studied supplements for osteoarthritis. But despite this research, there are still some questions about how well it works.

There are two types of glucosamine found in supplements: glucosamine hydrochloride and glucosamine sulfate.

One meta-analysis found that products containing glucosamine hydrochloride don’t do much to improve joint pain caused by osteoarthritis. Another study shows that glucosamine sulfate does improve these symptoms, so it may be a better option than glucosamine hydrochloride.

When taken over a long period of time, glucosamine sulfate may also help to slow down the progression of osteoarthritis. Studies suggest that it slows down narrowing of the joint space, a marker of the condition getting worse, when taken for up to three years.

Interestingly, a prospective study (published in BMJ 2019) of 466,039 participants without CVD (CardioVascular Disease), concluded that habitual use of glucosamine supplement to relieve osteoarthritis pain might also be related to lower risks of CVD events.

Try it: Glucosamine sulfate is typically taken once daily in a dose of 1,500 milligrams (mg). If this upsets your stomach, try spreading it out over three doses of 500 mg each. You can find glucosamine sulfate supplements on Amazon.


2. Chondroitin

Like glucosamine, chondroitin is a building block of cartilage. It may also help prevent cartilage breakdown from osteoarthritis.

Many clinical studies have found that chondroitin can reduce joint pain and stiffness in people with osteoarthritis. About 53 percent of people who take chondroitin have a 20 percent or greater improvement in knee pain.

Chondroitin sulfate may also slow down the progression of osteoarthritis when taken long-term. Studies show that it slows down narrowing of the joint space when taken for up to 2 years.

Joint supplements often combine chondroitin with glucosamine. But it’s still unclear if taking a combination supplement is any better than taking one or the other on their own.

Try it: Chondroitin is typically taken in a dose of 400 to 800 mg two or three times per day. You can find chondroitin supplements on Amazon.


3. Methylsulfonylmethane (MSM)

Methylsulfonylmethane (MSM) is another common ingredient in supplements said to help with joint pain. One of the most popular uses of MSM is to decrease joint or muscle pain. It has been shown to benefit those with joint degeneration, a common cause of pain in the knees, back, hands and hips.

In one randomised controlled study, MSM improved pain and functioning compared to a placebo in people with osteoarthritis.

A study in 100 people over the age of 50 found that treatment with a supplement containing 1,200 mg of MSM for 12 weeks decreased pain, stiffness and swelling in the joints, compared to a placebo (Int J Biomed Sci. 2015).

The group receiving the supplement also reported improved overall quality of life and less difficulty walking and getting out of bed (Int J Biomed Sci. 2015).

Another study in 32 people with lower back pain found that taking a glucosamine supplement containing MSM significantly reduced lumbar stiffness and pain upon movement, plus greatly increased quality of life (Curr Ther Res Clin Exp. 2005).

Try it: Typical MSM doses range from 1,500 to 6,000 grams per day, sometimes divided into two doses. 

You can find MSM supplements on Amazon.


4. Fish Oil and Omega-3s

The two types of omega-3 fatty acids found in fish oil are eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA).

For the omega-3 fatty acids in fish oil to work against arthritis, it’s necessary to consume a fairly large quantity of it each day. Fish oil — or cod liver oil — enclosed in capsules makes this fairly easy.

Fish Oil vs Cod Liver Oil

On the other hand, because cod liver oil contains very high amounts of vitamin A and vitamin D, taking too much can be toxic. For the purpose of treating arthritis, fish oil is the safer choice.

EPA and DHA

EPA and DHA can reduce inflammation, which causes swelling and pain. Research has indicated that both acids might suppress the body’s immune system. However, a 2016 study suggests that DHA might enhance immune function instead. DHA is more effective at reducing inflammation than EPA, but both have a role.

All of these effects makes fish oil potentially beneficial for people with arthritis.

In one study, people said their pain levels decreased after taking fish oil supplements.

Those who reported the improvement had taken a low dose rather than a high dose. They saw the improvement after 2 years. After 1 year, there was no significant improvement.

Commenting on this study, other scientists expressed further concerns. They noted that consuming more than 3 grams of fish oil a day could be hazardous.

Potential hazards include increased mercury consumption and bruising and bleeding. 

EPA and DHA come with other health benefits: They can help prevent heart attacks by making it harder for blood to clot. They help lower blood triglyceride levels and blood pressure. As well, EPA taken with statin medication is more effective in reducing the inflammation of arteriosclerosis than medication alone.

For the omega-3 fatty acids in fish oil to work against arthritis, it’s necessary to consume a fairly large quantity of it each day. Fish oil — or cod liver oil — enclosed in capsules makes this fairly easy.

On the other hand, because cod liver oil contains very high amounts of vitamin A and vitamin D, taking too much can be toxic. For the purpose of treating arthritis, fish oil is the safer choice as compared to cod liver oil.

Shop for fish oil supplement.

5. Curcumin

Curcumin is an antioxidant that may offer a variety of anti-inflammatory benefits. It’s present in turmeric, a mild spice that can add color and flavor to sweet and savory dishes, as well as teas.

It’s also available as a supplement.

Curcumin, present in turmeric, has long played a role in Chinese and Ayurvedic medicine, due to its anti-inflammatory properties.

This new meta-analysis on curcumin was published in 2021 by researchers at the University of Miami (1). After reviewing 10 different studies on curcumin and knee arthritis with almost thirteen hundred patients, the researchers concluded that:

“Although limitations exist within the 10 RCTs reviewed, this small set of studies show a reduction in pain and improvement in function similar to that of NSAIDs but with a reduced incidence of adverse events. Turmeric appears to be a safe adjunct to NSAID therapy allowing for additional analgesic benefit as well as a reduced dosage requirement for NSAIDs. “

Meaning that Curcumin was shown to be as good as NSAIDs like Motrin, Alleve, or Celebrex with far fewer side effects!

In 2019, some researchers found that curcumin capsules had a similar effect on the symptoms of knee osteoarthritis as diclofenac, an NSAID.

In the study, 139 people with OA of the knee took either a 50-milligram tablet of diclofenac twice a day for 28 days or a 500-milligram curcumin capsule three times a day.

Both groups said their pain levels improved, but those who took curcumin had fewer negative effects. The research suggested that people who can’t take NSAIDs may be able to use curcumin instead.

You can find curcumin supplements on Amazon.
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6. Resveratrol

Resveratrol is another nutrient that has antioxidant and anti-inflammatory properties.

Sources of resveratrol include:
  • grapes
  • tomatoes
  • red wine
  • peanuts
  • soy
  • some teas
In a 2018 study, scientists gave 110 people with mild to moderate OA of the knee a 500-milligram dose of resveratrol or a placebo.

They took this combination alongside a 15-gram dose of the NSAID meloxicam every day for 90 days.

People who took resveratrol found that their pain levels dropped significantly, compared with those who took the placebo.

More research is needed to confirm that resveratrol can benefit people with OA.

However, if you’re already taking another NSAID and it doesn’t reduce your pain as much as you’d like, the research suggests resveratrol may be a useful add-on.

You can find resveratrol supplements on Amazon.

7. Pine Bark Extract (Pycnogenol)

Pine bark acts as a local anti-inflammatory in synovial fluid (R) and three publications have shown it to improve KOA (knee osteoarthritis) pain and stiffness, NSAID (non steroidal anti inflammatory drug) use, physical and emotional well-being (RRR). Pine bark preparations have recently been “strongly recommended” to the rheumatology community as early and additive treatment for OA, likely based on the following meta-analysis (RR). 

In a 2020 randomized controlled trial, mineral rich algae with pine bark improved pain, physical function and analgesic use in mild-knee joint osteoarthritis, compared to Glucosamine.

Hip and Knee Exercises for Knee Pain

This research is a meta-analysis of 13 studies on exercises to help patello-femoral (knee cap) pain. The authors broke the studies into hip+knee, hip-only, and knee-only exercises. They found that hip+knee and hip-only exercises worked about as well as each other to get rid of PF (patello-femoral) pain, but that knee-only exercises were inferior.

Platelet Rich Plasma (PRP) for Knee Pain

Platelet-rich plasma (PRP) is a novel treatment for managing pain related to osteoarthritis (OA) of the knee. Some PRP preparations have approval from the US Food and Drug Administration (FDA), but approval does not yet cover the use of PRP in OA of the knee. Nevertheless, some clinics may offer it “off-label”.

PRP vs Hyaluronic Acid vs Steroid Injections

There are 20 PRP studies that show superiority over hyaluronic acid (source) and 5 PRP studies that show superiority over steroid injections (source).


Stem Cell Therapy for Knee Osteoarthritis: Evidence and Reviews

Some doctors and media channels argue that there is very little evidence to support the use of stem cells to treat orthopaedic conditions. However, there are more than 400 publications related to the use of stem cells in treating knee orthopaedic conditions alone.

There are currently more than 80 studies on stem cell treatment for knee osteoarthritis alone, under the U.S. Clinical Trial Registry.

Regenexx, the largest provider of stem cell therapy for orthopaedic conditions in the United States alone, have treated 30,000 patients with stem cell therapy for various joint conditions including knee pain. According to Regenexx, common regenerative medicine treatments used in common orthopedic problems have better research evidence than orthopedic surgery.
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Several other comparative studies have demonstrated good evidence in the treatment of osteoarthritis. However, there are several approaches and cell lines used. More well-designed and randomised controlled trials are needed to evaluate the best approach and universal consensus. As studies continue, the methods, forms and combinations of stem cell preparations are improving, and outcomes are expected to improve as well.

New Research on Meniscectomy and Steroid Shots

A study on meniscectomy (Arthroscopy 2021) looked at 11,652 patients with and 37,261 without a history of a knee steroid injection within 1 year of arthroscopic meniscectomy. The patients who received knee steroid injections within 1 month prior to this surgery developed post-operative infections at twice the rate of those who did not receive an injection. However, those patients who had an injection more than a month after surgery didn’t have any increased rate of infection.

The key takeaway for this is that you should avoid steroid injection within 1 month prior to removal of your knee meniscus.

What Does Arthritis in the Knees Feel Like?

- Pain that increases when you are active, but gets a little better with rest
- Feeling of warmth in the joint
- Stiffness in the knee, especially in the morning or when you have been sitting for a while
decrease in mobility of the knee, making it difficult to get in and out of chairs or cars, use the stairs, or walk
- Creaking, crackly sound that is heard when the knee moves

What are the First Signs of Arthritis in the Knee?

- Pain while climbing stairs or walking
- Joint stiffness after sitting for prolonged periods with bended knees
- Difficulty in straightening the knee after getting up in the morning
- Swelling over the knees that gets worse on walking
- Bones in the knee joint rub against each other giving rise to the sound of creaking, clicking or snapping, or grinding

What Vitamin Deficiency Causes Arthritis?

A deficiency of Vitamin D has been known to increase the likelihood of Rheumatoid Arthritis.

What Are The Worst Foods for Arthritis?

- Trans Fats : Can trigger or worsen inflammation
- Gluten : Has a connection with celiac disease and rheumatoid arthritis
- Refined Carbs and White Sugar : Exacerbates inflammation
- Processed and Fried Foods : Usually contains carcinogens and heavily processed ingredients, which cause inflammation and arthritic flare-ups.

What Are The Best Foods for Arthritis?

- Nuts : Magnesium, Zinc, Vitamin-E, Alpha-linolenic
- Garlic and Onions : Immune-boosting properties
- Beans : Folic acid, zinc, iron and potassium
- Citrus Fruit : Vitamin C
- Green Tea : Antioxidants and polyphenols

Anything to remember before starting supplements?

Some supplements play a very important part of our daily lives. They do various things such as boosting our immune system and reducing inflammation in our bodies. There are many types of supplements designed to reduce stress and inflammation in our bodies.

Before you start on any course of supplements, you may want to discuss it first with your doctor as they will consider any ongoing health issues you may have.

Never take more than the recommended dosage of supplements. You will find this amount marked on the label. Some supplements are designed for adults while others can be taken by children as well. It is not a good idea to give a supplement to a child unless it is designed for them.

Conclusion

Your doctor will likely recommend non-drug treatments if you have joint pain, and these recommendations may include supplements.

However, not all supplements are equally effective, and it’s essential to learn how to safely use them.

Before taking any supplements:
  • check first with your doctor that they are safe for you to use
  • get your supplements from a reputable source
  • follow the instructions provided
Other non-drug treatments can include:
  • trying to follow a healthy, balanced, and nutrient-dense diet
  • if you are over-weight, strive to loss weight 
  • find out the underlying cause of the joint pain. Could be from poor sitting or standing position.
  • physical therapy


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