Herbs and supplements for arthritis: what’s safe, and what might help?

 By Linda Caddick registered pharmacist and medical herbalist, Arthritis Assist

When you’re living with arthritis, it’s natural to look for extra ways to ease pain and stiffness. Some people find herbs and supplements helpful as a complement to their usual care (like movement, pacing, sleep, stress support and medicines). The good news is that many herbal products are generally safe for most people when they’re used appropriately. The tricky part is that “natural” doesn’t always mean “risk free”, herbs and supplements can still cause side effects or interact with prescription medicines. Click here to see the video we have about the safety of herbal remedies. 

The research on the effectiveness of herbs and supplements can be mixed. Some products have been studied in good-quality trials and show small to moderate improvements in pain or function, especially for osteoarthritis. Others don’t have enough reliable evidence yet. If you decide to try something, look for products with research behind them, and use them for a reasonable trial period. You should know before you start how long before you can expect to see some improvements. Also, stop if you notice side effects. Some natural products(and prescription medicines) need to be stopped prior to surgery. 

Turmeric contains curcumin, which has anti-inflammatory effects. Research trials suggest curcumin supplements can reduce pain and improve function for some people with knee osteoarthritis, and may be similar to anti-inflammatory medicines for symptom relief in the short term for some people. Results vary between products because different formulations absorb differently. 

Fish oils provide omega-3 fats that can support inflammation control. The best evidence is for inflammatory arthritis such as rheumatoid arthritis, where omega-3 supplements may reduce joint tenderness and morning stiffness for some people, and may help some people reduce their need for anti-inflammatory medicines (with medical guidance). 

Boswellia extracts have shown improvements in pain and function in some studies of knee osteoarthritis. As with turmeric, different extracts are not all the same, so results can vary depending on the quality of the extract and the dose used in the research. Good quality extracts are many more times effective so work at a much lower dose. 

Devil’s claw has been studied for osteoarthritis and other joint pain conditions. Some trials suggest it may help reduce pain, but the quality of research varies. It’s not suitable for everyone; it can upset the stomach and may interact with some medicines, so it’s important to check with your pharmacist, medical herbalist or naturopath. 

Collagen supplements (including collagen peptides/hydrolysate and undenatured type II collagen) have been studied in osteoarthritis. Some research shows improvements in pain and function for some people, particularly over the short to medium term. As with other supplements, product quality and study methods vary, so results are not guaranteed. 

Chondroitin has been widely used for osteoarthritis. Research suggests it may help some people, but results are inconsistent and benefits can take time. If you try it, you may need to use it for several months before deciding whether it’s helping. 

• Passion fruit peel extract – studied in knee osteoarthritis and may reduce pain and stiffness for some people. 
• Pycnogenol® (pine bark extract) – some studies suggest improvements in osteoarthritis symptoms. 
• L-carnitine – has been studied in osteoarthritis with mixed results; some reviews suggest improvements, but research quality varies. 

• Talk to your healthcare team first if you take regular medicines, have other health conditions, are pregnant/breastfeeding, or are planning surgery. 
• Ask an appropriately qualified person like a medical herbalist or naturopath, to help you select the best product(s) considering all your health conditions and current medicines. 
• Check for interactions – some herbs and supplements can affect blood thinners, anti-inflammatories, diabetes medicines, blood pressure medicines, and other health conditions. 
• Start one thing at a time so you can tell what’s helping (or causing side effects). 
• Give it a fair trial – some products may take weeks (or longer) to notice a change. 
• Choose reputable products and follow the label instructions. I always recommend using a New Zealand brand or buying from a New Zealand company.  We have good consumer laws here that prevent making excessive or false claims. We also have laws and testing so that you are more likely to get what it says on the label. This is not always true for imported products. 
• Stop and get advice if you notice side effects like stomach upset, rash, dizziness, bleeding or bruising more easily, or if your symptoms worsen.