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Osteoarthritis: In Depth

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What’s the Bottom Line?

What do we know about the effectiveness of complementary health approaches for osteoarthritis?

Natural Products

  • Despite extensive research, it’s still uncertain whether glucosamine and chondroitin have a meaningful impact on symptoms or joint structure in osteoarthritis.
  • The evidence on other natural products is too limited for any conclusions to be reached.

Mind and Body Practices

  • Acupuncture may help relieve osteoarthritis pain.
  • A small amount of evidence suggests that massage therapy may be helpful.
  • Participating in tai chi may improve pain, stiffness, and joint function in people with knee osteoarthritis. Qi gong may have similar benefits, but less research has been done on it.

What do we know about the safety of complementary health approaches for osteoarthritis?

  • Some natural products can have side effects or interact with drugs.
  • Mind and body practices generally have good safety records when used correctly. However, some may need to be adapted to make them safe and comfortable for people with osteoarthritis.
  • Magnetic therapies are not safe for people with some types of implantable medical devices.

About Osteoarthritis

Osteoarthritis (OA) is the most common type of arthritis. It occurs most often in the hands, knees, hips, and spine.

OA affects cartilage—the slippery tissue that covers the ends of bones in a joint. Cartilage allows bones to glide over each other and absorbs the shock of movement. In OA, the top layer of cartilage breaks down and wears away, allowing the bones under it to rub against each other. This can cause pain, swelling, and difficulty in moving the joint.

OA is most common in older people, but younger people can have it too, especially in joints that have been injured.

To find out more about OA, visit the National Institute of Arthritis and Musculoskeletal and Skin Diseases Web site.

What the Science Says About Complementary Health Approaches for Osteoarthritis

A variety of complementary approaches have been studied for osteoarthritis, including natural products, mind and body practices, and others. The following sections summarize the evidence on the effectiveness and safety of specific approaches.

Natural Products

Tainted Arthritis Supplements

U.S. Food and Drug Administration (FDA) has warned the public about several dietary supplements promoted for arthritis or pain that were tainted with prescription drugs. The hidden ingredients in these products could cause side effects or interact in harmful ways with medicines.

You can find a list of tainted arthritis/pain products and general information about fraudulent dietary supplements on the FDA Web site. It’s also a good idea to talk with your health care provider about any dietary supplement you’re taking or considering.

Mind and Body Practices

Other Complementary Health Approaches for Osteoarthritis

Guidelines for Treating Osteoarthritis

National health professional organizations have issued guidelines for treating OA. Some mention the use of complementary approaches.

The American College of Rheumatology’s guidelines

  • Conditionally recommend tai chi for knee OA
  • Conditionally recommend acupuncture for knee OA patients who are candidates for knee replacement but who cannot or will not have the surgery
  • Conditionally recommend against the use of glucosamine and chondroitin for knee or hip OA
  • Conditionally recommend topical capsaicin for hand OA but conditionally recommend against its use for knee OA.

The American Academy of Orthopaedic Surgeons’ guidelines for treating OA of the knee

  • Strongly recommend against acupuncture
  • Strongly recommend against glucosamine and chondroitin.

For more information, see the list of clinical practice guidelines on NCCIH’s Web page on arthritis.

NCCIH-Funded Research

NCCIH is funding a variety of studies on OA. Topics include:

  • A comparison of the effectiveness and cost-effectiveness of tai chi and standard physical therapy in patients with OA of the knee
  • The effects of a chair yoga program on elderly people with OA
  • An investigation of brain activity patterns associated with pain relief in people with knee OA who are receiving acupuncture or simulated acupuncture treatments.

More To Consider

  • Don’t use complementary health approaches to postpone seeing your health care provider about joint symptoms or any other health problem.
  • Keep in mind that dietary supplements may interact with medications or other supplements and may contain ingredients not listed on the label. Your health care provider can advise you. To learn more about using dietary supplements, see the NCCIH fact sheet Using Dietary Supplements Wisely.
  • Tell all your health care providers about any complementary or integrative health approaches you use. Give them a full picture of what you do to manage your health. This will help ensure coordinated and safe care.

For More Information

NCCIH Clearinghouse

The NCCIH Clearinghouse provides information on NCCIH and complementary and integrative health approaches, including publications and searches of Federal databases of scientific and medical literature. The Clearinghouse does not provide medical advice, treatment recommendations, or referrals to practitioners.

Toll-free in the U.S.: 1-888-644-6226

tty (for deaf and hard-of-hearing callers):

1-866-464-3615

Website: https://nccih.nih.gov/

Email: info@nccih.nih.gov (link sends e-mail)

National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)

The mission of NIAMS is to support research into the causes, treatment, and prevention of arthritis and musculoskeletal and skin diseases; the training of basic and clinical scientists to carry out this research; and the dissemination of information on research progress in these diseases.

Toll-free in the U.S.: 1-877-22-NIAMS

Website: https://www.niams.nih.gov

PubMed®

A service of the National Library of Medicine, PubMed® contains publication information and (in most cases) brief summaries of articles from scientific and medical journals. For guidance from NCCIH on using PubMed, see How To Find Information About Complementary Health Approaches on PubMed.

Website: https://pubmed.ncbi.nlm.nih.gov/

Key References

Acknowledgments

NCCIH thanks Partap Khalsa, D.C., Ph.D., NCCIH, for his contributions to the 2016 update of this publication.

This publication is not copyrighted and is in the public domain. Duplication is encouraged.

NCCIH has provided this material for your information. It is not intended to substitute for the medical expertise and advice of your health care provider(s). We encourage you to discuss any decisions about treatment or care with your health care provider. The mention of any product, service, or therapy is not an endorsement by NCCIH.

Last Updated: September 2016