When joint cartilage wears away, bone rubs against bone, causing osteoarthritis. Sound painful? It is.
Osteoarthritis seriously impairs the quality of life for 27 million Americans. Given that osteoarthritis is so disabling, painful, and common, lots of quack "cures" are out there, from shark cartilage to copper jewelry to snake venom.
But here are 13 natural remedies that research suggests may actually help ease arthritis pain.
The best remedy is not the easiest: maintaining a healthy weight, and losing weight if necessary.
Every pound you pare off means four pounds less pressure on your knees, says Laura Robbins, senior vice president of education and academic affairs at the Hospital for Special Surgery in New York City.
Some people will see their symptoms disappear if they lose 10 to 20 pounds, says Roy Altman, MD, a rheumatologist and professor of medicine at the University of California Los Angeles.
Physical activity is essential for people with osteoarthritis, whether it means walking around your apartment if you're a fragile older person or swimming laps if you're in better shape.
People used to think that exercise made arthritis worse, but the opposite is true. (Unless you're pounding the pavement; runners with knee osteoarthritis should cut down on mileage, cross train, and run on softer surfaces like tracks and dirt paths).
Exercise programs should include both aerobic exerciselike walking, swimming, or bikingand strengthening, such as isometric and isotonic exercises, Dr. Altman says.
Many people find that acupuncture helps relieve pain and disability due to arthritis; several studies have found benefit.
"Several trials show acupuncture to be helpful for many people with osteoarthritis," says Dr. Altman. "It's not helpful in everybody."
It seems that glucosamine can be beneficial for arthritis, but the type of glucosamine matters.
"There continues to be a lot of controversy about it. There's a fair amount of data that glucosamine sulfate is beneficial, but glucosamine hydrochloride is not," Dr. Altman says. "Almost all of the products that are sold here in the United States are glucosamine hydrochloride. There are no trials demonstrating that glucosamine hydrochloride benefits people with osteoarthritis."
In the studies that did find benefit for glucosamine sulfate, Dr. Altman says, patients took 1,500 milligrams once a day, which resulted in better absorption in the body than splitting the dose.
Early research suggested this supplement was promising when combined with glucosamine, but more recent studies indicate it's not.
Although some studies suggest that chondroitin sulfate slows arthritis progression, it hasn't been shown to help symptoms, says Dr. Altman. Studies that found the supplement helpful used 800 milligrams or 1,200 milligrams daily.
"They're really pretty safe," Dr. Altman says of the supplements. "The one thing about them is there's no major side effects. They're fairly well tolerated."
Other supplements have shown promise, but the evidence just isn't that strong, says Dr. Altman.
Industry-funded studies have found benefits for avocado soybean unsaponifiables (ASU), which are made from avocado and soybean oils, in patients with hip and knee arthritis. But industry-funded studies aren't as reliable as those funded by groups that don't stand to gain financially.
There's a bit of evidence that rose hips and highly concentrated ginger could be helpful, Dr. Altman says.
Although fish oil has anti-inflammatory properties, more evidence is needed.
Strong-smelling mentholated rubs and creams may make your skin tingle, but they have limited value for osteoarthritis, says Dr. Altman.
But there are some creams now available that have proven benefit, he adds. Diclofenac gel, sold in the US as Voltaren Gel or Pennsaid by prescription (but available over-the-counter in Europe), is a non-steroidal anti-inflammatory drug that can ease osteoarthritis pain in the knees, ankles, feet, elbows, wrists and hands. It hasn't been evaluated in osteoarthritis of the spine, hip or shoulder. (Dr. Altman is a consultant for Novartis, the maker of Voltaren Gel.)
Capsaicin cream can also relieve osteoarthritis pain, and it's available without a prescription.
It's made from the substance that gives chili peppers their heat.
Nobody knows how it works, although one theory is that it relieves pain by depleting the nerve ending of pain-impulse-transmitting chemicals known as "substance P" and calcitonin gene-related protein, Dr. Altman says.