Healthy joints : Stay ahead with nutraceuticals

Arthritis, an umbrella term for more than 100 different conditions, affects the joints and other parts of the body. It is one of the most chronic health problems, causing joint pain, inflammation, stiffness and reduce mobility, limiting the daily activities such as walking, bending, etc. People at risk of joint problems are those with obesity, infections, smoking, older people, joint injuries, lifting weight daily. Out of all, Osteoarthritis (OA), also called degenerative joint disease is the most common form of the disease. OA of the knee is prevalent in all parts of the world. OA has been affecting 15 million adults annually with prevalence ranging 22% to 39% in India.

While traditional treatment for OA typically involves drugs for reducing pain and inflammation such as anti-inflammatory medications, analgesics (pain-killer), surgery, as well as focusing on healthy body weight and regular physical activity, the nutritional and dietary interventions are an increasingly popular complementary approach - especially among those who prefer non-pharmacologic treatment options.

Nutraceuticals have been known to treat and prevent many joint related disorders. They are used in addition to traditional medicines as supportive therapy or on their own in managing many diseases and deficiencies.

It is important to understand the basic structure of joints before considering the role of nutraceuticals in OA. A Joint can be defined as a point of connection between two bones. A joint is made up of a cartilage (tissue that covers the surface of a bone in the joint), ligament (supports the movements of the joint), synovialmembrane- seals the joint, and synovial fluid (joint lubricating fluid secreted by the synovial membrane).OA is caused by the breakdown of cartilage and bones from the wear and tear resulting in pain and inflammation.

Nutraceuticals for joint health

Some of the most used nutraceuticals for OA are glucosamine, chondroitin, omega-3 fatty acid, curcumin, collagen, krill oil, gamma linolenic acid and avocado-soybean unsaponifiable. Several clinical trials have been performed to elucidate the efficacy of these products and the results have been variable.

Some of the nutraceuticals used for osteoarthritis include :

• Fish oil (omega-3 fatty acid)
• Glycosaminoglycans (GAGs) - glucosamine sulfate, chondroitin sulfate, and hyaluronic acid
• Olive oil
• Boswelliaserrata
• Turmeric (Curcumin)
• Ginger
• Rosehip
• Nigella sativa
• Devils claw
• Methionine
• Undenatured Type II Collagen

Nutraceuticals seem to play a role in processes that affect articular cartilage and in the balance of build-up and break down chemicals/signals in joints.

Nutraceuticals have helped in improving joint health due to their anti-inflammatory, anti-oxidant and chondroprotective action. They also help reduce pain and stiffness, improve joint mobility.

Pharmacological actions of nutraceutical in Osteoarthritis

(Action: none “-”, Low “+”, Moderate “++”, High “+++”)

Future prospects

Clinical trials of nutraceuticals are encouraging. However, more well-designed clinical trials are needed to ascertain efficacy and long-term safety of plant derived nutraceuticals. This approach will help in recommendation of nutraceuticals for OA treatment alone or in combination with traditional medicine.

In a nutshell, nutraceuticals have beneficial effects on joint pain and also improves the quality of life of the patient. This can be considered as a strategic tool for the management and prevention of OA as they have less side effects and lower costs.

References :

• Castrogiovanni P, Trovato FM, Loreto C, Nsir H, Szychlinska MA, Musumeci G. Nutraceutical supplements in the management and prevention of osteoarthritis. International journal of molecular sciences. 2016 Dec;18(12):2042.
• Loseli M, Awwad GEH, Bradshaw AR (2015) A Review of Nutraceuticals in Joint Arthritis. J Pain Relief 4:180. doi: 10.4182/2167-0846.1000180.
  https://www.omicsonline.org/open-access/a-review-of-nutraceuticals-in-joint-arthritis-2167-0846-1000180.php?aid=52805
• Aghamohammadi, D., Dolatkhah, N., Bakhtiari, F. et al. Nutraceutical supplements in management of pain and disability in osteoarthritis: a systematic review and meta-analysis of randomized clinical trials. Sci Rep 10, 20892 (2020).
  https://www.nature.com/articles/s41598-020-78075-x
• Vaishya R, Agarwal AK, Shah A, Vijay V, Vaish A. Current status of top 10 nutraceuticals used for Knee Osteoarthritis in India. Journal of clinical orthopaedics and trauma. 2018 Oct 1;9(4):338-48.
• D'Adamo S, Cetrullo S, Panichi V, Mariani E, Flamigni F, Borzì RM. Nutraceutical activity in osteoarthritis biology: a focus on the nutrigenomic role. Cells. 2020 May;9(5):1232.