Glucosamine, fish oil and turmeric for joint pain: what works?
Joint supplements are a huge industry, and most people with sore knees or hips have been told to try at least one. The evidence varies a lot between products. Here's what the larger reviews show for the three most popular.
This is general information, not individual dietary or medical advice. Steven is an osteopath, not a dietitian or pharmacist. Check with your GP or pharmacist before starting a supplement, particularly if you take other medicines.
Does glucosamine work for arthritis?
The best evidence says no. An analysis that pooled individual patient data from trials of glucosamine for knee and hip osteoarthritis found it was no better than placebo for pain or function at three months or at two years, and no better in any subgroup of patients. The authors concluded there is currently no good evidence to support its use for hip or knee osteoarthritis (Runhaar et al., Annals of the Rheumatic Diseases, 2017).
What about chondroitin?
Chondroitin is often sold with glucosamine. Results across trials are inconsistent, and Australian guidelines for knee and hip osteoarthritis don't recommend glucosamine or chondroitin.
Does fish oil help joint pain?
It depends on the type of arthritis. A meta-analysis of 42 trials found marine oil supplements had a small favourable effect on pain overall. The effect was significant in rheumatoid arthritis but not in osteoarthritis, and the overall quality of evidence was low (Senftleber et al., Nutrients, 2017). For inflammatory arthritis, fish oil is something to discuss with your GP or rheumatologist. For osteoarthritis, the evidence doesn't support it for pain.
Does turmeric or curcumin help knee arthritis?
There's some promising evidence. A systematic review of ten trials found that turmeric or curcumin extracts improved knee osteoarthritis pain and function compared with placebo, and in three small trials the effects were similar to anti-inflammatory medication, with no significant adverse events reported. The authors noted that the best dose and formulation aren't established (Paultre et al., BMJ Open Sport & Exercise Medicine, 2021).
Is cooking with turmeric enough?
Probably not for a measurable effect. The trials used concentrated extracts, often formulated to improve absorption, because curcumin from the spice is poorly absorbed. Turmeric in food is fine to enjoy, but it isn't equivalent to the doses studied.
Are these supplements safe?
They're generally well tolerated, but they aren't risk-free. Fish oil and turmeric can affect bleeding and may interact with blood thinners. Glucosamine is usually made from shellfish and may affect blood sugar or interact with warfarin. Turmeric extracts have occasionally been linked with liver problems. Always check with your GP or pharmacist, particularly before surgery or if you take regular medication.
If glucosamine seems to help me, should I stop?
If you feel it helps, it's well tolerated and your doctor has no concerns, that's your choice. Placebo effects in joint pain are real and can be substantial. Just be aware the evidence suggests the benefit isn't coming from the supplement itself, and weigh the ongoing cost.
What about collagen?
There's early evidence that collagen peptides combined with exercise may help joint pain and function, though more research is needed.
See our post on collagen for tendons and joints.
Do anti-inflammatory diets help?
A Mediterranean-style way of eating, with plenty of vegetables, fruit, whole grains, fish, olive oil and nuts, is good for general health and helps with weight management. Evidence that specific foods reduce osteoarthritis pain is limited.
What works better than supplements for osteoarthritis?
Exercise and, for people above a healthy weight, weight loss. These have the strongest evidence for reducing pain and improving function in knee and hip osteoarthritis, and are recommended first in clinical guidelines.
See our posts on body weight and knee arthritis and managing knee osteoarthritis.
How do I judge whether a supplement is working?
Try one at a time, at the dose used in research, for about three months, and track something concrete, such as how far you can walk or how stairs feel. If there's no clear change, stop.
Are joint supplements regulated in Australia?
Most are listed complementary medicines. Listing means the ingredients are considered low risk; it doesn't mean the product has been proven to work for the claims on the label. Doses and formulations also vary widely between brands.
Do supplements rebuild cartilage?
No supplement has been shown to regrow cartilage in an arthritic joint. The good news is that pain and function can improve substantially without any change in the cartilage, through strength, activity and weight management.
How can an osteopath help?
We assess your joints, treat hands-on to ease pain and stiffness, and build an exercise program, which is where the evidence is strongest. For supplement and medication questions, we'll point you to your GP or pharmacist.
See our training hub. Book an assessment at our Berwick clinic. A 60-minute initial consultation is $149, with no referral needed and HICAPS on-site.
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Book an initial consultation at RISE Sports & Spinal in Berwick. Clear diagnosis, hands-on treatment, and a plan that actually gets you better.
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