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Osteoarthritis (OA), a degenerative joint disease, is a significant cause of pain, disability, and reduced quality of life. While conventional treatments such as NSAIDs and corticosteroids are commonly used, they may lead to adverse side effects with long-term use. Herbal remedies offer a complementary or alternative approach with anti-inflammatory, chondroprotective, and analgesic properties.
Table of contents
Key Herbs for Osteoarthritis
1. Boswellia Serrata (Indian Frankincense)
- Mechanism: Contains boswellic acids that inhibit inflammatory mediators like leukotrienes.
- Evidence: Clinical studies have demonstrated its efficacy in reducing pain and improving function in OA patients, comparable to NSAIDs but with fewer side effects (Cameron & Chrubasik, 2014).
- Usage: Typically consumed in capsule or tablet form.
2. Turmeric (Curcuma longa)
- Mechanism: Curcumin, the active compound, exhibits potent anti-inflammatory and antioxidant effects.
- Evidence: A randomized trial showed turmeric is effective in reducing pain and inflammation, with results comparable to ibuprofen (Lindler et al., 2020).
- Usage: Consumed as capsules, teas, or incorporated into diets.
3. Ginger (Zingiber officinale)
- Mechanism: Contains gingerols and shogaols that suppress pro-inflammatory prostaglandins.
- Evidence: Ginger has been shown to reduce stiffness and pain in knee osteoarthritis (Akhtar & Haqqi, 2012).
- Usage: Typically used in teas, supplements, or as a spice.
4. Rhizoma Drynariae
- Mechanism: Known for promoting bone and cartilage repair and reducing joint inflammation.
- Usage: Traditionally used in decoctions or as part of herbal formulations.
5. Devil’s Claw (Harpagophytum procumbens)
- Mechanism: Harpagoside, the active component, has anti-inflammatory and pain-relieving properties.
- Evidence: Proven to reduce pain and improve joint mobility in clinical trials (Maksimović & Samardžić, 2018).
- Usage: Consumed as capsules or powders.
6. Eclipta alba
- Mechanism: Contains bioactive compounds that reduce oxidative stress and inflammation in joints.
- Usage: Used in traditional medicine as decoctions or extracts.
7. Rosehip (Rosa canina)
- Mechanism: Rich in polyphenols and anthocyanins, it exhibits anti-inflammatory and cartilage-protective effects.
- Evidence: A placebo-controlled trial showed significant improvement in pain and function with rosehip supplementation (Rein et al., 2004).
- Usage: Available as powders, teas, or capsules.
8. Gnetum montanum
- Mechanism: Known for its ability to reduce inflammation and support joint flexibility.
- Usage: Traditionally used as herbal teas or infusions.
9. Daemonorops draco
- Mechanism: Provides anti-inflammatory and antioxidant support, beneficial for joint repair.
- Usage: Utilized in powdered form or decoctions.
10. Black Cumin (Nigella sativa)
- Mechanism: Contains thymoquinone, which has proven anti-inflammatory and analgesic properties.
- Evidence: Shown to alleviate symptoms of knee osteoarthritis in a randomized controlled trial (Salimzadeh et al., 2017).
- Usage: Consumed as oil, capsules, or seeds.
Mechanisms of Action
Herbal treatments for osteoarthritis primarily work through:
- Anti-inflammatory Activity: Inhibition of pro-inflammatory cytokines such as IL-1β and TNF-α, and enzymes like COX-2 (Ansaripour & Dehghan, 2020).
- Chondroprotection: Herbs like Boswellia and Cốt Toái Bổ support cartilage regeneration.
- Antioxidant Support: Reduction of oxidative stress prevents cartilage damage.
- Pain Relief: Active compounds in herbs like Devil’s Claw and turmeric act on neural pain pathways.
Safety and Efficacy
- Fewer Side Effects: Most herbal remedies have milder side effects than conventional medications.
- Limitations: Variability in bioavailability, preparation methods, and dosages can influence efficacy.
- Clinical Validation: While many herbs are backed by traditional use, more high-quality clinical trials are needed to validate their long-term safety and effectiveness.
Recommendations
- Consultation: Always consult a healthcare provider before starting herbal therapies, especially if combining with other medications.
- Quality Assurance: Use standardized herbal products to ensure consistency and potency.
- Combination Therapy: Herbs can complement lifestyle changes, physical therapy, and conventional treatments.
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References:
Mobasheri, A. (2012). Intersection of Inflammation and Herbal Medicine in the Treatment of Osteoarthritis. Current Rheumatology Reports, 14(6), 604–616. https://doi.org/10.1007/s11926-012-0288-9
Cameron, M., & Chrubasik, S. (2014). Oral herbal therapies for treating osteoarthritis. The Cochrane Database of Systematic Reviews, 5, CD002947. https://doi.org/10.1002/14651858.CD002947.pub2
Lindler, B. N., Long, K. E., Taylor, N., & Lei, W. (2020). Use of Herbal Medications for Treatment of Osteoarthritis and Rheumatoid Arthritis. Medicines, 7(11), 67. https://doi.org/10.3390/medicines7110067
Akhtar, N., & Haqqi, T. M. (2012). Current nutraceuticals in the management of osteoarthritis: A review. Therapeutic Advances in Musculoskeletal Disease, 4(3), 181–207. https://doi.org/10.1177/1759720X11436238
Maksimović, Z., & Samardžić, S. (2018). Herbal Medicinal Products in the Treatment of Osteoarthritis. Osteoarthritis Biomarkers and Treatments. https://doi.org/10.5772/INTECHOPEN.80593
Rein, E., Kharazmi, A., & Winther, K. (2004). A herbal remedy, Hyben Vital (stand. powder of a subspecies of Rosa canina fruits), reduces pain and improves general wellbeing in patients with osteoarthritis–a double-blind, placebo-controlled, randomised trial. Phytomedicine: International Journal of Phytotherapy and Phytopharmacology, 11(5), 383–391. https://doi.org/10.1016/J.PHYMED.2004.01.001
Salimzadeh, A., Ghourchian, A., Choopani, R., Hajimehdipoor, H., Kamalinejad, M., & Abolhasani, M. (2017). Effect of an orally formulated processed black cumin, from Iranian traditional medicine pharmacopoeia, in relieving symptoms of knee osteoarthritis: A prospective, randomized, double‐blind and placebo‐controlled clinical trial. International Journal of Rheumatic Diseases, 20. https://doi.org/10.1111/1756-185X.13066
Ansaripour, S., & Dehghan, M. (2020). Efficacy of Some Herbal Medicines on Osteoarthritis with a Focus on Topical Agents: A Systematic Review. Current Pharmaceutical Design. https://doi.org/10.2174/1381612826666200429013728
Heidari-Beni, M., Moravejolahkami, A. R., Gorgian, P., Askari, G., Tarrahi, M., & Bahreini-Esfahani, N. (2020). Herbal formulation “turmeric extract, black pepper, and ginger” versus Naproxen for chronic knee osteoarthritis: A randomized, double-blind, controlled clinical trial. Phytotherapy Research, 34(10), 2675–2683. https://doi.org/10.1002/ptr.6671
Jo, H., Baek, C., Lee, J., et al. (2024). Anti-Inflammatory, Analgesic, Functional Improvement, and Chondroprotective Effects of Erigeron breviscapus in Osteoarthritis: An In Vivo and In Vitro Study. Nutrients, 16(7), 1035. https://doi.org/10.3390/nu16071035
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