Knee osteoarthritis is a painful, chronic, degenerative disorder due to the progressive loss and wear and tear of the articular cartilage. The prevalence of osteoarthritis (OA) in India is about 28.7%, among which the majority are women. Its treatment begins with symptomatic relief such as anti-inflammatory medications, painkillers and progresses to surgical treatment options. Recently, nutraceuticals derived from natural sources are stealing attractions in the management of knee OA as it plays a vital role in slowing the destruction of joints and reduction of inflammation. Nutraceuticals useful in the management of knee osteoarthritis are mentioned below.

Curcumin:

Curcumin is the main content of turmeric, derived from Curcuma longa which gives an intense yellow color to it. Curcumin has anti-inflammatory properties by which it blocks inflammatory markers. Several studies done on OA patients have shown that curcumin is effective in reducing pain.

Fish Oil:

Some fish contains omega-3 fatty acids such as salmon and sardine.  The eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) present in the fish oil act as an anti-inflammatory by modifying the metabolic pathway. Numerous studies reported consumption of fish oil improved physical function and reduced pain in knee OA patients.

Ginger:

Ginger is a well-known herb used in several diseases since ancient times. In Knee OA, ginger reduces the inflammatory markers. In numerous clinical trials consumption of ginger has observed pain reduction in patients with knee OA.

Green tea:

Green tea is rich in antioxidants; thus, it has benefits in several health conditions. It inhibits the inflammatory response due to the presence of polyphenols. Epigallocatechin-3-gallate (EGCG) is one of the polyphenols that inhibits enzyme activities and signal transduction pathways. However, there are no in-vivo human studies to confirm the benefits of green tea in knee OA.

Rosehip extract:

Rosehip is the fruit that is obtained from the blossom of the wild rose plants. Rosehip contains polyphenols, vitamin C, vitamin E, β-Carotene, Lycopene, Linoleic acid, EPA, and DHA. These compounds reduce the inflammation in the joints by regulating inflammatory response and prevent the destruction of cartilage. Multiple studies have evaluated its immunomodulatory and chondroprotective effects on the cartilage tissues. One of the studies observed consumption of rosehip extract reduced pain, stiffness, and severity of knee OA.

Boswellia:

Boswellia is a gum resin extracted from Boswellia serrata, also known as Indian frankincense. It is well-known for a variety of therapeutic benefits in inflammatory disorders. The most active component 3-O-Acetyl-11-keto-beta-boswellic acid (AKBA) present in Boswellia inhibits the inflammatory marker, 5-lipoxygenase, and reduces the production of pro-inflammatory cytokines involved in the cartilage destruction. In a clinical trial conducted on knee OA patients, supplementation of Boswellia reduced pain, stiffness, and physical functions.

Collagen peptide

Collagen is a protein that makes cartilage, bone, and skin. Hydrolysate Collagen (HC) is obtained from gelatinization and enzymatic hydrolysis of collagenic animal tissue. Oral consumption of HC increases collagen synthesis and prevents the degeneration of articular cartilage. Several clinical studies revealed that HC can reduce joint pain by controlling collagen damage.

Glycosaminoglycans

Glycosaminoglycans such as Glucosamine sulfate (GS) and Chondroitin sulfate (CS) are produced by chondrocytes and synoviocytes. GS is obtained from the chitosan and chitin exoskeleton of shellfish and CS from shark or bovine cartilage. Supplementation of GS and CS stimulates cartilage regeneration and reduces the pain and eventually protect from OA progression. GS modulates the inflammatory process and CS decreases the nuclear translocation of pro-inflammatory transcription factors.

The bottom line is the analgesic, anti-inflammatory, chondroprotective, and anti-arthritic actions of these nutraceuticals play a significant role in the management of knee OA. These supplements not only provide symptomatic relief but also interfere in the degeneration of articular joints and slow down the OA progression. Numerous clinical studies reveal that it can be used as an adjunct therapy for the management of knee OA because of its good safety and efficacy profiles.