13 Natural Remedies for Arthritis Pain

When joint cartilage wears away, bone rubs against bone, causing osteoarthritis. Sounds painful? It is.

Some call it "degenerative joint disease" or "wear and tear" arthritis. Osteoarthritis (OA) is the most common form of arthritis, according to the Centers for Disease and Prevention (CDC). It affects over 32.5 million Americans.

Since osteoarthritis is so disabling, painful, and common, many unproven "cures" are out there, from shark cartilage to copper jewelry to snake venom.

But here are 13 natural remedies that research suggests may help ease arthritis pain.

Weight Loss

According to the CDC, there is no cure for osteoarthritis, so symptoms are treated with a combination of therapies.

One of the best remedies—maintaining a healthy weight and losing weight if necessary—is not the easiest.

Still, every pound you lose means 4 pounds less pressure on your knees, said 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, said Roy Altman, MD, a rheumatologist and professor of medicine at the University of California, Los Angeles.

Exercise

People used to think exercise made arthritis worse, but the opposite is true—unless you're pounding the pavement. Physical activity is essential for people with osteoarthritis, says the CDC.

That could mean walking around your apartment or swimming laps if that is accessible to you.

Exercise programs should include both aerobic exercise—like walking, swimming, or biking—and strengthening exercises, such as isometric and isotonic exercises, said Dr. Altman.

According to the Arthritis Foundation, runners with knee osteoarthritis should work with a healthcare provider or physical therapist, paying close attention to pain, backing off when pain appears, and taking rest days. They should also choose a flat-soled shoe to run in and run on softer surfaces like grass or small gravel).

Acupuncture

Many people find that acupuncture helps relieve pain and disability due to arthritis.

One 2019 study published in the journal Medicine concluded that acupuncture might have some advantages in treating osteoarthritis of the knee, but further studies were needed. However, a 2018 Cochrane review of studies evaluating acupuncture for hip osteoarthritis concluded acupuncture probably has little or no effect in reducing pain or improving function in people with hip osteoarthritis.

"Several trials show acupuncture to be helpful for many people with osteoarthritis," said Dr. Altman. "It's not helpful in everybody."

Glucosamine

Some evidence suggests glucosamine—a natural component of cartilage, per the National Library of Medicine—alleviates arthritis pain, 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," said Dr. Altman. "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."

According to the National Library of Medicine, taking glucosamine sulfate by mouth for at least four weeks can provide some pain relief and improve function for people with knee osteoarthritis. However, products that contain glucosamine hydrochloride do not seem to work as well unless they are taken in combination with other ingredients.

In the studies that did find benefits for glucosamine sulfate, said Dr. Altman, patients took 1,500 milligrams once a day, which resulted in better absorption in the body than splitting the dose.

The American College of Rheumatology (ACR) has recommended that people with knee, hip, or hand osteoarthritis not use glucosamine, citing discrepancies in efficacy reported in studies that were industry-sponsored as opposed to publicly funded. The ACR notes that the potential toxicity of glucosamine is low, though some patients exposed to glucosamine may show elevations in serum glucose levels.

Chondroitin

Chondroitin is a structural component of cartilage, the tissue that cushions the joints and is produced naturally in the body. It is also available as a dietary supplement, according to the National Center for Complementary and Integrative Health (NCCIH).

The NCCIH says research suggests chondroitin isn't helpful for pain from osteoarthritis of the knee or hip. Still, no serious side effects have been reported in large, well-conducted studies of people taking chondroitin for up to 3 years.

A 2015 study published in Cochrane Database of Systematic Reviews analyzed 43 randomized controlled trials, including 4,962 participants treated with chondroitin and 4,148 participants given a placebo or another control. Most trials were in knee osteoarthritis, with few in hip and hand osteoarthritis. The authors concluded that chondroitin (alone or in combination with glucosamine) was better than placebo in improving pain in participants with osteoarthritis. However, the benefit was small to moderate. The authors also noted that chondroitin had a lower risk of serious adverse events compared with control.

"They're really pretty safe," said Dr. Altman. "The one thing about them is there's no major side effects. They're fairly well tolerated."

Still, the American College of Rheumatology (ACR) has recommended that people with knee and/or hip osteoarthritis use chondroitin sulfate or combination products that include glucosamine and chondroitin sulfate. However, the ACR conditionally recommended for patients with hand osteoarthritis.

Other Supplements

Other supplements have shown promise, but the evidence isn't that strong, said Dr. Altman.

According to the NCCIH, there is preliminary evidence that avocado/soybean unsaponifiables (ASU), supplements made from avocado oil and soybean oil extracts, may have modest beneficial effects on symptoms of osteoarthritis. However, safety information has not been sufficiently available.

There's evidence that rose hips and highly concentrated ginger could be helpful, said Dr. Altman.

Although fish oil has anti-inflammatory properties, more research is needed.

Topical Remedies

Strong-smelling mentholated rubs and creams may make your skin tingle, but many have limited value for osteoarthritis, said Dr. Altman.

According to the Arthritis Foundation, topical remedies that use menthol or camphor are called counterirritants. These remedies "work" by producing a cooling sensation to distract from the pain. They do not affect pain signals or inflammation. Menthol or camphor topicals have few side effects, but pain alleviation may disappear once the cooling sensation wears off.

Capsaicin Cream

Capsaicin cream can also relieve osteoarthritis pain and is available without a prescription. It's made from the substance that gives chili peppers their heat.

The National Library of Medicine explains that capsaicin affects nerve cells in the skin associated with pain, which results in decreased activity of these nerve cells and a reduced sense of pain.

Electricity

Electrical energy can help ease pain and swelling in arthritic joints. Physical therapists often employ transcutaneous electrostimulation, or TENS, which involves placing electrodes around the affected joint and delivering electromagnetic pulses through the skin.

A 2015 Cochrane review concluded that about half of people who try TENS get a 50 percent reduction in pain.

And there's electroacupuncture, in which the provider uses needles at acupuncture points attached to electrodes to pass an electric charge through the acupuncture needles.

There's some evidence that electroacupuncture can help relieve pain and ease joint stiffness. A 2016 study published in Evidence-Based Complementary and Alternative Medicine concluded that electroacupuncture treatment could relieve the pain of osteoarthritis of the knees and improve comprehensive aspects of knee osteoarthritis and the quality of life of patients with knee osteoarthritis.

Chiropractic Adjunctive Therapy

According to the Arthritis Foundation, chiropractors may offer several adjunctive therapies that can help osteoarthritis, including:

• Ultrasound: Sound waves can also produce a massaging effect on soft tissues and joints, possibly reducing swelling and decreasing pain and stiffness.
• Electrotherapy: Painless electric pulses treat soft tissue injuries by stimulating nerves and muscles.
• Low-level laser or "cold laser:" A non-heat-producing laser or light penetrates deep into the tissue, sometimes reducing inflammation.
• Infrared sauna: A specialized room uses controlled amounts of infrared heat to relieve pain and increase circulation.

In addition, heat and cold treatments can also help ease these muscle spasms, which aren't only painful but can interfere with sleep, per the National Library of Medicine,

Physical Therapy

The CDC cites physical therapy with muscle strengthening exercises as a common treatment for osteoarthritis.

However, most of the time, you don't need to see a physical therapist, said Dr. Altman. Still, in some cases physical therapy can be invaluable.

For example, someone who has trouble getting out of a chair can benefit from physical therapy and possibly even have PT administered at home.

But the therapist should be experienced in treating osteoarthritis. "Many physical therapists are used to treating stroke patients or sports injuries or other things where they're used to pushing people a lot," said Dr. Altman. "Physical therapy for osteoarthritis needs to be more gentle."

Assistive Devices

Shoe inserts, canes, splints, braces, and other devices that can help redistribute your weight to take the load off an arthritic joint or hip can be very beneficial, said Dr. Altman.

They are particularly helpful, for example, if someone has become knock-kneed or bow-legged as a result of having arthritic knees. Unloading braces can help restore normal weight distribution, reduce pain, and prevent your arthritis from getting worse.

While evidence for the benefits of shoe wedges is mixed, according to Dr. Altman, some people will find them helpful, especially if they have leg length discrepancies greater than a half-inch.

Information

It's not a therapy, but learning more about arthritis is a powerful weapon.

It's crucial that you understand osteoarthritis and what your limits are—and aren't, said Dr. Altman.

You also need to find a healthcare provider, possibly a rheumatologist (a specialist in diseases of the joints), who can diagnose osteoarthritis and distinguish it from inflammatory arthritis.

Your healthcare provider can take the time to work with you to develop an exercise plan and answer your questions, said Dr. Altman.

"In some physicians' offices where they only have seven minutes to see you, you're not going to get that education."