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Joint Health – Beyond the Basics

When it comes to joint health the conversation often centers around structural support – reinforcing, lubricating, and soothing the joint space. Healthy joints are protected and cushioned by layers of connective tissue called cartilage that allows them to move freely without any grinding or contact between the bone surfaces themselves.  A special fluid in the joint capsule, called synovial fluid, is also extremely important for joint function. It acts as a natural lubricant and cushions joint movement.

In conditions such as osteoarthritis, injury, and even in aging, there is a reduction in synovial fluid and a loss of cartilage that eventually leads to cartilage degeneration. This can result in joint pain, inflammation, stiffness and an eventual loss of mobility.

Conventional treatments may be analgesic or anti-inflammatory, while common natural treatments also include methylsulfonylmethane (MSM), glucosamine, chondroitin, collagen, and hyaluronic acid.

While each of these is an important component, more and more researchers are looking to botanical herbs and their many benefits for joint health.

Boswellia

The resin extracted from the tree Boswellia serrata is well known for its anti-inflammatory, anti-arthritic, and analgesic properties.  The resin contains boswellic acids that inhibit the enzyme 5-lipoxygenase (5-LOX), which is essential for the synthesis of leukotrienes; important mediators of inflammatory response. These extracts have been shown to improve joint function, reduce pain, and reduce the levels of cartilage degrading enzyme in the joint fluid.

A study published in “Arthritis Research & Therapy” has provided further evidence of the positive effects of Boswellia serrata extracts on the symptoms of osteoarthritis.  Patients receiving 250 mg boswellic acids demonstrated significant improvements in both pain and functional ability of the knee join with benefits seen as early as seven days and a 72% reduction in requirements for additional medications. Another novel finding of this study is the effect of boswellic acids on the prevalence of matrix metalloproteinases, or cartilage degrading enzymes, in the synovial fluid. 

Sengupta et al. A double-blind, randomized, placebo-controlled study of the efficacy and safety of 5-Loxin® for treatment of osteoarthritis of the knee. Arthritis Research and Therapy. 2008; 10: R85 https://pubmed.ncbi.nlm.nih.gov/18667054/

Withania somnifera (Ashwaghanda)

This Aryuvedic plant known as the Indian ginseng is normally associated with stress relief and for its hormonal benefits. Though more information about its benefits for joint health is being elucidated. Researchers have identified multiple bioactive compounds in W. somnifera which function as an analgesic, anti-inflammatory, anti-arthritic, and chondroprotective. A recent study from 2016 treated subjects with knee joint pain with 250 mg of W. somnifera extract vs placebo.  After 12 weeks the treated group had improved pain scores (using the WOMAC pain scales, Physician Global Assessment scale) further the requirement for rescue medication was lowest in this group.

Ramakanth GS, Uday Kumar C, Kishan PV, Usharani P. A randomized, double-blind placebo-controlled study of efficacy and tolerability of Withaina somnifera extracts in knee joint pain. J Ayurveda Integr Med. 2016;7(3):151-157. doi:10.1016/j.jaim.2016.05.003 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5052364/

The combination of botanicals – Scutellaria baicalensis (Chinese Skullcap) and heartwood extract of Acacia catechu (Black Catechu) This combination has over 15 human clinical studies and was found to be more effective than placebo for relieving joint pain, stiffness and joint immobility in subjects with OA. On the basis of these positive observations, it was concluded that the mechanism of dual COX/LOX inhibition may confer clinical safety and efficacy benefits comparable and, in some cases superior to traditional NSAIDs, without the side effects. Protecting the late phase of subsequent cartilage degradation by suppressing the loss of collagen from the joints. The net effect is substantial short-term and long-term joint health improvements.

Burnett, B P and Jia Q et-al. A medicinal extract of Scutellaria baicalensis and Acacia catechu act as a dual inhibitor of COX and 5-LOX to reduce inflammation. Journal of Medicinal Foods, 2007; 10 (3): 442-451 https://pubmed.ncbi.nlm.nih.gov/17887937/

Curcuma longa (Turmeric)

While much of the clinical focus for turmeric’s benefits have been on the active component curcumin there are benefits to the whole extract – specifically long polysaccharides called turmacin. These are the water-soluble compounds from turmeric root which have been shown to have anti-inflammatory and antioxidant activity, independent of curcumin. Preliminary clinical trials in patients with osteoarthritis have shown promising results. In a randomized, single-blind, placebo-controlled trial, the effects of Turmacin® (1000 mg/day) on a variety of clinical parameters were compared to glucosamine (1500 mg/day), a combination of Turmacin® and glucosamine (2500 mg/day), and placebo (800 mg/day) over a 42-day period. Osteoarthritis patients showed the greatest symptom improvement (measured by physical performance, questionnaires, and clinician assessment) when given Turmacin® over time. Turmacin® was well-tolerated and no adverse reactions associated with treatment were reported. In animal studies, Turmacin® has shown to reduce inflammatory agents (interleukin-12 and PGE2) and stimulate anti-inflammatory factors (interleukin-10). 

Ramanaiah I, Bharathi B, Senthilkumar A, Sasikumar M, Joshua AJ, Deepak M, Amit A, Chandrasekaran CV. (2015), Anti-inflammatory activity of polysaccharide fraction of Curcuma longa (NR-INF-02). Anti-inflammatory & Anti-allergy Agents in Medicinal chemistry. 14(1):53-62. https://www.eurekaselect.com/130154/article

Harpagophytum procumbens (Devil’s Claw): Devil’s claw is a member of the sesame traditionally cultivated in South Africa. It has been traditionally used for its anti-inflammatory and analgesic effects. Reviews have provided insight into the mechanism of action- namely its ability to increase GAG synthesis, promoting the formation of new cartilage and decrease inflammation by blocking key enzymes, like cyclo-oxygenase-2 (COX-2). A number of eight to 12-week studies demonstrated its ability to reduce pain and improves physical functioning in people with osteoarthritis.

Brien S, Lewith GT, McGregor G. Devil’s Claw (Harpagophytum procumbens) as a treatment for osteoarthritis: a review of efficacy and safety. J Altern Complement Med. 2006;12(10):981-993. doi:10.1089/acm.2006.12.981 https://pubmed.ncbi.nlm.nih.gov/17212570/

Dr. Navnirat Nibber

About The Author

Dr. NavNirat Nibber, ND is a graduate of the Canadian College of Naturopathic Medicine and a registered Naturopathic Doctor. She is a Co-Owner at Crescent Health Clinic, as well as a Senior Medical Advisor at Advanced Orthomolecular Research.

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