Joints are those areas in the body where two or more bones meet. These articular
structures or joints are composed of cartilage (connective tissue that covers the joint
bones thereby reducing friction), a synovial membrane bathed in lubricating synovial
fluid, ligaments and tendons (bands of connective tissue that provide support and
control movement), and bursas (fluid-filled sacs that have a cushioning effect). Most of
these joints are mobile and thus allow skeletal movement.
Joint pain (arthralgia) may be due to many different conditions. Some of these include
arthritis (rheumatoid and osteoarthritis), gout, obesity, lupus and injury. Osteoarthritis,
the most common cause of joint pain, is due to a degeneration of joint cartilage.
Rheumatoid arthritis is an autoimmune condition that presents with stiff, inflamed joints
that are often deformed. Painful, swollen joints greatly limit mobility and can severely
impact the quality of life.
Arthritis is the leading cause of disability in America. Data from the Center for Disease
Control (CDC) shows that arthritis and other painful joint conditions affect nearly 43
million Americans (1). The most common treatment of joint pain involves the use of nonsteroidal
anti-inflammatory drugs (NSAIDs). However, the prolonged use of NSAIDs can
lead to joint cartilage deterioration, which can contribute to the existing arthritic problem (2).
Several scientific studies have demonstrated the joint supportive and protective actions
of certain natural ingredients, including glucosamine, chondroitin and MSM
(methylsulfonylmethane). Glucosamine is an amino sugar that stimulates the synthesis
of glycosaminoglycans, the major structural component of cartilage. Glucosamine also
seems to aid in replenishing joint fluid (3,4). Chondroitin acts by maintaining the
structural integrity of connective tissue, including cartilage. Additionally, chondroitin
attracts fluid into cartilage, thus making it more shock-absorbent (5). MSM, a natural
source of sulfur, is needed for the synthesis and maintenance of cartilage (6).
Additional joint-supportive supplement ingredients include hyaluronic acid and devil’s
claw (Harpagophytum procumbens) root. Hyaluronic acid is found abundantly in joint
synovial fluid as well as cartilage and plays an important role in joint lubrication (4,5).
Devil’s claw root contains iridoid glycosides that appear to reduce inflammation (7). Our
current view is that devil’s claw root significantly reduces pain because of its antiinflammatory
activity.
There are a number of herbal extracts that are quite effective in supporting joint health.
These include: mangosteen pericarp (Garcinia mangostana), turmeric root (Curcuma
longa), andrographis (Andrographis paniculata), white willow bark (Salix alba) and
boswellia gum (Boswellia serrata). When combined in the form of a nutritional
supplement, these extracts provide a synergistic modulation of the production of pro-inflammatory prostaglandins and leukotrienes (5).
A relatively new ingredient that shows benefit to inflamed, painful joints is the extract of
hops (Humulus lupulus) cone. This extract is derived from the flowering part (cone) of
the female hops plant and is standardized to 30% alpha acids. These chemically
complex alpha acids relieve inflammation and pain in joints because of their powerful
antioxidant action as well as a direct and indirect inhibition of prostaglandins and
leukotrienes (8,9). These autacoids, specifically prostaglandin E2 and leukotriene B4,
are quite efficient in promoting the inflammatory response.
An exciting new aspect of combating joint dysfunction involves the promise of cellbased
therapies to regenerate joint cartilage. Cartilage is an unusual tissue in that it
lacks nerve cells and blood vessels and contains only one cell type, the chondrocyte. In
cases of injury or degenerative disease processes, intrinsic repair of joint cartilage is
limited, and degeneration usually continues until joint dysfunction occurs. Therefore, the
most logical approach appears to be an initiation of cartilage repair. This was very
difficult until the advent of several interesting cell-based techniques (10). One technique
focuses on isolating host cartilage cells or chondrocytes, culturing them under
laboratory conditions, and then injecting them into the dysfunctional area. Even more
recently, a radical approach focuses on mesenchymal stem cells, the progenitors of
chondrocytes. The prevailing thought is that these stem cells could effectively become
part of the existing cartilage, develop into chondrocytes, and form new tissue. This
therapy would be ideal because arthritic degeneration would not just be prevented but
rather there would be a reversal of the osteoarthritic disease process
.
Many other natural ingredients support and maintain joint health. Omega-3 fatty acids in
the form of fish oils and proteolytic enzymes are two of the more important ones.
Created by Dr. William J. Keller
REFERENCES:
1. National Center for Chronic Disease Prevention and Health Promotion. Arthritis. 2008. Available at: http://www.cdc.gov/ARTHRITIS/data_statistics/arthritis_related_statistics.htm Accessed December 18, 2008.
2. Brooks, P.M., Potter, S.R., Buchanan, W.W. "NSAID and osteoarthritis--help or hindrance?" J
Rheumatol. 1982;9(1):3-5.
3. University of Maryland Medical Center. Glucosamine. 2008. Available at:
http://www.umm.edu/altmed/articles/glucosamine-000306.htm Accessed December 18, 2008.
4. Uitterlinden EJ, Koevoet JL, Verkoelen CF, Bierma-Zeinstra SM, Jahr H, Weinans H, Verhaar JA, van Osch GJ. Glucosamine increases hyaluronic acid production in human osteoarthritic synovium explants. BMC Musculoskelet Disord. 2008 Sep 11;9:120.
5. Jellin JM, Gregory PJ, Batz F, Hitchens K, et al. Pharmacist’s Letter/Prescriber’s Letter Natural Medicines Comprehensive Database. 9th ed. Stockton, CA: Therapeutic Research Faculty; 2007.
6. University of Maryland Medical Center. Sulfur. 2007. Available at:
http://www.umm.edu/altmed/articles/sulfur-000328.htm Accessed December 22, 2008.
7. University of Maryland Medical Center. Devil’s Claw. 2007. Available at:
http://www.umm.edu/altmed/articles/devils-claw-000237.htm Accessed December 22, 2008.
8. Hougee S, Faber J, Sanders A, Berg WB, Garssen J, Smit HF, Hoijer MA. Selective inhibition of COX-2 by a standardized CO2 extract of Humulus lupulus in vitro and its activity in a mouse model of zymosan-induced arthritis. Planta Med. 2006 Feb;72(3):228-33.
9. Jellin JM, Gregory PJ, Batz F, Hitchens K, et al. Hops monograph. Pharmacist’s
Letter/Prescriber’s Letter Natural Medicines Comprehensive Database. Stockton, CA:
Therapeutic Research Faculty; 2010.
10. Luiggi, C. Cellular salve. The Scientist. 2011 June;5:30.
