Natural Remedies for Osteoarthritisby Sarah Ludwig Rausch Health Writer
From swelling, stiffness, and tenderness to the weird sounds your joints creak out when you move, having osteoarthritis (OA) can be, well, a pain. The good news? There are plenty of natural and home remedies that can help ease your symptoms. We asked two experts, Rajat Bhatt, M.D., a rheumatologist at Prime Rheumatology in Richmond and Pearland, TX, and Ken Johnson, P.T., director of ambulatory rehabilitation therapy services at the Johns Hopkins Rehabilitation Network in Baltimore, MD, to weigh in on what works, and what to watch out for. (As always, check with your doctor before adding anything new.)
Getting active may seem like a bad idea when your joints are in pain, but research shows that exercise is hugely beneficial. Not only can it help with movement, but it also decreases pain. Low-impact activities like walking and bicycling are good choices, as are stretching exercises like tai chi and yoga. “Tai chi helps with balance, yoga helps maintain joint flexibility, and walking helps overall conditioning,” says Dr. Bhatt. Johnson recommends walking on a treadmill set at an incline if your OA is advanced because it lessens the impact of your heel against the treadmill belt.
Water takes the stress off your joints, reducing your weight by 40% or more, according to Johnson. This makes water therapy a great option if you can’t bear weight, Dr. Bhatt says. To exercise comfortably, the water should be 83° to 88° F. “Most people like it a little bit warmer, but the benefits of that temperature are numerous, not just for the joints, but for many other vital systems,” says Johnson. “It helps with kidney function and circulation, improves cardiovascular fitness, it can benefit your strength, and people can do much more in water than they can on land.”
The research is a bit muddled when it comes to whether or not acupuncture—a practice that uses thin needles to stimulate specific points on the body—helps OA. “There’s some scientific evidence that acupuncture can provide relaxation to muscles or disturb the transmission of a pain message,” Johnson acknowledges. Some people with OA experience peripheral neuropathy—damage to the nerve cells—which has symptoms like weakness, numbness, tingling, and pain. Acupuncture can relieve these symptoms, and help with back pain, too, says Dr. Bhatt.
Both heat and cold can help arthritis pain and peripheral neuropathy, says Dr. Bhatt. Heat enhances blood flow to the inflamed area, which can increase inflammatory pain, but blood also carries nutrients in and takes waste away. Plus the warmth is soothing, so it’s a tradeoff, says Johnson. On the other hand, he points out that cold decreases blood flow, increasing stiffness and reducing incoming nutrients and outgoing waste products, but it numbs the area and minimizes the pain. “Everyone has an individual preference as to which one is better,” Dr. Bhatt says.
Topical Creams, Ointments, and Gels
OK, so they aren't totally "natural," but over-the-counter topicals like Aspercreme (lidocaine), Biofreeze (menthol), Bengay (salicylates), and Icy Hot or Capzasin (capsaicin) can help with OA pain. They come in creams, ointments, gels, sprays, foams, roll-ons, and oils—and each type works differently (for example, lidocaine numbs the area). Or, ask your doctor about a prescription for topical non-steroidal anti-inflammatory drugs. (“The response is very variable,” Dr. Bhatt says.) Cannabidiol (CBD) products are also in high demand for pain relief. Though Johnson notes there’s no scientific evidence to back them right now, many people find CBD products helpful.
Dropping extra weight can relieve pain, especially in your lower extremities. Johnson explains it this way: When you stand, gravity pulls you down, and the ground pushes up against you, equal to your body weight (ground reaction force [GRF]). The faster you move, the more the GRF increases, one to one-and-a-half times your body weight with walking and up to nearly three times your weight with running. There are around 2,000 steps in a mile, so if you take off one pound, you’ve reduced 2,000–3,000 pounds of strain on your joints for every mile you walk, and twice that with running, depending on your speed. “Losing one pound can be exponential in helping reduce overall joint stress,” Johnson says.
When you’re stressed, your body releases a stress hormone called cortisol into your system. Johnson says this often results in muscle tightness and blood flow restriction, which deprives the area (say, near a joint) of oxygen. This causes nerve tissue, which is much more sensitive than a muscle or joint, to start amplifying pain messages. To combat stress, try mind-body techniques like meditation, deep breathing, progressive muscle relaxation, and guided imagery. Studies show these approaches can reduce stress, anxiety, and depression, and relieve chronic pain. Dr. Bhatt suggests trying out apps like Calm or Headspace for guidance.
Not only does massage feel amazing, Dr. Bhatt says, but it also helps maintain joint flexibility and muscle strength. Massage can help with imbalances in your soft tissue, too, which may cause increased stress on your joints, says Johnson. It’s also another relaxation technique you can use to cope with pain-inducing stress and enhance your overall sense of wellbeing. Plus (as if you needed another excuse to book a massage) studies in people with arthritis show that massage does indeed improve knee, hand, and back pain. It may even improve your sleep and boost your mood.
Some people find that wearing light compression braces, wraps, or socks on their afflicted joints helps because they allow the joint to rest. Shoes and insoles that absorb shock and minimize stress are especially beneficial when you have arthritis in your hips, knees, and/or feet, Johnson says. As for devices like canes, braces, and wheelchairs, they can certainly help you cope with your OA better. However, Dr. Bhatt cautions that you need to be careful not to get too dependent on these devices because then you may not move your joint(s) as much. “Exercising the joint is very important,” he says.
Research has found that certain dietary supplements may help OA symptoms. SAM-e (S-adenosyl-methionine) is beneficial for relieving OA pain, similar to the relief you get from NSAIDs, says Dr. Bhatt. Boswellia serrata, a.k.a. Indian frankincense, can lessen pain and inflammation, plus Dr. Bhatt says it may also help mood stabilization. “That’s good because osteoarthritis patients can have depression, which can worsen osteoarthritis pain,” he says. A 2019 study found that curcumin, a compound in turmeric, was as effective as the NSAID Cambria (diclofenac) in treating knee osteoarthritis. Glucosamine and chondroitin may relieve pain and stiffness, though studies show mixed results.
All of these remedies are considered complementary to the treatment plan your doctor recommends. Before you try anything new, be sure to discuss it with your healthcare provider. This is especially true for supplements, which Dr. Bhatt says can have serious drug interactions. Once you have your doctor’s go-ahead, see what helps—it may be a combination of things. “What is the best treatment? It’s the treatment that works for you,” says Johnson. “We’re kind of trying to trick our central nervous system into thinking differently, so I tell patients to choose the remedy that works best for them.”