Nutritional Approaches for Musculoskeletal Pain and Inflammation

February 2022

Many nutritional approaches such as dietary supplements have purported anti-inflammatory properties, and some have a long history of use for treating inflammation and the pain that is associated with musculoskeletal inflammatory conditions such as osteoarthritis, rheumatoid arthritis, and tendinitis. Although there is some limited evidence that a few natural products may provide modest benefits, in general, there is insufficient evidence to support the use of many of these approaches for inflammatory conditions. This issue of the digest provides a current summary of the evidence of several natural products marketed for improving these conditions.

What the Science Says:
Nutritional Approaches for Musculoskeletal Pain and Inflammation

Modality and Summary of Current Research

Willow Bark (Salix alba)

In spite of its long history of use, only a few small clinical trials have been conducted that support the use of willow bark extracts in chronic low-back pain and osteoarthritis.

Omega-3 Fatty Acids

There is some evidence that omega-3 fatty acids may provide a modest benefit for symptoms of rheumatoid arthritis.

Devil’s Claw (Harpagophytum)

There is some limited evidence that devil’s claw may provide modest improvements in low-back pain over the short term. There is some moderate evidence that devil’s claw is beneficial for osteoarthritis of the spine, hip, and knee.

Ginger (Zingiber officinale)

Based on available evidence, it is unclear whether supplementation of ginger is beneficial in treating rheumatoid arthritis, osteoarthritis, or joint and muscle pain.

Thunder God Vine (Tripterygium wilfordii)

There is some evidence that thunder god vine may reduce some symptoms of rheumatoid arthritis; however, thunder god vine may be associated with some serious adverse side effects.

Turmeric (Curcuma longa)

Preliminary findings from laboratory research suggest that curcumin, a chemical found in turmeric, may have anti-inflammatory properties, but in spite of its long history of use for inflammatory disorders, there is insufficient evidence to support the use of turmeric supplementation for these disorders.

Bromelain (Pineapple plant)

There is some evidence that bromelain may be useful as adjunctive therapy to help improve acute nasal and sinus inflammation, but there is insufficient evidence as to whether bromelain has any beneficial effects on other inflammatory conditions.

Clinical Guidelines

Treatment of Osteoarthritis of the Knee (American Academy of Orthopaedic Surgeons)
Nonpharmacologic and Pharmacologic Therapies for Osteoarthritis of the Hand, Hip, and Knee (American College of Rheumatology/Arthritis Foundation)

Scientific Literature

Musculoskeletal Inflammation and Natural Products—Randomized Controlled Trials (PubMed®)

Information for Your Patients

NCCIH Clinical Digest is a service of the National Center for Complementary and Integrative Health, NIH, DHHS. NCCIH Clinical Digest, a monthly e-newsletter, offers evidence-based information on complementary health approaches, including scientific literature searches, summaries of NCCIH-funded research, fact sheets for patients, and more.

The National Center for Complementary and Integrative Health is dedicated to exploring complementary health products and practices in the context of rigorous science, training complementary health researchers, and disseminating authoritative information to the public and professionals. For additional information, call NCCIH’s Clearinghouse toll-free at 1-888-644-6226, or visit the NCCIH website at nccih.nih.gov. NCCIH is 1 of 27 institutes and centers at the National Institutes of Health, the Federal focal point for medical research in the United States.

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