In the news: New Research on Physical Activity & Botanicals for Osteoarthritis

Keep Moving – Good Advice for Those with Arthritis

A study published in the Lancet medical journal last August projects that nearly 1 billion people will have osteoarthritis (OA) – the most common type of arthritis – by the year 2050. According to the Centers for Disease Control and Prevention, more than 32.5% of Americans are living with this degenerative joint disease right now.

Research teams are currently working on innovative strategies for healing joints using techniques that tackle the biology and structural challenges of the disease(1). But, while promising, they are still on the horizon.

In the meantime, important recommendations from experts are to shed pounds if overweight, and to keep physically active to help ease the pain and stiffness of arthritis. But what kinds of exercise are best? Walking, biking, swimming and water aerobics are frequently recommended, particularly aquatic exercise as the buoyancy of the water takes the weight off painful joints. Light weights and activities that can boost range of motion are often advised as well.

Yoga is another activity that may help by improving balance and posture, preventing falls, and easing tenseness. A recently published(2)review (meta-analysis) of studies suggests that yoga may also reduce joint pain and stiffness, and improve physical function in knee OA.

The researchers conducted an analysis of 8 randomized controlled trials that evaluated yoga in OA of the knee. A variety of yoga types was studied, including chair yoga and hatha yoga (a usually gentle yoga that is often slower and more static than other styles of yoga, with longer pose holds).

The trials varied, with sessions taking place from 1 to 7 times weekly, and with sessions lasting 30 to 110 minutes each. The trials compared yoga with various other activities, non-yoga exercises, education and no treatment.

The analysis found that self-reported jont pain was decreased, with a moderate decrease in stiffness and improved physical function (usually measured by walking tests which involve walking a set distance at a certain pace, a stair climbing test, or a chair test – how many times a person can stand up from a chair without help in 30 seconds).

Botanicals That May Help Relieve OA Symptoms

Evidence suggests that inflammation plays a role in the development of OA. Two botanicals that show anti-inflammatory activity, Boswellia serrta and curcumin, have been examined to see if they impact OA, with reviews of these studies recently published. Boswellia with its active boswellic acids is a gum resin extracted from a tree, while curcumin is an active ingredient in the Indian spice turmeric.

The first study(3) analyzed 9 randomized controlled trials of various supplemental Boswellia serrata extracts / products that used WOMAC,VAS and LFI scales – well known tools for measuring pain, stiffness, and physical function in OA.

Compared to control, Boswellia reduced all three OA symptoms on all measurement scales. In a sub-group analysis, Boswellia extract standardized to a specific boswellic acid improved outcomes more than other Boswellia-containing products.

The second study(4), was a review of 10 reviews (called an umbrella meta-analysis) on the effects of curcumin, curcumonoids and turmeric extract on OA.

The results showed a significant drop in pain (WOMAC and VAS), with a modest decrease in stiffness and a moderate improvement in physical function compared with placebo but not when compared to a pain medication (NSAIDs).

References

1. Marshall L, Goda N. University of Colorado, News. https://www.colorado.edu/today/2024/03/26/joints-could-heal-themselves-researchers-could-get-there-5-years.
2. Kang LJ, et al. The impact of yoga on patients with knee osteoarthritis: A systematic review and meta-analysis of randomized controlled trials. PLoS One. July, 2024.
3. Dubey V, et al. Efficacy evaluation of standardized Boswellia serrata extract in osteoarthritis: A systematic review and sub-group meta-analysis study Explore (NY). 20:102983, 2024.
4. Bideshki MV, et al. The efficacy of curcumin in relieving osteoarthritis: A meta-analysis of meta-analyses. Phytother Res. 38:2875-91, 2024