Common causes of joint pain include direct trauma/injury, old injuries that haven't healed, and joint degeneration (osteoarthritis). Altered movement patterns may cause an increased repetitive load on certain joints leading to inflammation, early degeneration of bone and cartilage, and increased pain. Common sites for joint pain include the spine, shoulders, hand, hips, and knees. 

Joint pain is extremely common and it is important to manage the symptoms as well as to treat the cause. If the cause of the pain is not treated the joint may be subject to further complications down the road. Many conventional options like corticosteroid injections come with side effects and do not truly treat the root cause of joint pain. A holistic approach which focuses on strategies to lower inflammation, improve strength and flexibility, and restore proper movement patterns may be the best treatment method to start with when aiming to improve joint health. 

Natural Strategies to Improve Joint Health:

LIFESTYLE CHANGES

• Footwear changes/orthotics: according to the Osteoarthritis Research Society International, patients with osteoarthritis should receive proper advice regarding correct footwear. This proper footwear recommendation may be a change of shoe style or could be in the form of orthotics. The goal of this modification is to balance the body weight and decrease the stress and pressure placed on affected joint(s).

• Weight loss: Weight loss is one of the first recommendations for management of osteoarthritis according to the American College of Rheumatology. The American Academy of Orthopedic Surgeons also recommends weight loss in any individual with osteoarthritis and a BMI >25. You can read about some tips for increasing weight loss and improving body composition by following this link.

• Go Outside & Move: Sun exposure is an easy and natural source of vitamin D, which is critical for maintaining bone and joint health. Healthy vitamin D levels are necessary for the absorption of calcium which is one of the main minerals in bone. Movement and exercise outside is a "two birds one stone" approach to joint health (see below).

• "Movement Breaks": Taking breaks during work or school to move around are an excellent strategy improve blood flow and reduce pain in joints. Breaking up long periods of inactivity by going for a walk every 45 minutes will provide a noticeable difference in joint stiffness and pain. Another strategy that may help is finding different positions to complete your tasks. If possible, spending some of your time sitting, some standing, some kneeling, etc. can help reduce the stress on joints.

• Hydration: Like every part of our body, our joints need to be adequately hydrated to function properly. Drinking water throughout the day can make a big difference in the function of our joints while reducing pain.

THERAPIES

• Exercise: Getting out and moving is a very important when dealing with osteoarthritis and joint degeneration. Exercise has been proven to be much more effective than rest and a combination of strength training, stretching, and aerobic exercise is the best option for managing joint pain. (3). Yoga is an excellent option to improve strength and flexibility while keeping the joints moving.

• Physiotherapy: Physiotherapy in the form of exercises and other modalities are commonly performed by a chiropractor or physical therapist. These healthcare providers specialize in muscle and skeletal health while placing high importance on proper movement patterns. A good chiropractor or physical therapist is able to diagnose the source of the pain and develop care plans to optimize function and reduce pain. Therapeutic exercises directed by a professional have been shown to allow certain osteoarthritic joints to last longer, possibly delaying or preventing surgery (4).

• Chiropractic Manipulative Therapy: Chiropractors specialize in manipulation (aka the adjustment) which helps to restore normal movement patterns within joints. Chiropractic manipulation has been reported to help reduce pain in patients with joint problems (5). Although chiropractors are experts of the spine, they also have extensive knowledge and are able treat other joints in the body.

• Manual Therapy: Manual therapy can consist of many different modes of treatment done by chiropractors or physical therapists. These techniques include soft tissue massage techniques, joint mobilization, stretches, chiropractic manipulative therapy, and many others. A randomized controlled trial showed that manual therapy may be more effective than exercise in patients with osteoarthritis (6).

• Acupuncture: Acupuncture has been shown to work for most conditions related to joint pain. A systematic review shows that acupuncture is proven to be effective for reducing pain, improving mobility, and improving quality of life in those with joint degeneration (7).

SUPPLEMENTATION

• SAMe: S-Adenosyl-Methionine (SAMe) is a product made naturally in the body as a result of normal biochemical processes. Some studies may indicate that supplementation of 1200 mg/day of this natural substance may provide the same amount of relief as ibuprofen (8).

• Avocado-Soybean Unsaponifiables (ASUs): ASUs are made from the extract of avocado and soybean oils. This natural supplement has been shown to be effective at 300 mg/day for decreasing pain, improving symptoms, and improving function in patients with osteoarthritis (9).

• Boswellia Serrata: 100-250 mg/day of the herb known as Boswellia Serrata may be a safe and effective option in managing joint pain (9)

• Ginger: Ginger supplementation of 500-1000 mg/day has been shown to reduce severity of pain in those with osteoarthritis (10).

• Glucosamine: A Cochrane Review concluded that glucosamine sulfate supplementation may improve pain and function in people with joint pain, likely without the risk of side effects. The standard dose for glucosamine is 1500 mg/day (500 mg/3x daily) (11).

• Chondroitin: Chondroitin sulfate is a supplement that goes along great with glucosamine. It has been shown to be effective in patients with joint problems by decreasing pain, improving function, and slowing the progression and degeneration of cartilage in the joints (12). A standard protocol for chondroitin sulfate supplementation is usually around 1200 mg/day.

• Fish or Krill Oil: Fish and krill oil are known for their omega 3's EPA and DHA. These components are largely anti-inflammatory and supplementation has been shown to improve joint pain (13). To learn more about fish & krill oil, you can follow the link here

TOPICAL GELS

• Arnica: Arnica gel applied topically to the symptomatic area has been shown to be as effective as ibuprofen and other NSAIDS in people with joint pain. It reduces the pain and improves function to a similar or better level without the side effects (13).

• Capsaicin: Capsaicin is a natural derivative of chili peppers. Topical application of a capsaicin gel product has been shown to be effective at treating symptoms of joint degeneration (8).

Overall, if you are suffering from joint pain and are looking for ways to improve symptoms and manage/slow the progression there are plenty of options. Many lifestyle changes, supplements, and even topical gels have been shown to naturally improve this condition. Maintaining joint health is extremely important for daily function and will help avoid further complications in the long run.