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Many people concerned about the side effects of the anti-inflammatory painkillers and other medications commonly prescribed for arthritis prefer to treat their symptoms with supplements containing herbs or nutrients that are believed to be beneficial. This chapter gives an overview of many of the supplements commonly recommended for OA, RA and fibromyalgia and discusses the evidence regarding their effectiveness. It’s important to remember that, just because a supplement contains natural substances, it doesn’t mean that it’s harmless – many plants are poisonous to humans. Also, current legislation means that the content and quality of supplements cannot always be guaranteed. These issues are covered in this chapter.

How effective are supplements for arthritis?

Numerous supplements have been recommended for knee arthritis treatment; however, according to the report, ‘Complementary and alternative medicines for the treatment of rheumatoid arthritis, osteoarthritis and fibromyalgia’, published by Arthritis Research UK in 2009, only 40 have been tested using random controlled trials (RCTs). This doesn’t necessarily mean that other supplements are ineffective, but it does mean that reliable research into their effectiveness has not yet been done. RCTs are viewed as the most reliable type of trial because they randomly place participants in a treatment group or a control group. The treatment group receives the treatment under scrutiny, whilst the control group may receive a placebo or another treatment for comparison purposes. RCTs can be single-blind, where the participant doen’t know which treatment they are receiving, or double-blind, where neither the participants nor the researchers know who is receiving which treatment. Of the 40 supplements tested using RCTs, Arthritis Research UK concluded that only 17 had promising or consistent evidence regarding their effectiveness in treating arthritis.

How safe are supplements?

There is a Traditional Herbal Medicines Registration Scheme under which a growing number of herbal products are now registered. Registered herbal medicines must meet specific standards of safety and quality and carry agreed indications for their use. They are identified by the prefix THR, followed by a nine-digit number.

Also, some herbal medicines in the UK have a product licence. Licensed herbal medicines, like any other medicine, are required to demonstrate safety, quality and effectiveness and provide guidelines on safe use. They can be identified by a nine-digit number, prefixed by the letters PL.