Osteoarthritis of the knee and complementary medicines: how effective are they?

13/05/2022
13/05/2022

The treatments recommended by experts to control osteoarthritis of the knee include analgesics (painkillers) and anti-inflammatory medications, physiotherapy, exercise and weight loss. In addition to these measures, complementary medicines may also provide benefits and have their supporters. However, there is no confirmed scientific evidence of their effects and their safety is not always guaranteed. Caution and the advice of a medical professional remain essential.

“Complementary” medicines, also known as “alternative” or “natural” therapies, are becoming increasingly popular. They are sometimes used by people with OA of the knee wishing to reinforce the effects of their treatment or reduce the amount of painkillers they are taking.

According to the health authorities, they cannot replace conventional treatments and there is no evidence of their therapeutic action(1). Despite a lack of solid evidence with respect to their efficacy, some alternative therapies can be used in addition to conventional treatment, in particular/including for their placebo effect. The most popular of these methods include:

•    Herbal medicine

This is based on the use of medicinal plants in oral form (infusions, ampoules to be diluted, herbal powders or extracts in capsules, etc.) or in topical form (ointments). A variety of plants have demonstrated moderate effects on pain or stiffness in osteoarthritis affecting the limbs, including the knee, such as harpagophytum (devil’s claw), arnica, horsetail, turmeric or white willow(2). Beware since herbal medicines can interfere with other treatments and require precautions for use: read the instruction leaflet carefully and ask your doctor or pharmacist for advice.

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•    Acupuncture

This is a method inherited from Chinese medicine based on the stimulation of specific “energy” points in the body, using fine needles. It has demonstrated benefits on arthritic pain in various studies(1). However, these studies have not obtained significant clinical results providing genuine “evidence” of its efficacy. International rheumatology experts therefore remain cautious in their recommendations.

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•    Homeopathy

This therapy is based on the concept of “similars” (“like cures like”) developed by Samuel Hahnemann in the 18th century: tiny doses of a substance (mineral, animal or plant) are believed to combat a symptom caused by the same substance at high doses. This treatment may be prescribed by a doctor (homeopathic practitioner) or obtained from a pharmacy without a prescription. Causticum, Bryona Alba, Rhus Toxicodendron, Sulfur and Thuya, in particular, are proposed in the event of osteoarthritis. These famous little granules have their own specialist practitioners and many supporters, but their therapeutic action has not been proven.

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•    Nutritherapy

This therapy is based on the idea that supplements of micronutrients may help prevent or slow down the progression of certain diseases. In osteoarthritis, chondroitin, omega 3, glucosamine or silica supplements, combined with vitamins and trace elements, are proposed, for example. Their efficacy is still uncertain and the health authorities have banned any claims concerning osteoarthritis on the majority of food supplements available in France. “Avocado oil unsaponifiables” are considered to be an adjuvant treatment. Food supplements may also require precautions for use. Ask your pharmacist for advice.

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•    Mesotherapy

Developed in the 1950s, this method consists in giving multiple injections of small doses of medicines into the skin of the area to be treated. Anaesthetic, muscle-relaxing and anti-inflammatory substances, as well as calcitonin (a hormone that helps bind calcium) and vitamins, for example, are used by practitioners in osteoarthritis of the knee. There is no rigorous scientific validation of the efficacy and safety of mesotherapy. Infectious complications or allergic reactions are possible.

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Gemmotherapy, biomagnetism, auriculotherapy, massage therapy… There are many other methods that fall within the scope of “alternative or complementary therapies”: almost 400 have been identified altogether! There is no scientific evidence of their efficacy in osteoarthritis for any of them and the majority of them are not even regulated.