Osteoarthritis Treatment Guidelines

Supplements That Do Not Work

The American College of Rheumatology strongly recommends against glucosamine for knee, hip, and hand OA, based on high-quality evidence showing no benefit over placebo 1, 2, 3
The American College of Rheumatology strongly recommends against chondroitin for knee and hip OA, with the exception of conditional recommendation for hand OA 1, 2, 3
The American College of Rheumatology conditionally recommends against vitamin D for all OA sites, due to multiple trials showing small effect sizes or no benefit 1, 2
The American College of Rheumatology conditionally recommends against fish oil for all OA sites, based on a single trial that failed to show efficacy 1, 2
The American College of Rheumatology strongly recommends against bisphosphonates for all OA sites, due to a preponderance of data showing no improvement in pain or functional outcomes 1, 2, 3

The American Academy of Orthopaedic Surgeons found that turmeric and ginger extract demonstrate either some improvement or no change in patient outcomes, but evidence is limited by variability between manufacturers and lack of FDA oversight 4

The American Academy of Orthopaedic Surgeons recommends oral NSAIDs as a first-line pharmacologic option, which consistently demonstrate improved pain and function 4
The American Academy of Orthopaedic Surgeons recommends acetaminophen as a first-line pharmacologic option, which is effective for pain relief but carries an FDA black box warning 4
The American Academy of Orthopaedic Surgeons recommends topical NSAIDs, particularly for patients 75 years or older 5
The American Academy of Orthopaedic Surgeons recommends intra-articular corticosteroid injections, which are supported by 19 high-quality and 6 moderate-quality studies 4
The American Academy of Orthopaedic Surgeons recommends sustained weight loss and exercise programs as non-pharmacologic interventions, which benefit pain and function in overweight or obese patients 4