Are These Really The Best Joint Supplements In 2024? - Revgear Community (2024)

40% to 60% of Americans use complementary and alternative medicine to manage medical conditions like joint pain [30].

The good news is there are effective supplements for joint pain. Many have even been shown to be more effective than NSAIDs in clinical trials.

So, I’ve curated a list of the best joint supplements to reduce pain, improve osteoarthritis symptoms, and improve joint health for the long term.

Best Joint Pain Supplement

FlexAgain

Pros

  • Money back guarantee
  • Most comprehensive joint supplement
  • Third-party testing and Made in the USA
  • Omega-3s (1,100 mg) from algae for optimal absorption
  • 500 mg of curcumin extract for potent anti-inflammatory effects
  • 400 mg of glucosamine HCL and 250 mg of chondroitin for cartilage support
  • Ingredients and their doses backed by 100s of clinical trials

Cons

  • Currently, there aren’t any significant drawbacks
Joint Supplement1 Bottle3 Bottles6 Bottles
FlexAgain$69.47 ($2.31 per serving)$182.01 ($2.02 per serving)$289.99 ($1.61 per serving)

Best Joint Pain Supplement

FlexAgain

A powerful, clinically dosed joint supplement to alleviate joint pain and improve joint health.

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FlexAgain is by far the most comprehensive joint supplement on the market today. With a potent combination of omega-3s, curcumin, glucosamine, chondroitin, vitamin D, K2, bromelain, boswellia, resveratrol, MSM, and gingerols in clinically backed doses, there’s nothing that comes close to what you get for your money.

FlexAgain contains every active compound that can fit into a capsule supplement. It includes the best natural anti-inflammatories, including the only standardized gingerol compound that has been shown to reduce joint stiffness.

Additionally, the most important nutritional ingredients, like Omega 3 and vitamins D and K2, are included. It uses a purer form of glucosamine, known as glucosamine hydrochloride, meaning that it can fit fully dosed ingredients into the supplement.

FlexAgain also comes with a money-back guarantee, meaning that it is a no-risk option. It’s at a reasonable price point, with no other dietary supplement in its price range, especially since FlexAgain is clinically dosed. As a result, it is hands down our top pick for the best supplement for joint pain.

Best Budget Joint Supplement

Joint Buddy

Pros

  • 1,500 mg of glucosamine and 1,200 mg of chondroitin for comprehensive joint support
  • 1,000 mg of MSM to address inflammation and improve mobility
  • Inclusion of essential vitamins and minerals, such as selenium, to support overall joint health

Cons

  • No omega or curcumin
Joint Supplement1 Bottle3 Bottles6 Bottles
Joint Buddy$33.99 ($1.13 per serving)$61.99 ($1.03 per serving)$87.99 ($0.97 per serving)

Best Budget Joint Supplement

Joint Buddy

A budget joint supplement with key ingredients to reduce joint pain.

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Joint Buddy offers a more affordable alternative for those on a tighter budget without compromising on key ingredients.

While it may not have the extensive blend of FlexAgain, Joint Buddy still provides a solid foundation of glucosamine, chondroitin, and MSM, along with a host of supportive vitamins and minerals.

This makes it a viable option for those seeking a cost-effective joint supplement. And when we say it’s comprehensive, there’s a good dozen here. It’s like a multivitamin and glucosamine sulfate supplement rolled into one.

It’s better dosed than most glucosamine supplements available, and considering it’s priced comparatively and comes with extra MSM and vitamins, it’s a winner for joint pain relief at a low price point.

Best Anti-inflammatory Joint Supplement

Physio Flex Pro

Pros

  • 500 mg of curcumin extract for its potent anti-inflammatory properties
  • 200 mg of boswellic acid to further reduce inflammation
  • 200 mcg of selenium, known for its antioxidant and joint-protective benefits
  • Glucosamine HCL and chondroitin for cartilage and joint lubrication support

Cons

  • No omega oils
  • Not as comprehensive as FlexAgain
Joint Supplement1 Bottle2 Bottles3 Bottles
Physio Flex Pro$59.95 ($2.00 per serving)$109.90 ($1.83 per serving)$149.85 ($1.66 per serving)

Best Anti-inflammatory Joint Supplement

Physio Flex Pro

A powerful anti-inflammatory joint supplement to support joint health.

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Physio Flex Pro takes a targeted approach to joint health, focusing on ingredients shown to reduce inflammation effectively.

With a strong emphasis on selenium, turmeric, and other anti-inflammatory compounds, this supplement may be particularly beneficial for individuals struggling with chronic joint swelling and pain.

Many people used to rate Physio Flex Pro as the top option before the release of FlexAgain, and we’d have been inclined to agree with them.

Most Popular Joint Supplement

Relief Factor

Pros

  • 900 mg of omega-3 fatty acids for their anti-inflammatory effects
  • 667 mg of curcumin extract to reduce pain and swelling
  • 70 mg of resveratrol, a potent antioxidant with joint-protective properties

Cons

  • A little underdosed on resveratrol and omega
  • A bit overpriced
  • Sketchy marketing practices
Joint Supplement1 Bottle2 Bottles
Relief Factor$49.95 ($1.66 per serving)$93.95 ($1.56 per serving)

Most Popular Joint Supplement

Relief Factor

A well-marketed joint supplement that is clinically underdosed and may not provide joint relief.

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Relief Factor has gained widespread popularity due to its extensive marketing campaigns. While its ingredient profile is solid, with a blend of omega-3s, turmeric, and resveratrol, some users have reported that the dosages may not be optimal for maximum effectiveness.

We’d be inclined to agree with them. Compared to FlexAgain, which is at the same price point, its formula is inferior, as it contains the same active ingredients but at lower doses.

Nevertheless, Relief Factor remains popular among those seeking a well-known joint supplement brand.

Best Joint Supplement With High Omega 3

Nordic Naturals Omega-3: The Fish Oil Standout

Pros

  • 1,000 mg of omega-3s per serving, with a balanced ratio of EPA and DHA
  • Lemon-flavored soft gels for a more palatable experience
  • Affordable pricing compared to some joint-specific supplements

Cons

  • Just an omega supplement, nothing else
Joint Supplement1 Bottle
Nordic Naturals Omega 3$29.99 ($1.00 per serving)

Best Joint Supplement With High Omega 3

Nordic Naturals Omega-3

A pure omega-3 supplement to reduce inflammation and improve joint health.

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Whether you’re looking for a vegan alternative to fish oil or an everyday high-quality omega-3 supplement to support joint health, Nordic Naturals Omega-3 is a solid, well-priced, and reliable option.

This supplement, derived from pure fish oil, provides a concentrated source of EPA and DHA, the two primary omega-3 fatty acids known for their anti-inflammatory properties.

While it may not contain the comprehensive blend of other joint supplements, Nordic Naturals Omega-3 can be an excellent addition to your joint health regimen.

Joint Supplements to Avoid

Omega XL

Omega XL is a standard omega supplement. It’s priced against the best supplements to relieve arthritis pain and claims to have some particular type of omega. But that is simply not true. In fact, Nordic Naturals doesn’t even have as much EPA and DHA as it does.

Arthrozene

Arthrozene costs $65 a bottle, which is ridiculously high for what amounts to a collagen type II and Boswellia supplement.

Considering that 3 brands on our list contain that ingredient, along with far more effective ingredients for a lower price, we can’t recommend anyone get Arthrozene.

MoveMD

MoveMD is priced similarly to FlexAgain and claims to be great at treating knee osteoarthritis. But with potentially fake reviews, only one active ingredient, and a load of collagen (that is nowhere near the 10-20 grams needed), this one is likely not worth your time or money.

What Ingredients To Look For In Joint Supplements

Of course, before looking at brands of joint supplements in more detail, it’s important to understand the ingredients that contribute to their effectiveness and the science behind them. These include:

Omega-3 Fatty Acids

Many Americans turn to alternative treatments like omega-3 fatty acids to manage conditions like joint pain. Omega-3 fatty acids, particularly EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid) are found in fish oil and algae.

A comprehensive review of several studies found that taking omega-3 supplements for three to four months can significantly reduce the intensity of joint pain, the number of painful joints, the duration of morning stiffness, and the reliance on common pain medications [1][2].

This was observed in conditions such as rheumatoid arthritis and dysmenorrhea. However, the results didn’t significantly improve all the measured outcomes, such as physician-assessed pain levels.

This research supports the idea that omega-3s might be a helpful addition to traditional treatments for joint pain linked to various inflammatory diseases. However, further research is needed to understand and fully confirm their benefits in different settings [3][4].

Vitamin D

Various studies have investigated whether taking vitamin D supplements can reduce pain. A meta-analysis that pooled data from several randomized controlled trials found that vitamin D supplementation notably decreased pain scores in people with chronic pain conditions, especially those who already had pain when they started the supplement [5].

This suggests that vitamin D could be beneficial for managing chronic pain. Another study linked moderate vitamin D deficiency with worsening knee and hip pain over several years in older adults, suggesting that correcting this deficiency might slow the progression of joint pain [6].

In patients with rheumatoid arthritis, those with lower vitamin D levels experienced more pain and disability when their disease was active, highlighting the importance of maintaining adequate vitamin D levels [7].

Moreover, a study on various musculoskeletal pains showed that people with lower vitamin D levels were more likely to experience different types of bone pain, especially in the legs and general body aches, suggesting a broad role for vitamin D in managing pain across different conditions [8].

These studies collectively point towards a potential therapeutic role of vitamin D in reducing pain, particularly in conditions associated with chronic pain and inflammation.

Turmeric (Curcumin)

Recent research has evaluated the effects of turmeric and its active component, curcumin, on knee osteoarthritis and general arthritis symptoms.

These studies collectively demonstrate that turmeric supplementation can significantly improve pain and physical function in individuals with knee osteoarthritis. Its effects are comparable to those of non-steroidal anti-inflammatory drugs (NSAIDs) but with fewer side effects [9].

Meta-analyses and randomized controlled trials (RCTs) indicate that turmeric reduces pain scores and improves joint function as measured by standard indexes used in arthritis studies[10][11].

Furthermore, curcumin has shown potential in reducing inflammation, possibly contributing to its pain-relieving effects [12].

However, despite these promising results, researchers agree that more extensive and rigorously designed studies are necessary to determine the optimal dosage, formulation, and frequency of turmeric supplementation for treating arthritis effectively and to confirm these findings across broader populations [13].

It seems at least 500mg of curcumin daily is the threshold, and cheaper supplements for joint pain will just use a turmeric supplement. This isn’t any use, as curcumin only makes up about 7-12% of turmeric.

Glucosamine and Chondroitin

Glucosamine and chondroitin supplements are some of the more commonly used and prescribed supplements for arthritis in some countries. They are naturally occurring compounds found in the cartilage and connective tissues of the body.

However, the research isn’t so favorable for the treatment of joint pain [14][15][16]. However, many people report benefits in joint pain when taking it, and since it causes no harm, it’s useful to have in a joint supplement.

Collagen

90% of the collagen in cartilage is type II collagen [17]. Having enough type II collagen is essential for keeping your cartilage healthy and preventing osteoarthritis from getting worse [18].

The problem is that most supplements aren’t dosed nearly highly enough, as the studies usually call for 10-20 grams, which, of course, is of no use for capsule-based supplements.

Boswellia Serrata

Recent studies have examined the effectiveness of Boswellia serrata, a traditional medicinal plant, in treating knee osteoarthritis and general pain.

This plant’s resin has notable anti-inflammatory and analgesic properties, making it a candidate for natural pain management [19].

Clinical trials have shown that Boswellia serrata extract (BSE) significantly improves knee function, reduces pain, and decreases inflammation in osteoarthritis patients. The results are comparable to those of conventional non-steroidal anti-inflammatory drugs (NSAIDs) but with fewer side effects [20][21].

Additionally, the extract has been tested in healthy volunteers, showing increased pain tolerance and threshold compared to placebo, suggesting potential as an effective analgesic [22].

These findings indicate that Boswellia serrata could be a beneficial treatment for managing osteoarthritis and other pain-related conditions, offering a safer alternative to traditional painkillers.

Methylsulfonylmethane (MSM)

Several studies have explored the efficacy of Methylsulfonylmethane (MSM) in treating osteoarthritis and reducing exercise-induced pain and inflammation.

In various randomized, double-blind, placebo-controlled trials, MSM significantly improved symptoms such as knee pain and physical function in osteoarthritis patients without significant adverse effects [23].

Additionally, when combined with glucosamine, MSM demonstrated enhanced pain relief and anti-inflammatory effects compared to each agent alone [24].

While some trials focused on osteoarthritis outcomes, others assessed MSM’s impact on reducing muscle and joint pain post-exercise, with mixed results.

Not all studies found significant reductions in muscle damage or oxidative stress biomarkers, but some did report a clinically significant decrease in post-exercise pain [25].

MSM offers some benefits in managing osteoarthritis symptoms and potentially reducing exercise-induced discomfort, but more research is needed to understand its effectiveness and optimal usage [26].

Bromelain

Recent research highlights the potential benefits of bromelain, a natural pineapple enzyme, in treating joint pain and improving the quality of life for osteoarthritis patients.

One study demonstrated that daily doses of bromelain significantly reduced mild acute knee pain in healthy adults over one month, with higher doses proving more effective [27].

Another pilot study found that a gastroresistant supplement containing bromelain and Boswellia serrata significantly improved daily functioning and overall quality of life in patients with various forms of osteoarthritis without any reported adverse effects [28].

Additionally, a comparative study showed that a combination of bromelain, trypsin, and rutin provided relief from knee osteoarthritis symptoms as effectively as the conventional drug diclofenac, suggesting that bromelain could serve as a viable alternative to non-steroidal anti-inflammatory drugs (NSAIDs) [29].

These findings collectively suggest that bromelain holds promise as a treatment for reducing arthritis symptoms and enhancing life quality in affected individuals, warranting further investigation through rigorous controlled studies.

You need at least 100mg for it to be effective.

Evaluating the Effectiveness of Joint Supplements

Determining the effectiveness of joint supplements can be a complex process, as individual responses may vary. However, there are several key factors to consider when assessing the impact of these supplements on your joint health:

Pain Relief and Reduced Inflammation

One of the primary goals of joint supplements is to alleviate pain and reduce inflammation. Pay attention to any noticeable changes in your joint discomfort, swelling, and overall mobility after incorporating a supplement regimen.

Improved Joint Function and Flexibility

Observe if your joint range of motion, flexibility, and ease of movement have improved. This can be a reliable indicator of the supplement’s ability to support joint health and function.

Long-Term Joint Health Benefits

While some joint supplements may provide immediate relief, the accurate measure of their effectiveness lies in their ability to promote long-term joint health and potentially slow the progression of joint-related conditions, such as osteoarthritis.

Individual Responsiveness

Remember that everyone’s body and joint health needs are unique. What works well for one person may not have the same effect on another. Be patient, experiment with different supplements, and closely monitor your response to find the most effective solution for your joint health.

Frequently Asked Joint Supplements Questions

What are joint supplements?

Joint supplements are dietary products designed to support joint health by providing essential nutrients that aid in maintaining and repairing cartilage, reducing inflammation, and overall joint function. They are commonly used to alleviate symptoms of arthritis and other joint-related issues.

What ingredients should I look for in joint supplements?

Key ingredients to look for in joint supplements include:

  • Glucosamine: Supports cartilage formation and repair.
  • Chondroitin: Helps retain water in the cartilage, enhancing its elasticity.
  • MSM (Methylsulfonylmethane): Reduces inflammation and supports connective tissue.
  • Turmeric/Curcumin: Known for its anti-inflammatory properties.
  • Boswellia Serrata: Helps reduce inflammation and pain.
  • Bromelain: Breaks down inflammatory compounds.
  • Collagen: Supports cartilage strength and flexibility.
  • Omega-3 Fatty Acids: Reduces inflammation.

How do joint supplements work?

Joint supplements work by providing the necessary nutrients that help to:

  1. Rebuild cartilage: Ingredients like glucosamine and chondroitin aid in the repair and maintenance of cartilage.
  2. Reduce inflammation: Compounds such as MSM, turmeric, and omega-3 fatty acids help decrease joint inflammation.
  3. Lubricate joints: Hyaluronic acid helps maintain joint fluid, ensuring smoother movement and reducing friction.

Are joint supplements effective?

The effectiveness of joint supplements can vary depending on the individual and the specific condition being treated. Many users report significant relief from symptoms such as pain and stiffness. However, scientific evidence supporting their efficacy can be mixed, and results may take several weeks to become noticeable.

How long does it take for joint supplements to work?

The time it takes for joint supplements to show effects can vary, but most users begin to notice improvements within 4 to 8 weeks of consistent use. It may take longer for some individuals, while others may experience relief sooner.

Summary

FlexAgain is by far the most comprehensive joint supplement in a space where many supplements are underdosed or contain unproven ingredients. If you’re on a tight budget, Joint Buddy gives you key ingredients at half the price.

Best Joint Pain Supplement

FlexAgain

A powerful, clinically dosed joint supplement to alleviate joint pain and improve joint health.

CHECK CURRENT DEALS

Are These Really The Best Joint Supplements In 2024? - Revgear Community (6)

References

1. Goldberg, R. J., & Katz, J. (2007). A meta-analysis of the analgesic effects of omega-3 polyunsaturated fatty acid supplementation for inflammatory joint pain.Pain,129(1-2), 210-223.

2. Lee, Y. H., Bae, S. C., & Song, G. G. (2012). Omega-3 polyunsaturated fatty acids and the treatment of rheumatoid arthritis: a meta-analysis.Archives of medical research,43(5), 356-362.

3. Cordingley, D. M., & Cornish, S. M. (2022). Omega-3 fatty acids for the management of osteoarthritis: A narrative review.Nutrients,14(16), 3362.

4. Sibille, K. T., King, C., Garrett, T. J., Glover, T. L., Zhang, H., Chen, H., … & Fillingim, R. B. (2018). Omega-6: omega-3 PUFA ratio, pain, functioning, and distress in adults with knee pain.The Clinical Journal of Pain,34(2), 182-189.

5. Wu, Z., Malihi, Z., Stewart, A. W., Lawes, C., & Scragg, R. (2016). Effect of vitamin D supplementation on pain: a systematic review and meta-analysis. Pain physician, 19(7), 415.

6. Laslett, L. L., Quinn, S., Burgess, J. R., Parameswaran, V., Winzenberg, T. M., Jones, G., & Ding, C. (2014). Moderate vitamin D deficiency is associated with changes in knee and hip pain in older adults: a 5-year longitudinal study. Annals of the Rheumatic Diseases, 73(4), 697-703.

7. Haque, U. J., & Bartlett, S. J. (2010). Relationships among vitamin D, disease activity, pain and disability in rheumatoid arthritis. Clin Exp Rheumatol, 28(5), 745-7.

8. Heidari, B., Shirvani, J. S., Firouzjahi, A., Heidari, P., & HAJIAN?TILAKI, K. O. (2010). Association between nonspecific skeletal pain and vitamin D deficiency. International journal of rheumatic diseases, 13(4), 340-346.

9. Paultre, K., Cade, W., Hernandez, D., Reynolds, J., Greif, D., & Best, T. M. (2021). Therapeutic effects of turmeric or curcumin extract on pain and function for individuals with knee osteoarthritis: a systematic review. BMJ open sport & exercise medicine, 7(1), e000935.

10. Daily, J. W., Yang, M., & Park, S. (2016). Efficacy of turmeric extracts and curcumin for alleviating the symptoms of joint arthritis: a systematic review and meta-analysis of randomized clinical trials. Journal of medicinal food, 19(8), 717-729.

11. Calderón-Pérez, L., Llauradó, E., Companys, J., Pla-Pagà, L., Boqué, N., Puiggrós, F., … & Solà, R. (2021). Acute effects of turmeric extracts on knee joint pain: a pilot, randomized controlled trial. Journal of medicinal food, 24(4), 436-440.

12. Eke?Okoro, U. J., Raffa, R. B., Pergolizzi Jr, J. V., Breve, F., Taylor Jr, R., & NEMA Research Group. (2018). Curcumin in turmeric: Basic and clinical evidence for a potential role in analgesia. Journal of Clinical Pharmacy and Therapeutics, 43(4), 460-466.

13. Gaffey, A., Campbell, J., Porritt, K., & Slater, H. (2015). The effects of curcumin on musculoskeletal pain: a systematic review protocol. JBI Evidence Synthesis, 13(2), 59-73.

14. Wandel, S., Jüni, P., Tendal, B., Nüesch, E., Villiger, P. M., Welton, N. J., … & Trelle, S. (2010). Effects of glucosamine, chondroitin, or placebo in patients with osteoarthritis of hip or knee: network meta-analysis. Bmj, 341.

15. Clegg, D. O., Reda, D. J., Harris, C. L., Klein, M. A., O’Dell, J. R., Hooper, M. M., … & Williams, H. J. (2006). Glucosamine, chondroitin sulfate, and the two in combination for painful knee osteoarthritis. New England Journal of Medicine, 354(8), 795-808.

16. Melo, G., Casett, E., Stuginski?Barbosa, J., Guerra, E. N. S., Fernandes, D. A., Porporatti, A. L., … & De Luca Canto, G. (2018). Effects of glucosamine supplements on painful temporomandibular joint osteoarthritis: a systematic review. Journal of oral rehabilitation, 45(5), 414-422.

17. Holwerda, A. M., & van Loon, L. J. C. (2022). The impact of collagen protein ingestion on musculoskeletal connective tissue remodeling: a narrative review. Nutr Rev, 80(6), 1497-1514. doi:10.1093/nutrit/nuab083

18. Kannus, P. (2000). Structure of the tendon connective tissue. Scand J Med Sci Sports, 10(6), 312-320. doi:10.1034/j.1600-0838.2000.010006312.x

19. Siddiqui, M. Z. (2011). Boswellia serrata, a potential anti-inflammatory agent: an overview. Indian journal of pharmaceutical sciences, 73(3), 255.

20. Kimmatkar, N., Thawani, V., Hingorani, L., & Khiyani, R. (2003). Efficacy and tolerability of Boswellia serrata extract in treatment of osteoarthritis of knee–a randomized double blind placebo controlled trial. Phytomedicine, 10(1), 3-7.

21. Majeed, M., Majeed, S., Narayanan, N. K., & Nagabhushanam, K. (2019). A pilot, randomized, double?blind, placebo?controlled trial to assess the safety and efficacy of a novel Boswellia serrata extract in the management of osteoarthritis of the knee. Phytotherapy Research, 33(5), 1457-1468.

22. Prabhavathi, K., Chandra, U. S. J., Soanker, R., & Rani, P. U. (2014). A randomized, double blind, placebo controlled, cross over study to evaluate the analgesic activity of Boswellia serrata in healthy volunteers using mechanical pain model. Indian journal of pharmacology, 46(5), 475-479.

23. Kim, L. S., Axelrod, L. J., Howard, P., Buratovich, N., & Waters, R. F. (2006). Efficacy of methylsulfonylmethane (MSM) in osteoarthritis pain of the knee: a pilot clinical trial. Osteoarthritis and Cartilage, 14(3), 286-294.

24. Usha, P. R., & Naidu, M. U. R. (2004). Randomised, double-blind, parallel, placebo-controlled study of oral glucosamine, methylsulfonylmethane and their combination in osteoarthritis. Clinical drug investigation, 24(6), 353-363.

25. Withee, E. D., Tippens, K. M., Dehen, R., Tibbitts, D., Hanes, D., & Zwickey, H. (2017). Effects of Methylsulfonylmethane (MSM) on exercise-induced oxidative stress, muscle damage, and pain following a half-marathon: a double-blind, randomized, placebo-controlled trial. Journal of the International Society of Sports Nutrition, 14, 1-11.

26. Toguchi, A., Noguchi, N., Kanno, T., & Yamada, A. (2023). Methylsulfonylmethane Improves Knee Quality of Life in Participants with Mild Knee Pain: A Randomized, Double-Blind, Placebo-Controlled Trial. Nutrients, 15(13), 2995.

27. Walker, A. F., Bundy, R., Hicks, S. M., & Middleton, R. W. (2002). Bromelain reduces mild acute knee pain and improves well-being in a dose-dependent fashion in an open study of otherwise healthy adults. Phytomedicine, 9(8), 681-686.

28. Italiano, G., Raimondo, M., Giannetti, G., & Gargiulo, A. (2020). Benefits of a food supplement containing Boswellia serrata and bromelain for improving the quality of life in patients with osteoarthritis: A pilot study. The Journal of Alternative and Complementary Medicine, 26(2), 123-129.

29. Pavan, R., Jain, S., & Kumar, A. (2012). Properties and therapeutic application of bromelain: a review. Biotechnology research international, 2012.

30. Barnes, P. M., Powell-Griner, E., McFann, K., & Nahin, R. L. (2004, June). Complementary and alternative medicine use among adults: United States, 2002. In Seminars in integrative medicine (Vol. 2, No. 2, pp. 54-71). WB Saunders.

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