16/10/2025
Some robust clinical research
Hand osteoarthritis (HOA) is a degenerative joint disease that primarily affects the distal and proximal interphalangeal joints (DIP/PIP) and the first carpometacarpal joint at the base of the thumb, causing pain, stiffness, reduced grip/pinch strength, and characteristic bony nodules (Heberden’s and Bouchard’s nodes). Compared with knee or hip OA, HOA more often presents in mid-to-late life women, frequently involves multiple small joints symmetrically, and impairs fine motor tasks rather than weight-bearing function.
High-quality herbal trials in HOA are rare; most phytotherapy studies focus on knee OA. That’s why a recent Belgian multicentre, double-blind trial of standardised Curcuma longa (turmeric) and Boswellia serrata extracts is noteworthy: over 3 months, the combination achieved a statistically significant reduction in pain versus placebo and was generally well tolerated.
The double blind, randomised controlled trial included 162 adults with symptomatic hand OA (mean age, 63.1 years; 76.5% women) who reported hand pain on ≥ 50% of days in the prior month and ≥ 48 hours before baseline, with pain ranging from 40 to 80 mm on a 100-mm visual analogue scale (VAS) in at least one hand over the last 24 hours. The primary outcome was the mean change in finger pain on both hands during the past 24 hours on the VAS over 3 months.
At 3 months (intention-to-treat analysis), patients who received the plant extracts had a greater mean VAS pain reduction of 24.7 mm compared with 16.2 mm in those who received placebo (difference, -8.5 mm; P = 0.03); similar benefit was observed at month 1 (difference, -7.0 mm; P = 0.04). Patients receiving the plant extracts vs placebo also showed significant improvements in the patient global assessment (difference, -9.6 mm; P = 0.01) and quality of life score (P = 0.01) at month 3. There were no significant differences vs placebo for the number of painful/swollen joints, functional score, grip strength and analgesic consumption.
The number of adverse effects did not differ significantly between the two groups, and most of them were unrelated to the use of plant extracts. However, one patient taking the herbal combination developed acute hepatitis, judged as “probably related” (no further details provided).
The trial intervention was two tablets/day of a product containing Curcuma longa (turmeric) standardised dry extract: 237 mg, providing 200 mg curcumin and Boswellia serrata oleoresin: 51 mg, standardised to 65% boswellic acids and vitamin D3 (cholecalciferol): 3.6 μg (144 IU). (Note there is an error in the paper that states each tablet contained 1.4 mg of vitamin D (56,000 IU). Whoops!) Higher doses of these herbs might well achieve a better result.
This was a robust, well-designed RCT with a clinically relevant primary endpoint and a statistically significant and moderate benefit vs placebo.
For more information see: https://www.medscape.com/viewarticle/combination-plant-extracts-shows-promise-hand-osteoarthritis-2025a1000h5o?ecd=mkm_ret_250830_mscpmrk-OUS_InFocus_etid7668522&uac=48709HJ&impID=7668522
and
https://pubmed.ncbi.nlm.nih.gov/40554037/
