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Fullscript Protocol

Joint Pain

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Protocol development in integrative medicine is not typically a simple process. Individuals require individualized care, and what works for one patient may not work for another.

To establish these protocols, we first developed a Rating Scale that could be used to discern the rigor of evidence supporting a specific nutrient’s therapeutic effect.

The following protocols were developed using only A through C-quality evidence.

A
Systematic review or meta-analysis of human trials
B
RDBPC human trials
2+ studies and/or 1 study with 50 + subjects
C
RDBPC human trials
1 study

Glucosamine

1.5 to 2 g, per day, minimum 12 weeks1

  • Individual RDBPC studies consistently demonstrate reduction in pain and global symptoms of OA2
  • However, reviews and meta-analyses do not confirm this finding3
  • Combination with chondroitin may increase overall effectiveness4
Glucosamine in the Fullscript catalog

S-adenosyl methionine (SAMe)

1200 mg, one to two times per day, minimum 30 days1

  • Demonstrated effectiveness at reducing symptoms of osteoarthritis6
  • However, reviews and meta-analyses do not confirm this finding3
  • Multiple RDBPC studies demonstrated comparable pain reduction to OTC pharmaceuticals like naproxen and nabutone5,7
S-adenosyl methionine in the Fullscript catalog

Turmeric (Curcuma longa)

500 mg MERIVA, two to four times per day, minimum 30 days8

  • In small clinical trials (< 100 subjects), demonstrated effect in pain reduction, comparable to ibuprofen.9
  • One recent review confirmed that both whole turmeric extract and curcumin demonstrated short-term reduction in pain10
Curcumin (MERIVA) in the Fullscript catalog

Additional promising interventions with preliminary evidence demonstrating a reduction in OA symptoms include:

  • Green-lipped mussel extract
  • Indian Frankincense (Boswellia serrata)
  • L-carnitine 
  • Natural Eggshell Membrane
  • Pycnogenol
  • Type II Collagen

Disclaimer

The Fullscript Integrative Medical Advisory team has developed or collected these protocols from practitioners and supplier partners to help health care practitioners make decisions when building treatment plans. By adding this protocol to your Fullscript template library, you understand and accept that the recommendations in the protocol are for initial guidance and may not be appropriate for every patient.

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References

2
Systematic review or meta-analysis of human trials
a
https://www.ncbi.nlm.nih.gov/pubmed/12860572
3
Systematic review or meta-analysis of human trials
a
https://www.ncbi.nlm.nih.gov/pubmed/20847017
4
Systematic review or meta-analysis of human trials
a
https://www.ncbi.nlm.nih.gov/pubmed/10732937

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