Fullscript Protocols

Joint Pain

Woman ordering supplements on her laptop

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.

As a result, the Fullscript Integrative Medical Advisory team advises using an evidence-informed approach to protocol development. To simplify this process for practitioners, we have assembled a sampling of evidence-based standardized protocols that practitioners can use as a foundation when developing individualized protocols.

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 D-quality evidence. These are categorized as follows:

Class Qualifying studies Minimum requirements
A Systematic review or meta-analysis of human trials
B Human RDBPC ≥ 2 studies and/or 1 study with ≥ 50
subjects
C Human RDBPC or RCT 1 study < 50 subjects
D Human trials or In-vivo animal trials

RDBPC = Randomized Double-Blind Placebo Controlled
RCT = Randomized Controlled Trials

Please refer to the complete Rating Scale for further information.

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.

Upload this template

Joint Pain

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

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