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For millions of people, knee pain is more than an occasional annoyance. Osteoarthritis of the knee can make everyday activities—walking, climbing stairs, shopping or simply getting out of a chair—painful and difficult.
Osteoarthritis occurs as cartilage and other structures within a joint gradually deteriorate. Although it is often described as simple “wear and tear,” researchers increasingly recognize that inflammation also plays an important role. The condition becomes more common with age, and the knee is one of the joints most frequently affected.
Treatment usually focuses on managing symptoms. Exercise, weight management and physical therapy can help, while pain relievers and non-steroidal anti-inflammatory drugs (NSAIDs) are commonly used when additional relief is needed. But medications generally don't reverse the underlying disease, and long-term use of some pain medications can bring unwanted risks.
That has led researchers to investigate another possibility: Could something as simple as collagen supplementation help?
A recent randomized, double-blind, placebo-controlled clinical trial suggests it might.
Researchers in Spain recruited 120 adults between the ages of 30 and 81 who had moderate knee osteoarthritis and had experienced knee pain for at least six months. Participants were randomly divided into two equal groups.
One group took a daily supplement of hydrolyzed collagen peptides while the other received a placebo that looked and tasted the same. Neither the participants nor the researchers knew who was receiving which treatment until the study was completed—a design that helps reduce bias. Participants took the supplement or placebo every day for six months.
Hydrolyzed collagen is essentially collagen that has been broken into smaller protein fragments called peptides. This makes it easier to digest and absorb. Collagen itself is an important structural protein in cartilage, bone and other connective tissues.
The researchers weren't interested only in whether people felt better. They measured pain, ability to perform everyday activities and two blood markers associated with inflammation: C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR).
The most striking result involved pain.
At the beginning of the study, both groups reported similar pain levels—about 63 points on a 100-point pain scale. After six months, average pain in the collagen group had fallen to 35.5.
That represented a 43.6% reduction in pain.
The placebo group, by comparison, experienced only a 6.8% reduction. The difference between the groups was statistically significant.
Importantly, the improvement appears to have been large enough to matter in everyday life, not simply on a statistical spreadsheet. The researchers note that the reduction exceeded commonly used thresholds for what is considered a clinically meaningful improvement in osteoarthritis pain.
Less pain is useful, but the researchers also wanted to know whether people could actually do more.
They used a questionnaire called the Lequesne Algofunctional Index, which measures pain, walking ability and difficulty performing everyday activities. Lower scores indicate less disability.
After six months, scores in the collagen group improved by about 39%, while there was virtually no change in the placebo group. Even more striking, 90% of participants receiving collagen were classified as having only mild disability at the end of the trial, compared with just 8.3% of the placebo group.
The blood tests provided another interesting clue.
Among people taking the collagen supplement, CRP fell by about 56%, while ESR dropped by roughly 57%. Both inflammatory markers were significantly lower than in the placebo group after six months.
This is potentially important because osteoarthritis isn't simply the mechanical wearing away of cartilage. Inflammation within and around the joint is increasingly understood to contribute to pain and disease progression.
Exactly why collagen might help isn't completely settled. Previous research suggests that collagen-derived peptides can reach joint tissues and may stimulate cartilage cells to produce components needed to maintain the cartilage matrix. The vitamin C included in the supplement could also play a supporting role because vitamin C is involved in normal collagen production.
There was another encouraging finding: no adverse events were reported during the six-month trial, and participants generally rated the supplement highly for tolerability and satisfaction.
Still, the results don’t mean that collagen can cure osteoarthritis or rebuild damaged knees. But, for now, the study adds an intriguing piece to the puzzle. After six months of daily supplementation, people taking hydrolyzed collagen experienced substantially less knee pain, better physical function and lower markers of inflammation than those receiving a placebo.
For anyone living with osteoarthritis, that's an encouraging finding.
