According to a report from the Centers for Disease Control and Prevention, the prevalence of musculoskeletal (MSK) disorders among adults in the United States was 54.5% in 2012.1 These conditions represent a substantial burden for patients, societies, and healthcare systems, and it is anticipated that the prevalence will continue to rise as populations age.2
The use of dietary supplements to manage pain is common in individuals with MSK disorders, including those serving in the military, a population in which MSK injuries resulting from training and missions account for the majority of pain complaints and related medical consultations.1,3 In the absence of expert guidelines supported by evidence, consumers may choose to use dietary supplements based on questionable information. To address this gap, researchers from Uniformed Services University of the Health Sciences in Bethesda, Maryland, conducted a systematic review and meta-analysis on dietary supplements used for the relief of MSK pain.3
Using the Grading of Recommendations, Assessment, Development and Evaluation framework to analyze relevant study results, the review authors formulated conditional, evidence-based recommendations for 8 dietary ingredients that may be used as supplements to alleviate chronic MSK pain and associated symptons.3 This review does not constitute a formal practice guideline.
· Avocado soybean unsaponifiables: 300 to 600 mg/d
· Capsaicin cream: 0.025% to 0.075% applied 3 to 4 times per day
· Curcuma (as a food source when available)
· Ginger (as a food source when available)
· Prescription patented crystalized glucosamine sulfate: 1500 mg/d
· Melatonin: 3 to 5 mg/d
· Polyunsaturated fatty acids: 1200 mg/d
· Vitamin D: 2000 mg/d
The most frequent adverse effects reported in the studies included in the review were minor gastrointestinal complaints.
“Although uncertainties remain, thereby precluding any strong recommendations for immediate use, these dietary ingredients, when taken as part of a balanced diet, applied as a cream, or administered as a supplement, may help alleviate pain from chronic MSK conditions and are suggested for use,” the authors concluded.3 “In these cases, health care providers should be prepared to help individuals make decisions consistent with their own values.”