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Omega-3 supplements promise to help fight osteoarthritis
Last reviewed: 02.07.2025
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A recent study published in the journal Nutrients looked at the effectiveness of omega-3 polyunsaturated fatty acids (PUFAs) in modulating the progression of osteoarthritis (OA).
Osteoarthritis is a degenerative joint disease in which the destruction of articular cartilage leads to a proinflammatory response. Disease progression can be determined by various factors, such as the degree of inflammation, injury, biomechanics, and metabolism.
On the articular surfaces, articular cartilage provides low friction and high load transmission during joint movement. In addition to articular cartilage, osteoarthritis can also negatively affect ligaments, adjacent synovial membrane, and subchondral bone, leading to joint pain.
Symptomatic osteoarthritis is typically treated with exercise programs, education, and weight management programs. Medication is also available, but the presence of comorbidities complicates the use of drug therapy. Thus, there is an urgent need for alternative treatments to slow the progression of osteoarthritis.
Previous studies have shown that dietary supplements and changes in diet may be beneficial for patients with osteoarthritis. The anti-inflammatory properties of omega-3 PUFAs play a key role in the catabolic and inflammatory processes that contribute to the progression of osteoarthritis.
Omega-3 Supplements and Reducing Inflammation in Osteoarthritis
Omega-3 PUFAs have anti-inflammatory effects that have been shown to reduce cancer and vascular biomarkers, including those associated with chronic inflammation, metabolic diseases, and conditions that debilitate the musculoskeletal system.
Specialized pro-resolute lipid modulators (SPMs) counter-regulate pro-inflammatory mediators and promote the production of anti-inflammatory mediators at the cellular level via apoptotic cells, cellular debris, and phagocytosis of pathogens by macrophages. One study found that administration of SPMs for eight to twelve weeks resulted in improvement in knee osteoarthritis symptoms.
The ratio of n-6 to n-3 PUFAs is critical in determining whether a pro-inflammatory or anti-inflammatory response dominates. Previous studies have shown that a higher n-6/n-3 ratio was associated with greater osteoarthritic knee pain and functional limitations.
People with high saturated fatty acid intakes were also found to have reduced joint space width. However, this effect was not seen in those who consumed more PUFAs.
When examining the relationship between PUFA and synovial fluid collected from knee and shoulder joints, a positive correlation was found between n-6 PUFA and synovitis. However, an inverse relationship was noted between n-3 PUFA and cartilage loss in the patellofemoral joint.
A high n-3 diet has been associated with reduced progression of osteoarthritis. In a mouse model, 12 weeks of soybean and flaxseed oil supplementation resulted in greater cartilage thickening and decreased tumor necrosis factor α (TNF-α) levels in both chondrocytes and serum. In human studies, docosahexaenoic acid (DHA) treatment resulted in decreased apoptosis and increased chondrocyte proliferation, reflecting increased autophagy and cartilage thickening.
Omega-3 PUFAs, osteoarthritis and related diseases
Cardiovascular disease is inversely related to aerobic exercise, which often negatively impacts osteoarthritis. Previous studies have shown that people taking eicosapentaenoic acid (EPA) and DHA supplements had significantly lower triglyceride levels, neutrophil counts, and white blood cell (WBC) counts, suggesting that omega-3 supplements may mitigate adverse musculoskeletal events and preserve physical function.
Maintaining muscle mass is key to maintaining physical activity levels and reducing the risk of comorbidities. In this regard, omega-3 supplements have been shown to provide indirect benefits through muscle recovery after exercise. In a previous study involving older adults aged 60 to 85, omega-3 supplements derived from fish oil resulted in increased handgrip strength and quadriceps muscle size.
Delayed onset muscle soreness (DOMS) includes decreased joint range of motion, muscle strength, and muscle swelling. One study found that supplementation with EPA and DHA led to significant improvements in joint range of motion, decreased muscle soreness, and increased maximum voluntary contraction.
Studies consistently show that omega-3 PUFAs reduce cartilage degradation and inflammatory biomarker levels, thereby slowing the progression of osteoarthritis. Omega-3 PUFAs also provide indirect benefits by improving muscle recovery after exercise. More clinical trials are needed in the future to better understand standardized omega-3 supplements for modulating osteoarthritis.
It is important to note that there is no definitive evidence regarding the optimal dosage of omega-3 PUFA supplements, nor the ratio of DHA to EPA and n-6/n-3. Moreover, most studies have been conducted in animal models rather than humans. The source of the omega-3 PUFA may also influence potential results by affecting their bioavailability.