1 Vol.:(0123456789) Scientifc Reports | (2020) 10:20892 | https://doi.org/10.1038/s41598-020-78075-x www.nature.com/scientificreports Nutraceutical supplements in management of pain and disability in osteoarthritis: a systematic review and meta‑analysis of randomized clinical trials Dawood Aghamohammadi 1 , Neda Dolatkhah 2* , Fahimeh Bakhtiari 2 , Fariba Eslamian 2 & Maryam Hashemian 3 This study designed to evaluate the efect of nutraceutical supplementation on pain intensity and physical function in patients with knee/hip OA. The MEDLINE, Web of Science, Cochrane Library, Scopus, EMBASE, Google Scholar, Science direct, and ProQuest in addition to SID, Magiran, and Iranmedex were searched up to March 2020. Records (n = 465) were screened via the PICOS criteria: participants were patients with hip or knee OA; intervention was diferent nutritional supplements; comparator was any comparator; the outcome was pain intensity (Visual analogue scale [VAS]) and physical function (Western Ontario and McMaster Universities Arthritis [WOMAC] index); study type was randomized controlled trials. The random efects model was used to pool the calculated efect sizes. The standardized mean diference (SMD) of the outcome changes was considered as the efect size. The random efects model was used to combine the efect sizes. Heterogeneity between studies was assessed by Cochran’s (Q) and I2 statistics. A total of 42 RCTs were involved in the meta‑analysis. Nutritional supplementation were found to improve total WOMAC index (SMD = − 0.23, 95% CI − 0.37 to − 0.08), WOMAC pain (SMD = − 0.36, 95% CI − 0.62 to − 0.10) and WOMAC stifness (SMD = − 0.47, 95% CI − 0.71 to − 0.23) subscales and VAS (SMD = − 0.79, 95% CI − 1.05 to − 0.05). Results of subgroup analysis according to the supplementation duration showed that the pooled efect size in studies with < 10 months, 10–20 months and > 20 months supplementation duration were 0.05, 0.27, and 0.36, respectively for WOMAC total score, 0.14, 0.55 and 0.05, respectively for WOAMC pain subscale, 0.59, 0.47 and 0.41, respectively for WOMAC stifness subscale, 0.05, 0.57 and 0.53, respectively for WOMAC physical function subscale and 0.65, 0.99 and 0.12, respectively for VAS pain. The result suggested that nutraceutical supplementation of patients with knee/hip OA may lead to an improvement in pain intensity and physical function. Osteoarthritis (OA) as a degenerative chronic joint cartilage disorder is the most prevalent and principal reason for joint pain and functional impairment in the world 1 . OA is more prevalent in older adults and it will infict incredible economic and societal charges and disturb life quality in diferent aspects subsequently in the future 2 . On the other hand, discomfort, pain and decreases in functional ability because of OA can consequence a greater risk of overweight/obesity, diabetes mellitus and falls and fractures 3 . Issues that chip into the development of OA consist of general factors (age, sex, overweight/obesity and nutrition) and local biomechanical factors (joint injury, physical activities and joint space) 4 . OPEN 1 Department of Anesthesiology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran. 2 Physical Medicine and Rehabilitation Research Center, Aging Research Institute, Tabriz University of Medical Sciences, Emam Reza Hospital, Golgasht, Azadi Ave., Tabriz, Iran. 3 Department of Biology, School of Arts and Sciences, Utica College, Utica, USA. * email: neda_dolatkhah@yahoo.com