Creatine may help osteoarthritis

Creatine, a supplement better known for gym use, showed added benefits in a new knee osteoarthritis trial when paired with physical therapy and resistance exercise. (mdpi.com) Osteoarthritis is the wear-and-tear form of arthritis that damages cartilage, the smooth tissue that helps bones glide at a joint, and the knee is one of its most common sites. The Centers for Disease Control and Prevention says about 32.5 million adults in the United States have osteoarthritis. (cdc.gov) In the new randomized controlled trial, 40 adults ages 40 to 70 with mild to moderate knee osteoarthritis all completed four weeks of physical therapy, but only half also received creatine. The study was double-blind and placebo-controlled, meaning neither patients nor researchers knew who got the supplement during the trial. (mdpi.com) The creatine group used a common research schedule: 20 grams a day for one week, then 5 grams a day for three weeks. The physical therapy program included heat therapy, electrotherapy, manual therapy, and progressive resistance exercises. (mdpi.com; health.yahoo.com) After four weeks, the creatine group improved more than the placebo group on pain, knee symptoms, muscle strength, muscle mass, and a screening measure used to estimate fall risk. The paper reported no significant between-group difference in body weight, body mass index, or waist-to-hip ratio. (mdpi.com) That result fits a long-running pattern in knee osteoarthritis care: exercise is one of the main treatments, and researchers keep testing whether add-ons can help people get more from rehab. The American College of Rheumatology and Arthritis Foundation strongly recommend exercise for knee osteoarthritis in their guideline. (rheumatology.org) The creatine idea is not entirely new. A 2011 randomized trial in postmenopausal women with knee osteoarthritis found that creatine plus strengthening exercise improved physical function and lean mass more than exercise plus placebo. (pubmed.ncbi.nlm.nih.gov) But the evidence is still mixed and limited. A 2018 study found no effect of creatine monohydrate on inflammatory markers or cartilage-degradation markers in patients with knee osteoarthritis, and the new 2025 trial enrolled only 40 people over four weeks. (sciencedirect.com; mdpi.com) Creatine works by helping cells quickly recycle energy during short bursts of effort, which is one reason it has been studied for strength training. In knee osteoarthritis, that matters because stronger leg muscles can reduce strain around a painful joint and make rehab exercises easier to perform. (nih.gov; mdpi.com) Major medical groups do not list creatine as a standard osteoarthritis treatment, and the National Institutes of Health says people with kidney disease or other medical conditions should talk with a clinician before using supplements. For now, the new paper adds one more small trial to a field still centered on exercise, weight management, pain relief, and physical therapy. (nih.gov; cdc.gov)