We conducted a randomized, double-blind, placebo-controlled trial exploring the effects of methylsulfonylmethane (MSM) on knee osteoarthritis pain. Fifty adults aged 40 to 76 participated, taking either MSM or a placebo for 12 weeks.
While MSM did show improvements in pain and physical function, there was no significant effect on stiffness or overall symptom scores. This means that while MSM might help with certain aspects of osteoarthritis, the overall benefits and long-term safety need more research.
Read More
5
MSM shows minor benefits for OA
Efficacy of methylsulfonylmethane supplementation on osteoarthritis of the knee: a randomized controlled study.
We explored the effectiveness of methylsulfonylmethane (MSM) in treating knee osteoarthritis in a carefully designed clinical trial. Forty-nine participants received either MSM or a placebo for 12 weeks, and we measured their pain and physical function using various established scales.
Although patients taking MSM reported some improvement in pain and function, these changes were minor. It's still unclear if these results have real clinical significance for those suffering from osteoarthritis.
Read More
8
MSM improves mild knee pain
Methylsulfonylmethane Improves Knee Quality of Life in Participants with Mild Knee Pain: A Randomized, Double-Blind, Placebo-Controlled Trial.
In a well-structured randomized, double-blind, placebo-controlled trial, we explored how methylsulfonylmethane (MSM) affects those experiencing mild knee pain. The study involved 88 healthy Japanese participants, split evenly into two groups where one received 200 mg of MSM while the other received a placebo for 12 weeks.
By measuring the total score on the Japanese Knee Osteoarthritis Measure (JKOM) at the end of the trial, we found that the MSM group showed a significant improvement compared to the placebo group. Specifically, total JKOM scores changed markedly, with an improvement in knee and systemic health reported by participants who took MSM.
Our findings suggest that MSM might be beneficial for individuals with mild knee pain, marking it as a useful supplement for enhancing joint health. The positive outcomes underscore the potential of MSM as a supportive treatment option for managing mild arthritic conditions.
Read More
Most Useful Reviews
9
Knees no longer hurt
16 people found this helpful
It took away so much pain. I used this to manage arthritis and fibromyalgia. My knees used to ache badly in cold weather, and now I can go out with zero problems. It has assisted me in managing my fibromyalgia so I can enjoy life again.
Read More
9
Inflammation relief
10 people found this helpful
I bought this for my mother, who has arthritis. On the second day of taking it, she mentioned that an inflammation in her leg, which had been present for years, had subsided.
Read More
9
Night pain relief
8 people found this helpful
A big help for bi-lateral hand night pain. This product significantly minimises my night pain in both hands. I would definitely recommend it to anyone suffering from arthritis.
We investigated how methylsulfonylmethane (MSM) and a herbal extract called mobilee influence arthritis in human chondrocytes, the cells found in cartilage. By exposing these cells to interleukin (IL)-1β—a protein that can cause joint inflammation—we aimed to understand if these treatments could mitigate the damage commonly associated with osteoarthritis (OA).
We took chondrocytes from the femoral heads of patients undergoing hip replacement surgery and treated them with varying amounts of MSM and mobilee in the presence of IL-1β. Our tests measured cell survival and apoptosis—basically whether the cells lived or died—and assessed the levels of key proteins linked to cartilage breakdown and health.
Our results were encouraging. Both MSM and mobilee appeared to significantly reverse the negative effects brought on by IL-1β. Additionally, they managed to combat the activation of NF-κB, a pathway often implicated in inflammation and cell death. By reducing the levels of harmful enzymes and increasing beneficial proteins, these treatments seem to offer a potential new approach to improving joint health in arthritis patients.
In conclusion, this study suggests that MSM and mobilee could play a beneficial role in protecting cartilage cells from the inflammatory damage caused by IL-1β, providing a strong rationale for their consideration in arthritis treatment.
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9
MSM improves knee OA treatment
Comparison of Glucosamine-Chondroitin Sulfate with and without Methylsulfonylmethane in Grade I-II Knee Osteoarthritis: A Double Blind Randomized Controlled Trial.
We conducted a thoughtful investigation into how Methylsulfonylmethane (MSM) impacts the treatment of knee osteoarthritis (OA) when paired with glucosamine and chondroitin sulfate. In our study, 147 patients diagnosed with Kellgren-Lawrence grade I-II knee OA were randomly divided into three groups. One group received a combination of glucosamine and chondroitin sulfate, the second group received the same combination with MSM, and the third group was given a placebo.
The patients took their assigned capsules daily for three months, and we measured their pain and mobility before treatment and then at 4, 8, and 12 weeks after starting the regimen. The results revealed that the combination of glucosamine, chondroitin sulfate, and MSM offered noticeable clinical benefits for patients with knee OA. However, those taking only glucosamine and chondroitin sulfate experienced no significant improvement compared to the placebo group.
Our findings highlight the potential advantage of supplementing glucosamine and chondroitin with MSM for managing knee osteoarthritis. Nonetheless, the lack of improvement with glucosamine and chondroitin alone calls into question their effectiveness independently of MSM.
Read More
9
ARTRA MSM improves knee OA treatment
[Use of ARTRA MSM FORTE in patients with knee osteoarthritis: Results of a randomized open-label comparative study of the efficacy and tolerability of the drug].
We aimed to explore how the combined medication ARTRA MSM FORTE could help patients suffering from knee osteoarthritis (OA). This study involved 100 individuals who were experiencing noticeable pain while walking.
We divided participants into two groups: one group took ARTRA MSM, while the other received a similar combination without the MSM. Over the course of four months, we conducted monthly evaluations to track improvements in pain levels, mobility, and overall quality of life.
Notably, we observed that those taking ARTRA MSM experienced quicker reductions in pain and improvements in functional tests compared to the other group. In fact, 72% of patients taking ARTRA MSM reported feeling relief from pain more rapidly than those on the standard treatment. Based on these findings, we can comfortably recommend ARTRA MSM for managing knee OA in clinical settings.
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8
MSM improves mild knee pain
Methylsulfonylmethane Improves Knee Quality of Life in Participants with Mild Knee Pain: A Randomized, Double-Blind, Placebo-Controlled Trial.
In a well-structured randomized, double-blind, placebo-controlled trial, we explored how methylsulfonylmethane (MSM) affects those experiencing mild knee pain. The study involved 88 healthy Japanese participants, split evenly into two groups where one received 200 mg of MSM while the other received a placebo for 12 weeks.
By measuring the total score on the Japanese Knee Osteoarthritis Measure (JKOM) at the end of the trial, we found that the MSM group showed a significant improvement compared to the placebo group. Specifically, total JKOM scores changed markedly, with an improvement in knee and systemic health reported by participants who took MSM.
Our findings suggest that MSM might be beneficial for individuals with mild knee pain, marking it as a useful supplement for enhancing joint health. The positive outcomes underscore the potential of MSM as a supportive treatment option for managing mild arthritic conditions.
Read More
8
MSM reduces gouty arthritis symptoms
Modified Simiaowan prevents and treats gouty arthritis via the Nrf2/NLRP3 inflammasome signaling pathway.
We explored the therapeutic potential of Modified Simiaowan (MSM), a six-herb formula, specifically for its effects on gouty arthritis (GA). To understand how MSM influences the condition, we conducted a thorough investigation using mouse macrophages that were exposed to inflammatory stimuli and then treated with MSM.
Our findings showed that MSM effectively reduces inflammation and oxidative stress, which are key contributors to gouty arthritis. We measured the expression of inflammatory markers and the NLRP3 inflammasome pathway to see how MSM interacts at a biological level. This included utilizing techniques like western blotting and ELISA to gather essential data.
Furthermore, we validated MSM’s anti-inflammatory and antioxidant activities in rat models of GA. The treatments pointed to MSM alleviating symptoms through the Nrf2/HO-1/ROS/NLRP3 signaling pathway, indicating a promising mechanism of action. Overall, our results highlight MSM’s significant potential as a natural solution for managing gouty arthritis symptoms successfully.
It took away so much pain. I used this to manage arthritis and fibromyalgia. My knees used to ache badly in cold weather, and now I can go out with zero problems. It has assisted me in managing my fibromyalgia so I can enjoy life again.
Read More
9
Inflammation relief
10 people found this helpful
I bought this for my mother, who has arthritis. On the second day of taking it, she mentioned that an inflammation in her leg, which had been present for years, had subsided.
Read More
9
Night pain relief
8 people found this helpful
A big help for bi-lateral hand night pain. This product significantly minimises my night pain in both hands. I would definitely recommend it to anyone suffering from arthritis.
Read More
10
Pain-free movement
2 people found this helpful
Google James Coburn, arthritis, and read what he wrote. A doctor friend recommended this to me. I can now close my left hand without any pain. It is the most underrated product, as those without arthritis will likely develop it.
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9
Legacy pain relief
2 people found this helpful
Used this for years. This has been my go-to medication for arthritis. It is hard to find without Glucosamine, which my body dislikes. I am delighted to have found it on Amazon, as I take 3000 mg per day.
Arthritis is a general term that refers to inflammation of the joints, which can lead to pain, stiffness, and swelling. It encompasses over 100 different types, with osteoarthritis and rheumatoid arthritis being the most common. Osteoarthritis, often associated with aging, occurs when the cartilage that cushions the joints wears down over time. In contrast, rheumatoid arthritis is an autoimmune disorder where the body's immune system mistakenly attacks the joints, leading to chronic inflammation and potential disability if left untreated.
Symptoms of arthritis can vary widely depending on the type but typically include joint pain, swelling, reduced range of motion, and sometimes fatigue. Diagnosis usually involves a combination of physical exams, imaging tests, and blood tests. While there is currently no cure for arthritis, various treatments ranging from lifestyle modifications, physical therapy, and medications can help manage symptoms and improve quality of life. For those affected, seeking early diagnosis and intervention is crucial for slowing disease progression and preserving joint function.
Methylsulfonylmethane (MSM) is a naturally occurring sulfur compound that is often used as a dietary supplement. It is found in various fruits, vegetables, grains, and animal products, but its concentration in these foods is relatively low. MSM gained popularity for its potential health benefits, particularly in the realms of joint health, anti-inflammatory effects, and skin care. Many users report improvements in symptoms related to osteoarthritis and joint pain when using MSM supplements.
The mechanism behind MSM's effects is believed to be related to its ability to support the body's production of collagen, which is essential for maintaining healthy cartilage and connective tissues. Additionally, MSM is thought to have antioxidant properties that might help combat oxidative stress, further promoting joint and overall health. However, while many anecdotal reports support these claims, scientific research on the efficacy of MSM is still ongoing. As with any supplement, it's crucial to consult with a healthcare professional before incorporating MSM into your regimen, especially if you have underlying health conditions or are taking other medications.
MSM, or methylsulfonylmethane, is a sulfur compound that has gained popularity as a supplement for joint health and arthritis relief. Some studies suggest that MSM may reduce inflammation and pain associated with arthritis, making it a potential complementary treatment option. Users often report improved joint function and a reduction in discomfort, which can significantly enhance quality of life for those living with arthritis. However, while preliminary research is promising, the scientific community calls for more extensive clinical trials to confirm these benefits and fully understand how MSM interacts with arthritis.
It’s important to consult with a healthcare provider before adding MSM to your regimen, especially if you're already taking medications for arthritis or other health conditions. They can help determine if MSM is suitable for you and guide you on appropriate dosages. Keep in mind that while MSM may offer some relief, it should not replace conventional treatments prescribed by your healthcare provider. Combining MSM with other treatments, such as physical therapy, lifestyle modifications, and prescribed medications, may yield the best results in managing arthritis symptoms.
Based on user reviews, the time it takes to see results from this supplement for arthritis can vary. One user reported that their mother noticed a significant reduction in inflammation within just two days of starting the supplement Read Review. However, other users indicated that while some improvement was observed, it might not be as immediate. For instance, one user felt that the stiffness upon waking was greatly reduced, yet noted that overall joint improvement took a bit longer, with supplementation occurring every 2–3 days Read Review.
Overall, while some users may experience quick relief, others suggest a more gradual improvement over time as the supplement builds in effectiveness. Therefore, it seems to depend on the individual and their specific condition. Many users agree that consistency seems to lead to better results, so sticking with the supplement may enhance its effectiveness for arthritis management.
Methylsulfonylmethane (MSM) shows potential as a supplement for managing arthritis symptoms, specifically osteoarthritis and gouty arthritis, according to several studies. One trial highlighted that MSM, when given with glucosamine and chondroitin, led to noticeable clinical improvements in patients with knee osteoarthritis compared to those taking glucosamine and chondroitin alone ([5]). Another study indicated that MSM reduced inflammation and oxidative stress in mouse macrophages related to gouty arthritis, pointing to its anti-inflammatory properties ([3]).
However, the efficacy of MSM on its own remains unclear, as some studies found minimal significance in pain relief and functional improvement in osteoarthritis patients ([11]; [12]). Furthermore, while MSM seemed to slow the progression of arthritis in animal models, its isolated impact needs further investigation to clarify its effectiveness in human applications ([1]; [9]). In summary, while there is emerging evidence supporting MSM's role in arthritis treatment, additional research is required to establish its clinical benefits definitively and to determine optimal dosages and treatment regimen.
Users have reported a range of improvements in their arthritis symptoms after taking this supplement. One notable account involves a user’s mother who experienced a significant reduction in leg inflammation within just two days of starting the supplement, which had lingered for years Read Review. Additionally, another user noted that while stiffness upon waking was markedly improved, the overall improvement in their specific arthritis site was less immediate. They mentioned feeling considerable relief after taking the supplement intermittently, suggesting that even less frequent use can yield positive results Read Review.
Moreover, users expressed satisfaction with the supplement's performance, indicating it calms their arthritis symptoms effectively Read Review. Overall, while individual results can vary significantly, many users agree that consistency in taking the supplement is key to experiencing its benefits for joint health and inflammation reduction.
Users reported varying experiences when combining this supplement with others for managing arthritis symptoms. Some highlighted that they integrated MSM alongside this supplement, noting that MSM has been recognized for its benefits in joint health, including a reduction in pain and inflammation associated with arthritis Read Review. Specifically, one user mentioned that MSM effectively calmed their arthritis symptoms, implying a positive interaction between the two supplements Read Review.
Others expressed satisfaction with their overall results, regardless of additional supplements. For instance, one user experienced a significant decrease in leg inflammation within just two days, suggesting that even without combining with other products, the supplement was beneficial on its own Read Review. However, another user, who took the supplement intermittently, found notable improvements over time, which raises the effectiveness of the supplement irrespective of a regimented combination Read Review. Overall, it appears that while some users experienced enhanced effects by combining supplements, many still observed significant benefits from the supplement on its own.
Based on user reviews, a variety of experiences point towards MSM being effective for alleviating arthritis symptoms, although the ideal dosage appears to vary among individuals. Users report positive outcomes even with limited frequency; for instance, one reviewer mentioned they took the supplement once every 2-3 days and noticed significant improvements in their stiffness and overall condition Read Review. Other users have shared anecdotes of quick relief, with some observing inflammation reduction as early as the second day of use Read Review.
While there isn't a universally agreed-upon dosage among users, it is clear that many find MSM beneficial in managing arthritis symptoms when taken regularly. One reviewer highlighted its effectiveness as a joint health supplement, suggesting its role in reducing pain and inflammation Read Review. Overall, several users express satisfaction without specifying exact dosages, implying a personal approach may be needed to determine the right amount for maximum relief.
9
Inflammation relief
10 people found this helpful
I bought this for my mother, who has arthritis. On the second day of taking it, she mentioned that an inflammation in her leg, which had been present for years, had subsided.
6
Improved arthritis considerably
2 people found this helpful
When I wake up in the morning, the stiffness is greatly reduced. Although the original site of arthritis hasn’t improved much, I have noticed considerable improvement overall. I only took the supplement about once every 2–3 days and I’m satisfied with the results so far.
7.5
Convenient form
Good substitute for the powder form, especially while travelling. MSM really helps me; it calms my arthritis down.
6
Reduces pain
MSM is frequently used as a supplement to enhance joint health. Some studies indicate that it can help reduce joint pain and inflammation, which greatly benefits those with arthritis or other joint issues.
9
MSM improves knee OA treatment
Comparison of Glucosamine-Chondroitin Sulfate with and without Methylsulfonylmethane in Grade I-II Knee Osteoarthritis: A Double Blind Randomized Controlled Trial.
We conducted a thoughtful investigation into how Methylsulfonylmethane (MSM) impacts the treatment of knee osteoarthritis (OA) when paired with glucosamine and chondroitin sulfate. In our study, 147 patients diagnosed with Kellgren-Lawrence grade I-II knee OA were randomly divided into three groups. One group received a combination of glucosamine and chondroitin sulfate, the second group received the same combination with MSM, and the third group was given a placebo.
The patients took their assigned capsules daily for three months, and we measured their pain and mobility before treatment and then at 4, 8, and 12 weeks after starting the regimen. The results revealed that the combination of glucosamine, chondroitin sulfate, and MSM offered noticeable clinical benefits for patients with knee OA. However, those taking only glucosamine and chondroitin sulfate experienced no significant improvement compared to the placebo group.
Our findings highlight the potential advantage of supplementing glucosamine and chondroitin with MSM for managing knee osteoarthritis. Nonetheless, the lack of improvement with glucosamine and chondroitin alone calls into question their effectiveness independently of MSM.
8
MSM reduces gouty arthritis symptoms
Modified Simiaowan prevents and treats gouty arthritis via the Nrf2/NLRP3 inflammasome signaling pathway.
We explored the therapeutic potential of Modified Simiaowan (MSM), a six-herb formula, specifically for its effects on gouty arthritis (GA). To understand how MSM influences the condition, we conducted a thorough investigation using mouse macrophages that were exposed to inflammatory stimuli and then treated with MSM.
Our findings showed that MSM effectively reduces inflammation and oxidative stress, which are key contributors to gouty arthritis. We measured the expression of inflammatory markers and the NLRP3 inflammasome pathway to see how MSM interacts at a biological level. This included utilizing techniques like western blotting and ELISA to gather essential data.
Furthermore, we validated MSM’s anti-inflammatory and antioxidant activities in rat models of GA. The treatments pointed to MSM alleviating symptoms through the Nrf2/HO-1/ROS/NLRP3 signaling pathway, indicating a promising mechanism of action. Overall, our results highlight MSM’s significant potential as a natural solution for managing gouty arthritis symptoms successfully.
5
MSM shows minor benefits for OA
Efficacy of methylsulfonylmethane supplementation on osteoarthritis of the knee: a randomized controlled study.
We explored the effectiveness of methylsulfonylmethane (MSM) in treating knee osteoarthritis in a carefully designed clinical trial. Forty-nine participants received either MSM or a placebo for 12 weeks, and we measured their pain and physical function using various established scales.
Although patients taking MSM reported some improvement in pain and function, these changes were minor. It's still unclear if these results have real clinical significance for those suffering from osteoarthritis.
7
MSM shows potential, needs more research
Systematic review of the nutritional supplements dimethyl sulfoxide (DMSO) and methylsulfonylmethane (MSM) in the treatment of osteoarthritis.
We explored the potential of methylsulfonylmethane (MSM) and dimethyl sulfoxide (DMSO) as treatments for osteoarthritis (OA) through a systematic review of randomized controlled trials.
While our findings show that MSM seems to offer some benefits over placebo for those with mild to moderate OA in the knee, the evidence isn’t conclusive yet.
The studies evaluated had varying quality, especially with DMSO research, which requires us to approach the results with caution.
More thorough research is essential to establish the right dosages and confirm the long-term safety and effectiveness of MSM and DMSO.
7
MSM shows limited arthritis benefits
The effect of MSM in the treatment of ankle arthrosis: Is MSM as effective as methylprednisolone or hyaluronic acid?
We explored how methylsulfonylmethane (MSM) compares to other treatments like methylprednisolone and hyaluronic acid in addressing ankle arthritis that stems from trauma, known as posttraumatic ankle osteoarthritis (PTAO). In our study, we monitored how 32 adult rats responded to different treatment methods over eight weeks. We divided them into four groups: one received MSM orally, while the others received injections of methylprednisolone or hyaluronic acid. The fourth group served as a control.
Our findings showed that both the methylprednisolone and MSM groups had better radiological results compared to the control group, indicating some effectiveness. However, when we assessed the severity of arthritis, the methylprednisolone group performed notably better than the hyaluronic acid group. Interestingly, we found no significant differences between the MSM and control groups in terms of histopathological changes, which raises questions about the efficacy of MSM on its own.
Additionally, there was no notable change in the range of motion among the groups, suggesting that while both MSM and methylprednisolone may slow the progression of arthritis, MSM might not offer substantial benefits compared to current treatment standards. This makes it clear that an honest review of treatment options in daily practice is needed.
7
MSM shows potential benefits
Assessment of safety and efficacy of methylsulfonylmethane on bone and knee joints in osteoarthritis animal model.
We examined how methylsulfonylmethane (MSM) affects cartilage in arthritis using growing rats and a mouse model.
Our findings showed that while MSM did not influence cartilage formation in rats, it did decrease cartilage degeneration in mice with osteoarthritis after 13 weeks of treatment, suggesting a potential benefit.
However, we also found that high doses of MSM led to reductions in body, liver, and spleen weight, indicating the need for caution with supplementation.
References
Akpınar K, Şimşek EK, Özen ÖI, Haberal B. The effect of MSM in the treatment of ankle arthrosis: Is MSM as effective as methylprednisolone or hyaluronic acid?. J Orthop Res. 2024;42:1527. doi:10.1002/jor.25795
Toguchi A, Noguchi N, Kanno T, Yamada A. Methylsulfonylmethane Improves Knee Quality of Life in Participants with Mild Knee Pain: A Randomized, Double-Blind, Placebo-Controlled Trial. Nutrients. 2023;15. doi:10.3390/nu15132995
Qin DE, Liang W, Yu Y, Whelan EC, Yuan X, et al. Modified Simiaowan prevents and treats gouty arthritis via the Nrf2/NLRP3 inflammasome signaling pathway. J Ethnopharmacol. 2024;318:116906. doi:10.1016/j.jep.2023.116906
Cheleschi S, Fioravanti A, De Palma A, Corallo C, Franci D, et al. Methylsulfonylmethane and mobilee prevent negative effect of IL-1β in human chondrocyte cultures via NF-κB signaling pathway. Int Immunopharmacol. 2018;65:129. doi:10.1016/j.intimp.2018.10.004
Lubis AMT, Siagian C, Wonggokusuma E, Marsetyo AF, Setyohadi B. Comparison of Glucosamine-Chondroitin Sulfate with and without Methylsulfonylmethane in Grade I-II Knee Osteoarthritis: A Double Blind Randomized Controlled Trial. Acta Med Indones. 2017;49:105.
Notarnicola A, Maccagnano G, Moretti L, Pesce V, Tafuri S, et al. Methylsulfonylmethane and boswellic acids versus glucosamine sulfate in the treatment of knee arthritis: Randomized trial. Int J Immunopathol Pharmacol. 2016;29:140. doi:10.1177/0394632015622215
Panuccio E, Memeo A, Richetta S. [Evaluation of the combined treatment of oral viscosupplementation with hyaluronic acid intra-articular injection on symptomatic knee osteoarthritis]. Clin Ter. 2015;166:e321. doi:10.7417/T.2015.1886
Alekseeva LI, Sharapova EP, Kashevarova NG, Taskina EA, Anikin SG, et al. [Use of ARTRA MSM FORTE in patients with knee osteoarthritis: Results of a randomized open-label comparative study of the efficacy and tolerability of the drug]. Ter Arkh. 2015;87:49. doi:10.17116/terarkh2015871249-54
Ezaki J, Hashimoto M, Hosokawa Y, Ishimi Y. Assessment of safety and efficacy of methylsulfonylmethane on bone and knee joints in osteoarthritis animal model. J Bone Miner Metab. 2013;31:16. doi:10.1007/s00774-012-0378-9
Notarnicola A, Tafuri S, Fusaro L, Moretti L, Pesce V, et al. The "MESACA" study: methylsulfonylmethane and boswellic acids in the treatment of gonarthrosis. Adv Ther. 2011;28:894. doi:10.1007/s12325-011-0068-3
Debbi EM, Agar G, Fichman G, Ziv YB, Kardosh R, et al. Efficacy of methylsulfonylmethane supplementation on osteoarthritis of the knee: a randomized controlled study. BMC Complement Altern Med. 2011;11:50. doi:10.1186/1472-6882-11-50
Brien S, Prescott P, Bashir N, Lewith H, Lewith G. Systematic review of the nutritional supplements dimethyl sulfoxide (DMSO) and methylsulfonylmethane (MSM) in the treatment of osteoarthritis. Osteoarthritis Cartilage. 2008;16:1277. doi:10.1016/j.joca.2008.03.002
Kim LS, Axelrod LJ, Howard P, Buratovich N, Waters RF. Efficacy of methylsulfonylmethane (MSM) in osteoarthritis pain of the knee: a pilot clinical trial. Osteoarthritis Cartilage. 2006;14:286.