Top 10 supplements for musculoskeletal support

Clinically validated nutritional supplements offer chiropractors effective, evidence-based options for managing musculoskeletal conditions. These interventions can deliver pain relief and functional improvements, making them valuable additions to patient treatment plans.

Patients are seeking long-lasting solutions for their musculoskeletal (MSK) conditions. Studies show more than 50% of American adults are dealing with joint pain, swelling and subsequent mobility issues. The goal is to provide solutions that address the underlying causes of muscle and joint pain without harming the liver, kidneys, heart or stomach. Many patients may habitually turn to non-steroidal anti-inflammatory drugs (NSAIDs) without knowing other options can be just as effective.

The nutrients and botanicals highlighted in this article were chosen for the scientific and clinical evidence behind them, their multiple mechanisms of action and because they are generally well-tolerated.

1 Curcumin

The top spot belongs to curcumin for many reasons. This yellow-orange polyphenol from turmeric (Curcuma longa) has been the subject of more than 27,000 published studies. Research has demonstrated curcumin’s efficacy as a monotherapy, in combination with conventional care or other nutrients, and can even match over-the-counter and prescription medications for MSK conditions or diseases.

A 2025 review article found curcumin significantly impacted osteoarthritis (OA). Versus placebo, curcumin significantly reduced visual analog scale scores and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores for pain, function and stiffness. Curcumin even demonstrated effects on joint pain comparable to those of NSAIDs. For delayed-onset muscle soreness, curcumin showed reductions in creatine kinase levels and muscle soreness vs. placebo, while also improving muscle strength and joint flexibility.

A specific form of curcumin combined with turmeric essential oil has shown similar efficacy to paracetamol in OA with better improvements in C-reactive protein and TNF-α levels, has been compared to diclofenac sodium in OA and demonstrated similar efficacy with fewer adverse effects, and outperformed diclofenac sodium in a clinical trial involving rheumatoid arthritis.^,,

2 Boswellia

Boswellia (Boswellia serrata) comes in at a close second and is often combined with curcumin for MSK concerns. Boswellia helps reduce excessive 5-lipoxygenase (5-LOX) inflammation, a critical mediator of joint pain. Reducing 5-LOX inflammation helps mitigate the production of pro-inflammatory leukotrienes, which are often elevated in musculoskeletal conditions. Research has found boswellia is a top choice for alleviating pain and stiffness from knee OA. Clinical data has shown boswellia can reduce pain scores by 45 to 60% in just 90 days, relief patients will notice. A study involving curcumin and boswellia found 500 mg twice a day of the herbal combination outperformed 100 mg twice daily of celecoxib for pain relief, walking distance and joint line tenderness over a 12-week period.

3 Palmitoylethanolamide (PEA)

Palmitoylethanolamide (PEA) is a lipid mediator that is endogenously produced, but levels may be reduced in inflammatory and pain conditions. PEA shows incredible benefits for nerve pain. Through the preservation of endocannabinoids such as anandamide, PEA has broad-spectrum analgesic properties that can even be effective for central or peripheral sensitization. In one study, the majority of participants with sciatica reached 50% pain reduction in just three weeks. Other research has found PEA effective for failed back surgery syndrome, carpal tunnel, neuropathic pain and can reduce the need of rescue medications.^, PEA can be combined with the enzyme serratiopeptidase, a proteolytic enzyme, for synergistic effects.

4 Omega-3 fatty acids

The majority of American adults (and kids) are deficient in omega-3s. Omega-3s have been shown to reduce pain related to rheumatoid arthritis, migraine, dysmenorrhea and other pain conditions. Their activities help resolve acute inflammation through their incorporation into cell membranes and enzymatic conversion into specialized pro-resolving mediators; these actions reduce the likelihood of acute inflammation becoming chronic inflammation and central sensitization.

5 Magnesium

Magnesium is another nutrient deficient in the majority of the population. One of the most common indicators of deficiency is muscle cramping. Magnesium plays a crucial role in skeletal muscle metabolism, supporting overall muscle mass and regeneration. Magnesium also plays a role in preventing central sensitization. Adequate magnesium levels support neuromuscular function and may reduce muscle spasms and tension that contribute to MSK pain.

6 Vitamin D3 (with K2)

Vitamin D3 plays a crucial role in calcium metabolism and bone density. A 2022 clinical trial found vitamin D3 and K2 supplementation increased lumbar interbody fusion rates by approximately 28% versus control. After six months of follow-up, the vitamin D3/K2 group also had higher bone mineral density. Other positive outcomes include increases in procollagen type 1 levels. Other research has found vitamin D deficiency can lead to higher rates of nonspecific musculoskeletal pain.

7 Glucosamine and chondroitin

These nutrients are generally paired together, so much of their research is intertwined. A 2025 systematic review included more than 140 studies, approximately 60% of them being randomized controlled trials. The majority focused on osteoarthritis and joint pain, with more than 90% of efficacy studies showing positive outcomes. Plus, glucosamine and chondroitin were well-tolerated with minimal or no adverse effects. The studies included glucosamine and chondroitin compared to placebo or celecoxib.

8 Comfrey

Topical comfrey is a valuable adjunct to supplementation for MSK issues and manual therapies. Clinical research has found it effective for myalgias (from acute blunt trauma or chronic strain), cervical spine functional disorders, ankle sprains, tendinitis and wound healing.^, One clinical study found topical comfrey significantly reduced pain scores (active motion, pain at rest and functional impairment) in as little as three to four days after acute ankle sprain. In that same timeframe, a significant reduction in swelling was noted. A specialized comfrey cream free of pyrrolizidine alkaloids is preferred because of its safety, including for abrasions or broken skin, making it a go-to for kids (over age four), high-performance athletes, seniors and everyone in between.

9 Creatine

Creatine is an amino acid shown to preserve muscle mass, especially in older adults. Sarcopenia, age-related reduction in strength, muscle mass and functionality, is a risk factor not only for osteoporosis but also for increased morbidity and mortality. Accumulating research shows creatine supplementation, ideally paired with resistance training, has favorable effects on body composition, including lean muscle mass, muscle strength, bone turnover and functional ability.

10 Hydration

Plain and simple, adequate hydration is foundational for musculoskeletal health. With water comprising nearly 70% of muscle mass, even mild dehydration can impair muscle endurance and strength. A general daily guideline is drinking half of your body weight (in pounds) of water (in ounces). So a 150-pound person would need around 75 ounces of water. This number needs to be individualized, especially for active individuals.

Final thoughts

We now have clinically validated nutritional options to present to patients when musculoskeletal conditions arise. Offering these alternatives can provide comparable efficacy to conventional treatments and improved safety profiles for long-term use.   

Lexi Loch, ND, received her doctorate in naturopathic medicine from the National University of Natural Medicine, where she graduated with highest honors. In addition to her practice, she is a medical writer and editor, researcher, educator and patient advocate. Her articles have been published in various natural health periodicals and reference books. Prior to her education as a physician, Loch worked in veterinary medicine as a certified veterinary technician. She is also an accomplished athlete, playing collegiate volleyball and participating in overseas tournaments, is an avid snowboarder and has been world ranked in downhill longboarding. Loch is a member of the Scientific Affairs and Education team for EuroPharma Inc. She can be reached at lloch@europharmausa.com.