Can magnesium help knee pain and osteoarthritis?

Marion Hauser, MS, RD

Some consider magnesium a miracle mineral. Its biological functions are far too numerous to provide here other than its protective functions in cardiovascular disease, certain cancers, cholesterol metabolism, problems of fatigue, problems of sleep, and problems of depression and anxiety. In this article we will concentrate on magnesium’s beneficial effects on joint related pain.

Is magnesium good for joint pain?

As with any supplement or nutrition component of food, there is a controversy as to whether magnesium supplementation would help some one with joint pain. For each study that you find suggesting magnesium’s benefit in help with knee pain, you can find a study that says it doesn’t. There are those who say magnesium or any type of supplementation may provide a placebo effect. That is also entirely possible. If you are reading this article you are probably looking for magnesium’s benefits. So let’s look at some research.

Lower magnesium intake was associated with worse pain and function in knee osteoarthritis

  • In a study from February 2018 University of Minnesota doctors found lower magnesium intake was associated with worse pain and function in knee osteoarthritis, especially among individuals with low fiber intake.(1)

People with higher serum magnesium levels had significantly lower risk of knee osteoarthritis

  • A November 2019 study in the journal Medicine (2) says: “The impact of magnesium on risk of knee osteoarthritis is still under investigation. . .  Although higher daily intake of magnesium was associated with a significantly reduced risk of fracture in patients with knee osteoarthritis, it was not significant for lowering the risk of knee osteoarthritis. (However) Meta-analysis also showed that population with higher serum magnesium levels had significantly lower risk of knee osteoarthritis.” In the end the researchers concluded that magnesium did not seem to prevent knee osteoarthritis, but it could help with bone fractures after the development of knee osteoarthritis.

Sometimes we ask Magnesium to do a lot. A recurrent theme that I want to stress is that it is difficult for any medicine or supplement to undo or reverse years, even decades of degenerative knee or joint disease.

Magnesium’s role in inflammation and cartilage rebuilding in helping patients with osteoarthritis

So again, let’s always remember that supplements may have some benefit, but if you have significant knee pain or osteoarthritis breakdown, it is very unlikely that magnesium supplementation will reverse a degenerative knee condition. Some knees are too far gone for magnesium to help.

A 2016 study in the medical journal Life sciences (3) sought to “unravel” the role of magnesium in how it may help people with osteoarthritis. Here are the learning points.

  • Magnesium is widely involved in human physiological processes (inflammation) that may play key roles in the generation and progression of diseases.
  • Magnesium deficiency is considered to be a major risk factor for osteoarthritis development and progression.
  • Magnesium deficiency is active in several pathways that have been implicated in osteoarthritis, including:
    • increased inflammatory mediators,
    • cartilage damage,
    • defective chondrocyte biosynthesis (you don’t make good cartilage),
    • calcification in soft tissue,
    • and a weakened effect of analgesics (magnesium makes painkillers work better, a subject that you need to discuss with your doctor).
  • Abundant evidence in animal models now suggests that the nutritional supplementation or injection of magnesium represent effective therapies for osteoarthritis.

Studying magnesium’s effect on inflammation, joint space and bone spurs

A 2015 study in the journal PLOS Public Library of Science one, (4) looked at  cross-sectional associations between dietary magnesium intake and radiographic knee osteoarthritis, joint space narrowing, and osteophytes (bone spurs).

The research team took these facts into account from previous studies that suggest that low magnesium levels could contribute to chronic inflammation and joint degenerative disease.

  • Low-grade systemic inflammation may play an important role in the development and progression of osteoarthritis.
  • Previous studies revealed that low dietary magnesium intake was associated with elevated serum C-reactive protein.
  • Animal studies also indicated that some proinflammatory cytokines (interleukin-6, tumor necrosis factor α) were increased when magnesium was deprived the test animals.
  • There is also a strong correlation between magnesium and the immune response. (Low magnesium poor response, good magnesium levels better response).
  • Activation of cells:
    • (e.g., macrophages (the cells that clean up dead and dying tissue),
    • neutrophils (immune cells that head to the site of infection or inflammation),
    • and endothelial cells (blood vessel cells that act during chronic inflammation as a fluid transport among other activities) was reported to be associated with magnesium deficiency as well.
  • Low magnesium intake may be a contributing factor to the development of osteoarthritis through inflammatory and/or immune mechanism.

Conclusion point: The study found an association Magnesium and joint space in the knee suggesting that magnesium may help with joint space narrowing symptoms.

Combining Vitamin C and Magnesium

A November 2020 animal study in the medical journal Bioactive materials (5) found that while previously demonstrating that magnesium could be a therapeutic alternative for osteoarthritis through the management of inflammation and cartilage regeneration, it may not work well enough by itself. One reason is that oxidative stress in the body can create an inflammatory response beyond magnesium’s ability to handle it. This will lead to an accelerated cartilage breakdown. To that end supplementing magnesium with vitamin C may help. As we know vitamin C is a potent antioxidant and when combined with magnesium the researchers were able to show additive effects to significantly alleviate the joint destruction and pain. The researchers suggested that the combination of magnesium and vitamin C could inhibit bone spur formation and reduce inflammation in the knee synovium. Let me point out that this was an animal study using intravenous solutions of magnesium and vitamin C. We have to be realistic in understanding how much a combination of vitamin C and magnesium can help in degenerative joint and knee disease.

The family of magnesium rich foods include: Leafy Greens – Spinach and Chard, Pumpkin seeds, Yogurt, Almonds, Black beans, avocado, figs, bananas, and dark chocolate

Magnesium’s effect on pain

A July 2020 study published in the medical journal Nutrients (6) In terms of antinociceptive (pain blocking) action, magnesium prevents central sensitization (chronic pain leads to a problem of over sensitization of pain. In other words, the more pain you have, the longer you have it, the worse the pain is felt), and attenuates preexisting pain hypersensitivity (if you already suffer from over sensitization of pain (magnesium seems to be able to help). These beneficial effects of magnesium therapy have also been reported in patients with neuropathic pain, such as malignancy-related neurologic symptoms, diabetic neuropathy, post-herpetic neuralgia, and chemotherapy-induced peripheral neuropathy. In addition, magnesium treatment is reportedly able to alleviate fibromyalgia, dysmenorrhea, headaches, and acute migraine attacks.”

Magnesium and joint related nerve pain

A Brazilian research team writing in the European journal of oral sciences (7) found that Magnesium deficiency was implicated in nerve pain in patients suffering from TMJ.  They wrote that their study’s findings may lead to a better understanding of central processing in the nociceptive trigeminal pathway (Trigeminal neuralgia is a very painful condition where pain radiates into the face and jaw) and the development of new approaches to treat orofacial pain with a TMJ origin.

A study published in the journal Magnesium research (8) went so far as to suggest that Magnesium promotes sciatic nerve regeneration. Let’s take a better look at this research:

This research was from the Department of Neurosurgery, Taichung Veterans General Hospital, Taichung, Taiwan.

  • The doctors tested the effect and mechanism of magnesium supplementation on a sciatic nerve crush injury in mice.
  • Mice were randomly divided into three groups with low-, basal- or high-Magnesium diets (corresponding to 10, 100 or 200% Mg of the base diet).
  • Neurobehavioral, electrophysiological and regeneration marker studies were conducted to explore nerve regeneration.
    • First, a high magnesium diet significantly increased plasma and nerve tissue magnesium concentrations.
    • In addition, magnesium supplementation improved neurobehavioral, electrophysiological functions, enhanced regeneration marker, and reduced deposits of inflammatory cells as well as expression of inflammatory cytokines. (These are benefits we noted above – simply an anti-inflammatory effect).
    • Furthermore, reduced Schwann cell apoptosis (death). Schwann cells in simplest terms support and protect neurons among their many functions)
  • In summary, improved neurological function recovery and enhanced nerve regeneration were found in mice with a sciatic nerve injury that were fed a high- magnesium diet, and Schwann cells may have been rescued from apoptosis by the suppression of inflammatory responses.

A follow up research to this study (9) surrounds the possible use of a dissolvable magnesium wire place near sciatic nerve damage.  The magnesium is thought to be able to induce Schwann cells (cells that rebuild neurons, in essence cells that help rebuild nerves cells) to secrete nerve growth factor and promote the regeneration of nerve axons after central nervous system injury.

Dietary magnesium in humans with osteoarthritis average age 62

In a June 2019 study, (10)  researchers evaluated the relationship between dietary magnesium intake and prevalence of knee osteoarthritis. A topic that up to June 2019, was “poorly explored in the (medical research) literature.”

  • Overall, 783 people participating in this study (59.8% females; average  62.3 years) and having an MRI assessment of knee osteoarthritis were assessed for the benefits or non-benefits of magnesium in helping with their knee pain.
  • The people in this study were given a diet that increased their magnesium intake by 100 mg/day. One ounce of pumpkin seeds for instance contains 168 mg of magnesium. One ounce of almonds contains 80 mg.
  • What the researchers noted in the group of slightly more women than men with an average age of 62 is that higher magnesium intake (i.e., increase of 100 mg/day) corresponded to a significant increase in mean cartilage thickness, cartilage volume at medial tibia, cartilage volume and mean cartilage thickness at central medial femur, and cartilage volume and mean cartilage thickness in the central medial tibiofemoral compartment.
  • In conclusion, an increased magnesium dietary intake is associated with a better knee cartilage architecture, also when adjusting for potential confounders, suggesting a potential role of magnesium in the prevention and treatment of knee osteoarthritis.

In summary, magnesium could help. May not help everyone. Some knees are too far gone.

Magnesium and overall reduction of joint related pain

The roll call of benefits for magnesium are long. As they relate to problems of joint pain magnesium has been found to:

The amazing healing power of food is seen throughout my articles on this site. Here are a few of them:

References for this article:

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This article was updated February 19, 2021

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