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Orthomolecular Medicine News Service, Nov 27, 2019

Six Approaches to Treat Knee Pain

Commentary by Tom Taylor

(OMNS November 27, 2019) How many people have your heard complain about knee pain? In teenagers it may be dismissed as "growing pains." In adults, knee problems often are struggled with for years until they cut it out and replace it. This is expensive, with painful recovery, and very likely wildly overused. This article will list interesting alternatives to be considered before letting the saw and chisel crowd have a whack at your knee.

A starting assumption before going down this list is that health is otherwise in good shape. A good diet and having a high level of antioxidants e.g. vitamin C, is an assumed starting point for any knee recovery (see point 4 below).

Having studied several sources, here is a list of possible solutions that some have found effective.

1. Niacinamide

Niacinamide and niacin are both forms of vitamin B-3. The difference is that niacin causes skin flushes that are uncomfortable for some people, but it also increases "good" HDL cholesterol and helps to lower "bad" LDL cholesterol. Niacinamide doesn't cause either of those effects but it is used by the body as effectively as niacin as the essential nutrient and NAD precursor vitamin B3. In 1949, William Kaufman M.D. Ph.D. wrote a small book on his findings of using niacinamide as a solution to knee issues. Seems like an odd path today, but as some of us may recall today, in 1943 all processed cereal and grain products were enriched with niacin per USDA/FDA directive to stop pellagra, a disease that had become common with nutrient deficient white flours. With that public health success, it is easy to see how work like Kaufman's would follow. In his preface Kaufman stated, "It will be seen that the common form of joint dysfunction was corrected or ameliorated in time by adequate niacinamide therapy." In simple terms he found niacinamide helped to relieve joint pain. Kaufman gave different dosages based on levels of pain. Since Kaufman's work, Abram Hoffer established that 3 grams a day is fine for most anybody, so if one wants to try niacinamide, Hoffer would likely suggest a gram at every meal for 3 grams a day. The details of Kaufman's work can today be found at

An improved source of niacinamide information is chapter 7 of the book "Niacin, The Real Story" by Abram Hoffer et. al. This chapter's title is, "Reversing Arthritis with Niacinamide: The Pioneering Work of William Kaufman." Niacin will likely provide the same benefit to arthritis as provided by niacinamide -- and in addition will help to lower cholesterol. Following the advice in the Hoffer book, to minimize flushing, you can start with a very low dose of niacin (25 mg) and slowly increase up to 500 mg or more.

Interestingly, my wife recently had a bum knee one morning for no apparent physical reason. Eventually, she tried niacinamide at one 500 milligram dose per day. She noticed the improvement almost immediately and while she is generally a supplement skeptic, she thought the improvement was worthwhile enough to be very careful to pack the niacinamide for a two-week trip.

2. Fallen arches contribute to knee pain

It is widely known that people with "flat feet" cannot do the 20-mile hikes that military boot camp requires. Misaligned feet cause misaligned knees, eventual bone-on-bone pain and misalignment on up the skeleton. This interesting 20-minute video by Dr. Alan Mandell. D.C. does a very nice job of piecing this story together. Even though you do not believe this is an issue for you, his explanations of skeletal structure are well worth a few minutes of your time. To prevent and reverse fallen arches, you can try arch supports, either over-the-counter, or custom-designed. You can also wear supportive shoes; they may be more comfortable than e.g. sandals or flag shoes. These efforts won't cure the problem, but they can prevent pain. In some cases, the problem is caused by a shortened Achilles tendon, and appropriate exercises to stretch the tendon may help.


DMSO (dimethyl sulfoxide) is an odorous liquid natural product that many, including me, will claim helps with knee and leg pain when applied topically. Simply stated, DMSO is a source for dietary sulfur, a common mineral needed by the body. DMSO is an official product for sore horse knees, but for reasons known mostly to people now on FDA retirement pensions it was never widely approved for human use. Other countries reportedly approve it for many more uses. Typically applied externally, it is a very easy item to buy on the web.

The 1993 book "DMSO, Nature's Healer" by Dr. Morton Walker says a lot in the title. And on page 31, Dr. Stanley W. Jacob, co-discoverer of the therapeutic properties of the drug, says: "We've had only three new (medicine) principles in our century the antibiotic principle, the cortisone principle, and the DMSO principle." With that type of enthusiasm, where did DMSO disappear to? The FDA shut down all trials in November, 1965 (page 129) and directed that all records be returned to sponsoring pharmaceutical companies. Various squabbles ensued, but between 60 Minutes and the FDA, the pharmaceutical industry evidently lost interest and it appears the world just moved on. DMSO was first identified in 1866, so typically, anything that old fails to hold the interest of big medicine.

If one types in "DMSO pain" in a YouTube search, an interesting and short testimonial pops up "Fast Pain Relief for Guitarists - DMSO and How to Use It." This guy gives a very informative 4 minutes on DMSO. He states topical DMSO loosened his finger joints so he could hold a guitar pic again. Well worth watching even if you never pick up a guitar pic. Numerous other DMSO testimonials and play lists follow in the YouTube list after his piece. This list suggests numerous first-person testimonials as to DMSO pain relief benefits.

Before hauling off and trying DMSO, please note it is hard on the skin when applied full strength. Most recommend cutting it 30% to 50% with distilled water or, like the guitarist suggests, obtaining a cream. A second and very important note is it literally soaks thru the skin and carries whatever is on the skin in with it. However, since the safety of ingesting large amounts of DMSO has not been established, do not swallow solutions containing DMSO.

4. Excellent diet

To give your knees the best chance to recover, eat a variety of foods, including lots of colorful vegetables and fresh fruits, dark green leafy vegetables, nuts, moderate amounts of meat and fish. Avoid sugar, white flour, white rice, and grits that are processed to remove the germ and bran that contain the vitamins and minerals. In addition to niacin/niacinamide, make sure you get adequate doses of essential nutrients. Take a multivitamin supplement, along with extra vitamin C (1000-3000 mg/d in divided doses), vitamin D (2000-5000 IU/d), vitamin E (400-800 IU/d), and magnesium (300-500 mg/d in divided doses, in citrate, malate, or chloride form). The chondrocytes in the joint need all these nutrients in order to grow more cartilage. To learn more about how this works, check out the book by Smith and Penberthy, "The Vitamin Cure for Arthritis" (ISBN-13: 978-1591203124). Numerous other papers, books, and videos cover this topic. There are numerous examples on Orthomolecular News.

5. Injections

There are injectable solutions that I have not studied, but are promoted by various doctors and medical centers. For example, there are several medical centers that are advertising using stem cell injections for knee issues. The safest type is "autologous stem cell therapy" which uses the patient's own cells to minimize complications.

6. Orthopedic Surgery

Two surgeons (Drs. Zalzal and Weening) do a really nice job of explaining knee pain issues from a surgeon's perspective at They are big advocates of exercise, drugs in selected cases, and surgery as a last approach. Though they appear to be good, careful doctors, they do not appear to give diet much weight. Here is their 18-minute video titled, "Treating Knee Arthritis Without Surgery."

A Mechanical Engineering Observation

A limitation of mechanical solutions is they eventually wear out, ball-joints on a car being a common example. What if the automotive companies spent an extra thousand or so per car and created a lubricant injection system for ball joints? What would happen? They would probably never wear out before the owner died, but the car market considers replacement joints cheap. The nutrition suggestions listed above are a whole lot like lubricant injection for your own joints. Do nutrition right and knees will naturally regenerate. It will be a long time before they wear out. Knee replacement is expensive and irreversible.


Nutrition can prevent and reverse knee pain. We all tend to think the knee is a mechanical joint, but the knee is unique that it can self-repair given the right building ingredients. Listed above are three knee nutrition items that have worked for many and are worth a try, niacinamide, DMSO, and a better overall diet with vitamin and mineral supplements. They are inexpensive and can be tried at home. Thus, it is apparent that "you are what you eat" applies to knees and a diet managed to aid the knee can only bring benefits.

This article has provided examples from medical doctors, chiropractic doctors and nutrition advocates. It is well worth your time to work through all of these before doing the irreversible joint replacement. Man-made knee joints will wear out like ball-joints on a car.

(Tom Taylor has engineering degrees from Georgia Tech and a MBA. He became interested in nutrition subjects as a solution to feeling too old and stiff to do the peculiar positions required to work on boats and airplanes. He has contributed prior articles to OMNS.)

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