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Collagen Type 2 for Joint and Knee Pain

Collagen supplements are advertised to help reduce joint pain, improve stiffness, and slow down the progression of arthritis.

But do they ACTUALLY work? 🤔

Let’s look at what some recent clinical trials say. 👇

Collagen is a type of protein that is naturally found in the body and is a key component of cartilage. Articular cartilage is what helps pad and protect our bones. Osteoarthritis by definition is caused by the loss of articular cartilage.

The theory is that taking collagen supplements can help increase the body’s natural production of collagen. This in turn can help improve the strength and elasticity of the cartilage in the body which hopefully leads to less wear and tear and less arthritis. So that’s the science behind how collagen supplements might help, but now the question is, does it actually work? Let’s take a look at the results of a few recent clinical trials.

The first study aimed to evaluate the impact of type 2 collagen on knee osteoarthritis in individuals 60 to 80 years old.

Participants were randomized to either 40 mg of type 2 collagen or a control group. Both groups then underwent a standard physical therapy treatment.

The results showed a significant improvement in visual analog pain score in the collagen group. They went from a baseline score of 7 out of 10 down to a score of 3. The control group scores went from 7 down to 6. There was also a significant improvement in total WOMAC score.

The biggest critiques of this study is that no placebo was used in the control group. This is critically important in a randomized controlled trial because the goal is to determine the true effect of a treatment being tested, independent of any placebo effect.

So what we really need is a randomized controlled trial that includes a placebo group. And that’s what this study did.

It was a three month randomized controlled trial comparing 40 mg of undenatured type 2 collagen, glucosamine and chondroitin dosed at 1500 mg and 1200 mg respectively, and placebo.

The results showed that type 2 collagen reduced pain, stiffness, and physical function associated with osteoarthritis compared to baseline and compared to placebo. In addition, WOMAC osteoarthritis scores for the type 2 collagen group were found to be similar to the glucosamine and chondroitin group. Both groups improved by around 33 points. This is significantly more when compared to the 14 point improvement in the placebo group.

The authors go on to conclude that type 2 collagen is considerably effective in improving the overall symptoms of osteoarthritis and that the effects are comparable to that of glucosamine and chondroitin. Now while this was a well done study that showed positive results, the limitation of the trial is that they had a very small sample size with only 30 or so subjects in each group.

So now what we need is a larger sample size and that’s when we look to systematic reviews and meta-analyses. Unfortunately, I was only able to find one systematic review and meta-analysis listed on pubmed in the last 15 years for the use of collagen supplementation in arthritis. This study was published in March of 2019 and aggregated data from 5 randomized controlled trials for a total of 519 subjects. All of these studies compared collagen treatment to placebo.

The results showed that collagen gave a significant reduction in the score of the total WOMAC index by 8 points when compared to placebo. There was also a significant reduction in the visual analog pain score after collagen administration. The authors go on to conclude that collagen is effective for the treatment of improving osteoarthritis symptoms.

So if we just took a brief look at the conclusions of these clinical studies, we may think collagen supplementation will work tremendously in reducing symptoms related to knee osteoarthritis. But there is just not that much clinical trial evidence supporting its use.

There is currently only one systematic review and meta-analysis looking at the use of collagen for joint pain. The studies were all heterogenous and used both hydrolyzed collagen as well as undenatured collagen. Dosing was also all over the place. To make things worse, every single one of the studies included in the meta-analysis was funded by industry or pharmaceutical companies. And they have a clear motive to report favorable results.

Let’s contrast this to other common supplements. There is plenty of clinical trial evidence suggests that Boswellia serrata and turmeric curcumin both have large effect sizes in reducing symptoms related to symptomatic knee osteoarthritis. Glucosamine chondroitin when taken together seems to have low to moderate effect size in reducing symptoms.

So I want to be clear that I’m not saying collagen supplements don’t work. They might. But I just don’t think there is sufficient data right now to widely recommend them. If you are interested in taking supplements, I would recommend looking at options that have been more widely studied and seem to have more evidence for their use.


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