Mechanistic Convergence of Bio-nutritional Agents in Osteoarthritis: Translational Insights and Evolving Paradigms

A BSTRACT Osteoarthritis (OA) is a multifactorial degenerative joint disease that causes pain, stiffness, and a reduction in function. It is characterized by increasing cartilage degradation, subchondral bone remodeling, and synovial inflammation. Conventional pharmaceutical treatments such as nonsteroidal anti-inflammatory medications (NSAIDs) and corticosteroids remain commonly utilized for symptom relief; however, their long-term usage is typically limited by unpleasant effects and limited power to influence disease development. The therapeutic potential of nutraceuticals as supplements in the treatment of OA is becoming clearer. Bio-nutritional substances, including glucosamine, chondroitin sulfate, omega-3 fatty acids, curcumin, polyphenols, vitamins, and minerals, demonstrate anti-inflammatory, antioxidant, and chondroprotective activities. These drugs converge mechanistically by influencing important molecular pathways such as nuclear factor-kappa B, mitogen-activated protein kinase, and matrix metalloproteinases, ultimately lowering catabolic activity and oxidative stress inside joint tissues. Synergistic interactions, for instance, between curcumin and boswellic acid or resveratrol paired with NSAIDs, further boost therapeutic effects. Despite encouraging results, a lack of standardized formulations and low bioavailability impede clinical translation. Nano formulations, tailored delivery systems, and nutrigenomic-guided personalization are examples of emerging technological developments that present new opportunities to maximize efficacy and patient-specific response. Current evidence supports improvements in pain ratings, mobility, and general quality of life; however, strong, long-term clinical trials are necessary to confirm safety, dosage consistency, and the genuine disease-modifying potential. Nutraceutical-based therapies offer a developing paradigm in integrative OA therapy, harmonizing with holistic, preventative, and patient-centered healthcare approaches. A methodical methodology produced a list of possible investigations. PubMed, Web of Science, and Google Scholar were databases used to conduct the review.