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A meta-analysis of the analgesic effects of omega-3 polyunsaturated fatty acid supplementation for inflammatory joint pain

Goldberg, Robert J.a,c; Katz, Joela,b,c,d,*

doi: 10.1016/j.pain.2007.01.020
Research papers
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Between 40% and 60% of Americans use complementary and alternative medicine to manage medical conditions, prevent disease, and promote health and well-being. Omega-3 polyunsaturated fatty acids (ω-3 PUFAs) have been used to treat joint pain associated with several inflammatory conditions. We conducted a meta-analysis of 17 randomized, controlled trials assessing the pain relieving effects of ω-3 PUFAs in patients with rheumatoid arthritis or joint pain secondary to inflammatory bowel disease and dysmenorrhea. Meta-analysis was conducted with Cochrane Review Manager 4.2.8. for six separate outcomes using standardized mean differences (SMDs) as a measure of effect size: (1) patient assessed pain, (2) physician assessed pain, (3) duration of morning stiffness, (4) number of painful and/or tender joints, (5) Ritchie articular index, and (6) nonselective nonsteroidal anti-inflammatory drug consumption. Supplementation with ω-3 PUFAs for 3–4 months reduces patient reported joint pain intensity (SMD: −0.26; 95% CI: −0.49 to −0.03, p = 0.03), minutes of morning stiffness (SMD: −0.43; 95% CI: −0.72 to −0.15, p = 0.003), number of painful and/or tender joints (SMD: −0.29; 95% CI: −0.48 to −0.10, p = 0.003), and NSAID consumption (SMD: −0.40; 95% CI: −0.72 to − 0.08, p = 0.01). Significant effects were not detected for physician assessed pain (SMD: −0.14; 95% CI: −0.49 to 0.22, p = 0.45) or Ritchie articular index (SMD: 0.15; 95% CI: − 0.19 to 0.49, p = 0.40) at 3–4 months. The results suggest that ω-3 PUFAs are an attractive adjunctive treatment for joint pain associated with rheumatoid arthritis, inflammatory bowel disease, and dysmenorrhea.

aDepartment of Psychology, York University, Toronto, ON, Canada

bSchool of Kinesiology and Health Science, York University, Toronto, ON, Canada

cDepartment of Anesthesia and Pain Management, Toronto General Hospital and Mount Sinai Hospital, Canada

dDepartment of Anesthesia, University of Toronto, Canada

*Corresponding author. Address: Department of Psychology, BSB 232, York University, 4700 Keele Street, Toronto, ON, Canada M3J 1P3. Tel.: +416 736 2100x40557; fax: +416 736 5814.

E-mail: jkatz@yorku.ca

Submitted September 1, 2006; received in revised form December 23, 2006; accepted January 22, 2007.

© 2007 Lippincott Williams & Wilkins, Inc.
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