Terminalia Chebula for Joint Pain: Does It Work?

observational-study PMID: 28969626

Quick Summary: Research suggests that a supplement made from Terminalia chebula fruit may help reduce joint pain and improve mobility in overweight adults, especially after exercise.

What The Research Found

This study looked at a special extract from the Terminalia chebula fruit, called AyuFlex. It found that taking this supplement:

Reduced knee pain during and after exercise.

Improved overall joint function and comfort.

Helped people walk further in a 6-minute test.

Study Details

Who was studied: 105 overweight adults (ages 35-70) who had knee pain when they exercised.

How long: The study lasted for 84 days (about 3 months).

What they took: Participants took either a placebo (a sugar pill), 250mg of AyuFlex twice a day, or 500mg of AyuFlex twice a day.

What This Means For You

If you're an overweight adult who experiences joint pain, especially with exercise, Terminalia chebula extract might help. It could potentially:

Make exercise more comfortable.

Improve your ability to move around.

Reduce post-exercise soreness.

Important: The study used a specific extract (AyuFlex). Results may vary with other Terminalia chebula products.

Study Limitations

The study only included overweight people with mild knee pain. It might not work the same way for everyone.

The study was relatively short (3 months). We don't know the long-term effects.

The study focused on pain and function, not on the underlying causes of joint problems.

Key Findings

AyuFlex®, a standardized aqueous extract of Terminalia chebula fruit, significantly improved joint health metrics in overweight adults with activity-induced knee discomfort. Key outcomes included enhanced global joint function (mKOOS, P=0.023), reduced knee discomfort during activity (VAS, P=0.001), improved 6-minute walk distance (P=0.047), and decreased post-exercise knee soreness (P<0.05 for both doses). The 250 mg twice-daily dose demonstrated comparable efficacy to 500 mg twice-daily for most endpoints, with no significant adverse events reported. COMP biomarker levels showed a non-significant decreasing trend (P=0.104).

Study Design

This was a randomized, double-blind, placebo-controlled clinical trial (RCT) with a 2-week placebo lead-in period. It enrolled 105 overweight, healthy adults (35–70 years) experiencing activity-induced knee discomfort (≥30 mm on 100 mm VAS) but no resting pain. Participants were randomized to placebo, AyuFlex® 250 mg twice daily (AyuFlex1), or 500 mg twice daily (AyuFlex2) for 84 days. Primary outcomes measured joint function via mKOOS and mWOMAC scales; secondary outcomes included VAS assessments, 6-minute walk test, and knee range of motion.

Dosage & Administration

Two doses of AyuFlex® were tested:
- AyuFlex1: 250 mg twice daily (total 500 mg/day)
- AyuFlex2: 500 mg twice daily (total 1,000 mg/day)
The supplement was administered as a standardized aqueous fruit extract in capsule form. Both doses showed efficacy, with no significant differences between them for most outcomes.

Results & Efficacy

mKOOS global scores: Significant improvement vs. placebo (P=0.023) for combined AyuFlex groups.
Knee discomfort (VAS): 30.1% reduction with activity (P=0.001) at day 84.
6-minute walk test: Increased distance covered (P=0.047) and reduced post-test discomfort (P=0.026).
Knee soreness post-exercise: Significant reductions for AyuFlex1 (P=0.022) and AyuFlex2 (P=0.043).
Whole-body joint function (VAS): Improved (P<0.029).
Biomarkers: COMP showed a non-significant downward trend (P=0.104); hsCRP and TNF-α remained stable. Safety parameters were within normal limits.

Limitations

The study exclusively enrolled overweight adults with mild activity-induced knee discomfort, limiting generalizability to clinical osteoarthritis populations or healthy-weight individuals. The 12-week duration may be insufficient to assess long-term effects on structural joint changes. Lack of an active comparator (e.g., glucosamine) and reliance on subjective outcome measures (e.g., VAS) introduce potential bias. Biomarker changes were minimal, suggesting limited impact on underlying pathology.

Clinical Relevance

For overweight adults experiencing exercise-related joint discomfort, Terminalia chebula extract (AyuFlex®) at 500 mg/day total dose may improve functional mobility and comfort without adverse effects. The 250 mg twice-daily dose offers equivalent efficacy to higher doses, supporting cost-effective supplementation. Results suggest utility for maintaining joint function during physical activity, though effects on structural joint integrity remain unproven. Users should prioritize this extract for symptom management rather than disease modification.