ProScan Imaging

Multiple locations in Cincinnati and Northern Kentucky

Supporting bones, muscles, joints, and recovery—with evidence in mind

Supplements can sometimes support musculoskeletal health, but I recommend that they are used to supplement a healthy diet.

They do not replace good nutrition, adequate protein, strength training, physical therapy, sleep, or appropriate medical treatment.

And more is not necessarily better. Your individual needs depend on your diet, medications, medical conditions, laboratory results, bone health, and goals.

To make the evidence easier to understand, we have included an evidence rating for the specific reason the supplement is being used.

STRONG — well-established evidence for this purpose
MODERATE — meaningful evidence, although limitations remain
MIXED — research results or professional recommendations differ
EMERGING — promising, but more research is needed

Calcium

Evidence: STRONG — bone health when dietary intake is inadequate

Calcium is an essential building block of bone. The goal is not necessarily to take a calcium supplement—it is to make sure you are getting enough total calcium from food + supplements.

Typical daily target

• Most adults: approximately 1,000 mg/day
• Women over 50 and adults over 70: approximately 1,200 mg/day

Food sources are generally preferred whenever possible. Divide the dose as well; potentially utilize food throughout the day, or start with food and if you notice you will be short that day, add a 500mg supplement at dinner.

If your diet already provides adequate calcium, additional supplementation may not be necessary.

Helpful tip: Calcium is absorbed best in smaller amounts rather than taking a large dose at once. Calcium citrate may be particularly useful for people with reduced stomach acid or those taking acid-suppressing medication.

Use caution if: You have kidney disease, a history of kidney stones, elevated blood calcium, or certain parathyroid disorders.

Vitamin D

Evidence: STRONG — deficiency and bone health

Evidence: MIXED — osteoarthritis pain

Vitamin D helps the body absorb calcium and is necessary for normal bone mineralization.

Low vitamin D can contribute to impaired bone health and, when significantly deficient, may contribute to muscle weakness.

Common supplementation

Often 800–2,000 IU of vitamin D3 daily, depending on diet, sun exposure, age, medical history, and laboratory results.

Vitamin D is one supplement where testing can help personalize the plan.

Higher-dose vitamin D should generally be used to correct a documented deficiency rather than taken indefinitely without monitoring.

More is not automatically better.

Magnesium

Evidence: STRONG — correcting inadequate magnesium intake

Evidence: EMERGING — specific musculoskeletal symptom benefits

Magnesium participates in hundreds of processes throughout the body, including normal muscle contraction, nerve function, energy production, protein synthesis, and bone metabolism.

Magnesium-rich foods include nuts, seeds, beans, whole grains, and leafy green vegetables.

When supplementation is appropriate, magnesium glycinate is frequently selected because it is generally well tolerated.

Common supplemental range

Approximately 100–350 mg of elemental magnesium per day, depending on dietary intake and individual needs.

Look at the label for elemental magnesium, not simply the total weight of magnesium glycinate.

Use caution if: You have significant kidney disease.

Magnesium can also interfere with the absorption of several medications, including certain antibiotics and osteoporosis medications.

Turmeric / Curcumin

Evidence: MODERATE — osteoarthritis pain and stiffness

Curcumin is one of the major active compounds found in turmeric.

Research suggests that certain curcumin preparations may provide modest improvement in pain and function in osteoarthritis, particularly knee osteoarthritis.

However, studies use very different formulations and doses, so results cannot necessarily be applied to every turmeric product on the shelf.

Common studied range

Approximately 500–1,000 mg/day of curcuminoids, depending on formulation.

Absorption varies dramatically among products.

Some supplements contain piperine, or black pepper extract, to increase absorption. Greater absorption may also increase the potential for medication interactions.

Use caution if: You take anticoagulant or antiplatelet medications, have gallbladder disease or liver disease, or are preparing for surgery.

Boswellia serrata

Evidence: MODERATE — osteoarthritis pain and function

Evidence: EMERGING — inflammatory/autoimmune joint conditions

Boswellia, also known as Indian frankincense, has a long history of use in Ayurvedic medicine.

Its active compounds, including boswellic acids, influence several inflammatory pathways.

Clinical studies in osteoarthritis suggest that Boswellia extracts may reduce joint pain and stiffness and improve function. However, many studies are relatively small and use specific standardized extracts.

Boswellia is also being studied for inflammatory and autoimmune conditions. Its mechanisms are compelling, but current clinical evidence is not strong enough to consider it a treatment for autoimmune arthritis or a replacement for rheumatologic therapy.

Commonly studied doses

Products vary considerably. Clinical studies have used standardized Boswellia extracts ranging from approximately 100–1,000 mg/day, depending on the concentration of boswellic acids and formulation.

For this reason, comparing products by milligrams alone can be misleading.

Use caution if: You are pregnant, take multiple medications, have gastrointestinal sensitivity, or are preparing for surgery.

For patients with rheumatoid arthritis or another autoimmune disease, supplements should complement—not replace—appropriate rheumatologic care.

Devil's Claw

Evidence: MODERATE — osteoarthritis

Evidence: MODERATE/EMERGING — short-term low-back pain

Devil's claw (Harpagophytum procumbens) is an herb native to southern Africa that has traditionally been used for musculoskeletal discomfort.

Evidence suggests it may provide modest benefit for osteoarthritis of the spine, hip, or knee, and some research suggests short-term improvement in low-back pain.

Much of the research has focused on extracts standardized for compounds called harpagosides.

Because products differ substantially, there is not one universally recommended milligram dose.

Important: Devil's claw is not appropriate for everyone.

Use caution or avoid if you have:

• Peptic ulcer disease
• Gallstones
• Certain heart or circulatory conditions
• Diabetes treated with glucose-lowering medication

It may affect blood glucose, blood pressure, heart rate, and medication metabolism.

Glucosamine + Chondroitin

Evidence: MIXED

Glucosamine and chondroitin are naturally occurring components of cartilage and remain among the most commonly used supplements for joint health.

Research results are inconsistent.

Some studies have shown modest improvement in osteoarthritis symptoms, while higher-quality studies have shown little or no meaningful benefit.

Professional guidelines also disagree.

For example, current American College of Rheumatology guidance recommends against glucosamine for knee, hip, and hand osteoarthritis and against chondroitin for knee and hip OA, while allowing that chondroitin may have a role in some patients with hand osteoarthritis.

If you choose to try glucosamine/chondroitin, consider it a time-limited personal trial rather than an automatic lifelong supplement.

Common studied doses

Glucosamine sulfate: approximately 1,500 mg/day

Chondroitin sulfate: approximately 800–1,200 mg/day

If you notice no meaningful improvement after approximately 8–12 weeks, there may be little reason to continue.

Use caution if: You take warfarin or other medications affecting coagulation. Discuss use with your physician if you have diabetes or significant shellfish allergy concerns.

Omega-3 Fatty Acids

Evidence: MODERATE — rheumatoid arthritis symptoms

Evidence: MIXED — osteoarthritis

EPA and DHA are omega-3 fatty acids found primarily in fatty fish and fish-oil supplements.

Their anti-inflammatory effects have been extensively studied.

For musculoskeletal conditions, evidence is more convincing for modest symptom improvement in rheumatoid arthritis than for standard osteoarthritis.

Whenever possible, consider food first.

Good sources include:

• Salmon
• Sardines
• Trout
• Herring
• Mackerel

If using a supplement, look at the amount of EPA + DHA, rather than simply the total milligrams of “fish oil.”

Supplementation should be individualized, particularly in patients taking medications that affect coagulation or those with certain cardiovascular conditions.

Schedule your injection

If we have not discussed an injection, please call or message to discuss prior to scheduling. Cancellation fees would apply.

Before Your Injection

One week before your injection, please let us know if you are taking a blood thinner, medications or supplements that may affect bleeding. We may have discussed this at your visit. If we did not, or you have questions, please call the office 7 days prior to the injection. Do not stop a prescribed blood thinner unless your prescribing clinician specifically tells you to do so. 

If you have diabetes, check your blood sugar at least the morning of your appointment. If it is high, please call prior to your appointment to let us know. We may need to reschedule your injection visit as corticosteroid injections can temporarily increase blood sugar for several days afterward. 

Please also tell us if you have an upcoming surgery, have recently had surgery, have had a recent fracture, have medication or latex allergies, or have had an unusual reaction to an injection in the past.

On the morning of your injection, please have breakfast or a light meal before coming to your appointment. 

Drink plenty of water unless you have been given different instructions. 

Call our office before your appointment if you are not feeling well, have a fever or recent infection, are taking antibiotics for an active infection, or have a rash, cut, sore, wound, or other skin problem near the area that will be injected. 

Wear comfortable clothing that allows easy access to the area being treated, and bring an updated list of your medications and supplements if we do not already have one.

After your injection, you may have mild soreness, pressure, bruising, or temporary increased discomfort at the injection site. 

Keep the injection area clean and dry for the remainder of the day, and avoid soaking in a bath, pool, or hot tub for 24 hours. 

Unless you were given different instructions, light daily activity is encouraged, but avoid strenuous exercise, heavy lifting, or activities that significantly stress the injected area for the first 24–48 hours. 

Ice may be used for 15–20 minutes at a time for discomfort with cortisone or gel injections; please use cool water only for PRP injections for the first 72 hours. 

Follow the medication instructions provided for your specific injection, as recommendations may differ depending on whether you received corticosteroid, hyaluronic acid, PRP, or another treatment. 

If you have diabetes, monitor your blood sugar more closely after a corticosteroid injection, as levels may temporarily increase. 

Contact our office if you develop increasing redness, warmth, swelling, drainage, fever, chills, severe or progressively worsening pain, or any other concerning symptoms. Seek urgent medical care for difficulty breathing, facial or throat swelling, or other signs of a severe allergic reaction.