Magnesium for Joint Pain

What is Magnesium?

Magnesium is an abundant alkaline earth metal. It is easily found in the earth’s crust and seawater as salts.

Magnesium is essential to living systems. It is incorporated into the chlorophyll of plants. In humans, magnesium is required by more than 300 different enzymes for their proper functioning. It is also important because of its roles in the formation and regulation of essential compounds such as the energy molecule, ATP, and genetic materials like DNA and RNA.

Because magnesium ions dissolve easily in water, they are present in mineral water. Since it is sour to taste, magnesium gives mineral water a natural sour taste.

Although magnesium is easily obtained from the diet and its deficiency is rare, more than half of the population never meets the recommended daily intake values.  Magnesium can be obtained from green leafy vegetables, nuts, cereals, spices, coffee, and tea.

Ideally, about 24 grams of magnesium is stored in the human body. Only 1% of this is found in extracellular spaces. 60% are found in the skeleton and 39% inside the cells with 20% of this found in the cells of the skeletal muscles.

Even when the serum levels of magnesium remain within the normal range, there can still be a deficiency of the mineral within cells.

Although magnesium deficiency may occur silently, its symptoms can be pronounced.

Magnesium deficiency and even chronic, low levels of magnesium can cause asthma, diabetes, and osteoporosis. Adequate magnesium levels are also beneficial for reducing the risks of heart attack and stroke; for reducing migraine headaches and joint pain due to fibromyalgia and arthritis.

Low levels of magnesium can be due to reduced absorption due to phytate and fat. Phosphates can also compete with the absorption of magnesium.

However, magnesium improves the absorption of calcium.

Magnesium: Salts, Supplement and Safety

Magnesium is sold both as a dietary supplement and pharmaceutical preparation. Magnesium salts can be used to treat eclampsia, magnesium deficiency as well as to restore magnesium levels in people with hypomagnesemia.

The bioavailabilities of magnesium from its salts vary.

For example, magnesium oxide is the most common type of magnesium supplement; it has the highest magnesium content by weight of all magnesium supplements but it is also the one with the least bioavailability. This means that the amount of magnesium released from it and available to cells for use is rather low.

The amino acid salts have a better absorption profile and of these, magnesium citrate is the best.

Magnesium is a safe mineral. It is easily excreted from the body since it is water-soluble. Magnesium obtained from dietary sources is mostly excreted through the kidneys with urine. Therefore, there is a very low chance of toxicity from dietary sources.

However, toxicity can occur from oral magnesium supplements and drugs especially when after the ingestion of large doses by people with poor renal function.

Magnesium, Bone Health, and Arthritis

A 2004 paper published in The Journal of Nutritional Biochemistry examines the scientific literature on the link between osteoporosis and magnesium deficiency both in clinical studies with human participants and laboratory studies using animal models.

Given that the reported magnesium intake for the average citizen is lower than the recommended intake, the study concluded that the risk and incidence of magnesium deficiency are far higher than currently believed.

This paper also identified the possible causes of bone loss in people with chronic magnesium deficiency.

Magnesium deficiency causes long-term changes in skeletal bones and hormonal balance in the body. It also influences the immune system.

The study specifically mentioned the release of inflammatory cytokines by Substance P due to magnesium deficiency.

In addition, magnesium deficiency increases the production of parathyroid hormone and reduces the production of vitamin D which functions as a hormone and is also needed for mineralization of the bones.

A third mechanism by which magnesium deficiency weakens the bones is through the depletion of calcium. Since magnesium improves the absorption of calcium, magnesium deficiency is almost always followed by calcium deficiency.

With low calcium levels, the body starts depleting the bones of calcium. This weakens the bones and the joints. In fact, where megadoses of calcium supplements are taken without also including magnesium, the result can be damaging.

Large doses of calcium in the absence of magnesium will cause the calcification of soft tissues and joints. Since calcium supplementation without magnesium can cause the deposition of calcium in the joints, it is not advisable since it does not properly mineralize the bone but cause joint pain.

Therefore, the overall results of magnesium deficiency are osteoporosis, arthritis, and joint pain.

In a 2009 study published in the journal, Osteoarthritis, and Cartilage, the efficacy of magnesium sulfate in the treatment of osteoarthritis and joint pain was accessed in rats.

In that study, the rats were injected with collagenase in the knees. Collagenase is an enzyme that breaks down collagen. In this case, it weakened the cartilage and induced arthritis symptoms.

After 1 week, the rats were divided into 2 groups. The first group was injected with magnesium sulfate in the same knee while the other group only got a placebo in the form of normal saline.

Both groups were then observed and regularly examined for 8 weeks.

The results showed that magnesium sulfate was effective in reducing the inflammation of the synovial membrane. Also, there was less swelling and cartilage degeneration in the rats receiving the magnesium salt compared to those who got normal table salt.

Magnesium sulfate also increased the metabolism of the cells making up the cartilage while reducing their rate of dying. Finally, magnesium was able to reduce pain transmission and the perception of joint pain in the rats.

Magnesium and Joint Pain

Magnesium is needed for the mineralization of the bone. In fact, some experts argue that it is more important than calcium for this purpose.

When calcium is present without equal or even greater amounts of magnesium, the body switches on the parathyroid hormone to start removing calcium from the bones.

While this is a corrective feedback mechanism to prevent over-calcification of the bones, the high levels of calcium cannot mineralize the bone without magnesium. Therefore, this results in the removal of calcium from the bones even though it was never added in the first place.

When the parathyroid hormone removes calcium from the bone, it deposits it in soft tissues and joints.

When calcium builds up in the joints, it reduces the articulation of those joints and causes joint pain. Therefore, magnesium is needed to reduce the activity of the parathyroid hormone, to prevent the deposition of calcium in the joints and to prevent the demineralization of the bones.

For these reasons, magnesium supplements are needed to prevent joint pain. To do this, magnesium has to balance out calcium. It will improve calcium absorption as well as promote the proper use of calcium to help rebuild the bones.

Magnesium also prevents the activation of parathyroid hormone and the chain reaction it triggers.

However, the parathyroid hormone is not the only important endogenous compound affected by magnesium levels. Another important compound that is increasingly active during magnesium deficiency is Substance P.

Substance P is a neuropeptide with different functions. It can act as a neurotransmitter and also as a modulator of other neurotransmitters. It is involved in the transmission of pain from the peripheral nerves to the central nervous system. Therefore, Substance P is important to the perception of joint pain.

The effect of Substance P becomes more pronounced when there is a deficiency of magnesium.

This neuropeptide is also involved in the formation of edematous swelling which can occur at the joint to worsen pain. Swelling makes the joint tender and painful to touch.

In addition, the accumulation of fluid develops a pressure that presses on pain nerves. The sensation of joint pain is them amplified by Substance P on its way to the brain.

Therefore, magnesium is needed to reduce the ability of Substance P to amplify and transmit joint pain. In this way, magnesium behaves very much like painkillers.

How to Take Magnesium for Joint Pain

Make sure to consult your doctor before starting on magnesium supplementation. This is necessary especially if you are also taking other drugs to manage your joint pain or other diseases.

People with kidney or heart problems should only take magnesium supplements under the supervision of their prescribing physicians. This is because kidney problems reduce the excretion of magnesium and can cause toxicity. In addition, high doses of magnesium can dramatically slow down heart rate and cause hypotension.

Ideally, you should reduce your calcium intake if you are already taking calcium supplements. This will help you regain a good calcium-magnesium balance while preventing the worsening of your joint pain due to calcium deposition in the joints.

In the US, the calcium-magnesium ratio is usually 10:1 in the diet. The ideal ratio should be 1:1 and magnesium supplements can be used to achieve this.

The recommended dose of magnesium supplements for adults is 300 – 400 mg per day. However, this can be increased to 600 mg per day to produce faster results. Furthermore, vitamin B complex is recommended to be taken along with magnesium. This is because vitamin B6 controls the amount of magnesium taken up by the cells.