Inclusion Criteria:

• Patients with either a pragmatic diagnosis of osteoarthritis of the knee, with no other known rheumatological condition and who report the following clinical features (based on the ACR classification for knee OA1):

  • knee pain on most days of the previous month
  • morning stiffness of less than 30 minutes duration
  • “stiffness” in resting the joint and and are aged over 40 years

• osteoarthritis of the hip, with no other known rheumatological condition and who report the following clinical features (based on the ACR classification for hip OA2):

  • hip pain on most days of the previous month and at least two of the following 3 features:
  • ESR < 20mm/hour
  • Radiographic femoral or acetabular osteophytes
  • Radiographic joint space narrowing (superior, axial and/or medial)
  • And are aged over 45 years of age
• The diagnosis of osteoarthritis will be confirmed by X-ray. Only patients who have grade 2 to 4 of the Kellgren and Lawrence scale will be recruited. (The Kellgren and Lawrence scale ranges from grade 0 to grade 4 where grades 0 and 1 represent doubtful osteoarthritic changes and therefore a doubtful diagnosis.)
• Patients who have been on stable medication (conventional or complementary, including nutritional medicine) for the past three months, but are still getting symptoms (incomplete responders)
• Only those patients who record baseline pain scores on the WOMAC scale of at least 20 mm on the VAS for a minimum of 6 out of 7 days monitored during the period from Clinic Visit 1 (screening) and Clinic Visit 2 (baseline)
• Ability to comply with the requirements of the study and to give informed consent
• For women of child-bearing potential: negative pregnancy test

Exclusion Criteria:

• Participation in an investigational trial within 30 days prior to enrollment
• Previous treatment with Devil’ s Claw within 90 days prior to enrollment
• Patients awaiting a replacement knee or hip joint
• Patients with other conditions that cause pain
• Patients with congenital dislocation of the hip
• Patients who have had operations on their hip due to previous trauma
• Patients with severe co-morbidities – including severe cardiac or pulmonary disease and cancer
• Dementia, psychoses, or other significant impairment of mental status that would prohibit sufficient comprehension, provision of informed consent and to allow undertaking of the necessary self-care or toxicity reporting
• Patients taking corticosteroid medication
• Known allergies against any of the ingredients of the treatments
• Patients who would be unable to complete the self assessment forms, or to attend for X-ray and clinical examination
• Patients with other known rheumatic disease such as rheumatoid arthritis
• Patients with the diagnosis gout
• Patients who report a red or hot swollen joint (which is unlikely to be due to OA), and would require further rheumatological assessment
• Patients with conditions known to be contraindicated to the study medication i.e. patients with gastric or duodenal ulcers; gallstones; patients taking drugs for arrhythmias; patients with heart failure
• Patients who are pregnant, trying to become pregnant or breastfeeding