DMSO is Not Effective for Treating Arthritis
DMSO (Dimethyl Sulfoxide) is not recommended for the treatment of arthritis as there is insufficient evidence supporting its effectiveness and it is not included in current rheumatology treatment guidelines.
Current Treatment Guidelines for Arthritis
The 2021 American College of Rheumatology (ACR) guidelines for rheumatoid arthritis management make no mention of DMSO as a treatment option 1. Instead, these guidelines recommend:
- Methotrexate as the anchor drug for initial treatment of rheumatoid arthritis
- Disease-modifying antirheumatic drugs (DMARDs) for patients at risk of persistent disease
- A treat-to-target approach aiming for remission or low disease activity
- Combination therapy with biologic or targeted synthetic DMARDs when appropriate
The European League Against Rheumatism (EULAR) recommendations similarly do not include DMSO in their treatment algorithms for early arthritis or established rheumatoid arthritis 1.
Evidence Regarding DMSO for Arthritis
The limited research on DMSO for arthritis shows:
- A 1989 study found that intra-articular DMSO provided only short-term anti-inflammatory effects in rheumatoid arthritis patients 2
- A 1983 experimental study in rabbits showed that DMSO did not suppress arthritis and may have even worsened inflammatory and destructive joint changes 3
- A 1985 review concluded that while DMSO may provide temporary pain relief in arthritis, claims for anti-inflammatory effects or acceleration of healing are unwarranted, and it cannot alter the progression of degenerative joint disease 4
DMSO as a Vehicle for Other Medications
The only established medical use of DMSO related to arthritis is as a delivery vehicle for topical diclofenac:
- Diclofenac sodium 1.5% in 45.5% DMSO solution (D-DMSO) is approved in the US for osteoarthritis pain 5
- A 2009 study showed that topical diclofenac in DMSO vehicle was more effective than placebo or DMSO vehicle alone for knee osteoarthritis 6
Recommended Treatment Approaches for Arthritis
For rheumatoid arthritis, current guidelines recommend:
- Early initiation of DMARDs, ideally within 3 months of symptom onset
- Methotrexate as first-line therapy unless contraindicated
- NSAIDs for symptomatic relief at the minimum effective dose for the shortest time possible
- Short-term systemic glucocorticoids (<6 months) or intra-articular injections for local symptoms
- Regular monitoring of disease activity to guide treatment decisions
For osteoarthritis, topical NSAIDs (including diclofenac with DMSO as a vehicle) may be appropriate, but DMSO alone is not recommended.
Conclusion
While DMSO may have some use as a delivery vehicle for other medications like diclofenac, there is no evidence supporting its use as a standalone treatment for arthritis. Patients seeking arthritis treatment should follow established guidelines that recommend conventional DMARDs, biologics, and other evidence-based therapies under the care of a rheumatologist.