Turmeric, Black Seeds, Flaxseed and Medicago Sativa in Knee Osteoarthritis

Inclusion Criteria: At least 6 months of diagnosis of knee osteoarthritis, and whose OA diagnosis meets the American College of Rheumatology criteria, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain subscale baseline value of ≥ 9 (0-20 scale), Functional Capacity Classification of I-III, Radiograph evidence of OA in the target knee with a Kellgren-Lawrence score of 2 or 3, Morning stiffness of <30 min duration or crepitus on active motion, which are present upon examination. Exclusion Criteria: Evidence of other conditions or diseases of the skin or joints, Evidence of partial or complete knee joint replacement or anticipated joint replacement in the target knee, Contraindications to the use of non-steroidal anti-inflammatory drugs (NSAIDs) or who use anticoagulant therapy that prohibits them from using NSAIDs, Pregnancy, planning to become pregnant or breastfeeding during the study period, Ischemic heart disease, heart failure, end-stage cirrhosis, end-stage renal failure, or psychiatric conditions that prevent an adequate evaluation of the study outcomes, Insufficient cognitive functioning to participate and complete the questionnaires, Unable or unwilling to follow up and complete the study pathway, Having active cancer undergoing treatment that prevents the evaluation of the outcome measures, A history or diagnosis of other arthritic conditions, such as rheumatoid arthritis, joint and bone deformities, fibromyalgia, and/or other inflammatory and immune system disorders, Type I or II diabetes or obesity (body mass index ≥ 39), Suffering from painful conditions or frequent headaches requiring the use of systemic opiates or derivatives, or the need for additional NSAID or COX-2 inhibitors, Receiving systemic or intra-articular corticosteroid injections.