Additionally, various forms of physical therapy offer established non-pharmacologic benefits. Examples of complimentary medicines that have been proposed to offer benefits for osteoarthritis include acupuncture, nutraceuticals and botanicals. Use of complimentary medicine as an alternative therapeutic approach is common in conditions associated with pain and discomfort and especially when local traditions support such approaches. However, recent studies have revealed heightened cardiovascular risks, which may limit the application of the COX-2 specific class of NSAIDs. Moreover, therapy has recently been dominated by the COX-2 specific class, which was designed to reduce unwarranted renal and gastrointestinal side-effects associated with non-specific COX inhibitors. NSAIDS provide symptomatic relief but do not abrogate the underlying disease process. Pharmaceutical approaches to disease management include the popular non-steroidal anti-inflammatory class (NSAIDs) which block cyclo-oxygenase (COX). Despite the prevalence of the disease, current therapeutic options are not optimal. Osteoarthritis is a painful and debilitating joint condition that affects hundreds of millions worldwide. Sierrasil may offer an alternative therapy in subjects with joint pain and dysfunction. The natural mineral supplement, sierrasil alone and in combination with a cat's claw extract, improved joint health and function within 1–2 weeks of treatment but significant benefits over placebo were not sustained, possibly due to rescue medication masking. Tolerability was good for all groups, no serious adverse events were noted and safety parameters remained unchanged. Rescue medication use was 28-23% lower in the herbomineral combination and high dose sierrasil groups although not statistically different from placebo (P = 0.101 and P = 0.193, respectively). VAS was significantly improved at 4 weeks in all groups (p < 0.001) but was significantly greater in all sierrasil groups compared to placebo (p < 0.05). In contrast, after 1 or 2 weeks of therapy all the sierrasil groups displayed significant reductions in WOMAC scores (p < 0.05) and at week 4 displayed a 38–43% improvement. Placebo-treated individuals failed to show significant benefits at 4 weeks (11% reduction in total WOMAC). In reference to baseline values sierrasil treated groups had a considerably faster onset of benefits. 27%) but this was not statistically significant. All four groups showed improvement in WOMAC and VAS scores after 8 weeks (p < 0.001), in all 3 groups receiving sierrasil the magnitude of benefits were greater vs. Ninety-one of the 107 patients successfully completed the protocol. Safety measures included vital signs and laboratory-based assays. Visual analog score (VAS) for pain, consumption of rescue medication (paracetamol), and tolerability were secondary variables. Primary efficacy variables were WOMAC scores (A, B, C and total). Patients (n = 107) with mild to moderate osteoarthritis of the knee were randomly assigned to one of 4 groups high dose sierrasil (3 g/day), low dose sierrasil (2 g/day), low dose sierrasil (2 g/day) + cat's claw extract (100 mg/day) or placebo, administered for 8 weeks. This study was designed to determine if a natural mineral supplement, sierrasil, alone and in combination with a cat's claw extract ( Uncaria guianensis), vincaria, has therapeutic potential in mild to moderate osteoarthritis of the knee.