In a 2×2 factorial randomized controlled trial of 117 adults with knee osteoarthritis, both inulin prebiotic supplementation and physiotherapy-supported exercise independently produced clinically meaningful reductions in pain vs placebo, with exercise improving functional mobility and inulin uniquely improving pain sensitivity and grip strength. Inulin was also associated with increased glucagon-like peptide-1 and butyrate levels, suggesting a potential gut–muscle and gut–pain axis mechanism, although no synergistic effect between interventions was observed.

Source: Nutrients