Yale Researchers Test an Epilepsy Drug for Osteoarthritis Pain and Cartilage Loss

A drug used to prevent seizures may one day help people with aching joints. Researchers at Yale tested lacosamide, an epilepsy medication, in early experiments on osteoarthritis. It eased pain and helped protect cartilage at the same time. It does this by acting on a single protein found in both pain nerves and cartilage cells. The team also tested a gel that releases the drug inside the joint, so one injection lasts about a month. The research is still early, and no one has tested it in people yet. Here is what the study found, and what you can do for your joints in the meantime.

Why Osteoarthritis Treatment Falls Short

Osteoarthritis (OA) develops when the cartilage that cushions and lubricates your joints is damaged and worn away. As the cartilage thins, the joint becomes painful and stiff. Hundreds of millions of people worldwide live with it.

The trouble is what we can offer them. Over-the-counter pain relievers and steroid injections dull the pain for a while, but neither stops the joint from deteriorating. Once the damage is advanced, the main option is joint replacement surgery, which comes with its own complications and a long recovery. Right now, no FDA-approved medicine both relieves OA pain and prevents cartilage from breaking down.

A team at Yale School of Medicine may have found a way to close that gap, and with a drug that already exists. Lacosamide is approved to treat epilepsy. Repurposing a drug like this saves time, because it has already passed safety testing and can move to a new condition faster than a brand-new compound.

The study, published in Bioactive Materials in February 2026, tested lacosamide in mice and in human cartilage cells in the lab. In both, the drug slowed cartilage breakdown and encouraged repair. In the mice, it also reduced pain-related behavior.

This is preclinical research. It has not yet been tested in people with OA. But the goal behind it matters to every patient with this condition. As lead researcher Chuan-Ju Liu put it: “We need therapies that don’t just mask pain but actually change how the disease progresses.”

The Protein Linking Pain and Cartilage Loss

Lacosamide works by blocking a protein called Nav1.7, and that’s why the Yale team looked at it. Nav1.7 sits on the surface of cells and helps them send electrical signals. It has long been linked to pain. It’s found in pain-sensing nerves, and people born with certain Nav1.7 mutations can develop unusual pain disorders.

Here’s what researchers found next: Nav1.7 isn’t only in nerves. It’s also in chondrocytes, the cells that look after your cartilage. These cells have two jobs: clearing out old, worn tissue and building new tissue. In a healthy joint, they keep the two in balance, and Nav1.7 stays fairly quiet.

In osteoarthritis, that balance tips. Nav1.7 becomes more active than it should be. The same protein that turns up pain signals also pushes cartilage cells to break tissue down faster than they rebuild it. One protein, two problems: pain and cartilage loss.

That’s the reasoning behind the treatment. If you block Nav1.7, you may be able to ease the pain and protect the joint at the same time. In the words of lead researcher Chuan-Ju Liu: “By blocking this single protein, we can potentially quiet the pain nerves and tell the cartilage cells to not only stop breaking down but start repairing as well.”

There’s also some human evidence on the pain side. Lacosamide has helped people with a rare nerve condition caused by Nav1.7 mutations. That’s a different disease from osteoarthritis, so it supports the idea but doesn’t prove it will work in arthritic joints.

Finding the Sweet Spot for Joint Repair

The researchers tested lacosamide in two settings: human cartilage cells grown in the lab, and mice with osteoarthritis. The results were consistent across both.

In the cell experiments, blocking Nav1.7 with lacosamide did two things. It slowed the breakdown of cartilage, and it nudged the cells to start making new cartilage proteins. In the mice, the drug reduced cartilage degeneration and pain-related behavior. Images from the study show cartilage restored in the joints of mice treated with lacosamide.

The most useful finding may be about dose. The team found a “sweet spot,” a narrow, low range where the drug worked best. Liu described it this way: “There is an optimal range where the drug helps restore balance without overcorrecting.” She also noted that “what stood out was not just its effectiveness, but how little of a dose was needed.” Earlier work had shown that a related drug could protect joints, but lacosamide reached the target with less medicine.

This matters for two reasons. A lower dose usually means fewer side effects. And it tells us cartilage cells respond to precise adjustment, not heavy-handed blocking. Liu’s takeaway: “This tells us the system is finely tuned.”

For readers, one practical point. Lacosamide is a prescription seizure medication. The dose used in these experiments was carefully tested for a specific purpose, and more is not better here. Nobody should take it for joint pain outside a doctor’s supervision.

Getting the Drug Where It’s Needed

The researchers also tested how to give the drug. In mice, injecting lacosamide directly into the affected joint worked better than giving it by mouth, even at lower doses.

There was a catch. Joints clear liquids quickly, so an injected drug doesn’t stay put for long. Repeat injections would be needed to keep it working, which isn’t practical for patients.

The team’s solution was a hydrogel, a soft, water-based gel. They built it from collagen type II, a protein that is a natural part of cartilage. It’s designed to solidify inside the joint and release lacosamide slowly over many weeks. Liu described it as “a local reservoir” that “holds the drug in place in the location it is needed most.” In her words, it “transforms a daily pill into a long-lasting, local treatment that stays active for a month or longer.”

The comparison in mice was clear. One injection of the lacosamide-loaded hydrogel every four weeks protected cartilage better than a daily oral dose.

For patients, this approach has two practical advantages. It means one treatment a month instead of a pill every day, which makes it easier to stick with. And it delivers the drug to the joint itself, not through the whole body. Whether that lowers side effects hasn’t been tested yet, so it’s too early to promise it.

My Personal RX on Protecting Your Joints for the Long Haul

Lacosamide is still years away from being proven in people with osteoarthritis, and nobody knows yet if it will work. Your daily habits are what you can act on today. Joints respond well to consistent care, and small changes add up over time.

Here’s what I’d tell a patient sitting in my office. If joint pain lasts more than a few weeks, see your doctor before you start any new routine.

1. Keep Moving: Walking, swimming, and cycling keep joints lubricated and reduce stiffness. Too much rest makes stiff joints worse.
   
2. Strengthen the Muscles Around Your Joints: Strong thigh and hip muscles take load off your knees. Aim for two strength sessions a week.
3. Watch Your Weight: Every extra pound puts roughly four pounds of added pressure on your knees as you walk. Even modest weight loss can ease pain.
4. Warm Up First: Spend five to ten minutes on gentle movement before exercise. Cold, stiff joints are easier to injure.
5. Support Your Joints From Within: My Collagen Plus Joint is formulated for joint function and comfort, and it fits easily into a daily routine.
6. Fill Common Nutrient Gaps: Bones and muscles carry your joints. The Core Four Bundle pairs Omega-3 Fish Oil with Vitamin D3 + K2, Ultra Cal-Mag, and MindBiotic for that foundation.
7. Eat More Anti-Inflammatory Foods: Build meals around fatty fish, vegetables, berries, nuts, and olive oil.
8. Use Heat and Cold: Heat eases morning stiffness. Cold helps with swelling after a flare-up.
9. Wear Supportive Shoes: Cushioned, well-fitted shoes reduce the impact that travels up to your knees and hips.
10. Follow a Complete Plan: Dr. Partha Nandi’s Protocol For Optimizing Your Health & Wellbeing shows how movement, nutrition, and sleep work together.

Sources:

1. Nield, D. (2026, October 13). FDA-Approved drug could be repurposed to relieve osteoarthritis pain and protect cartilage. ScienceAlert. https://www.sciencealert.com/fda-approved-drug-could-be-repurposed-to-relieve-osteoarthritis-pain-and-protect-cartilage
2. He, C., Huang, G., Moradi, L., Bi, J., Yang, X., Xin, L., Cui, X., Arya, V., Wiznia, D. H., Waxman, S. G., Fu, W., & Liu, C.-J. (2026). Collagen II hydrogel-mediated sustained delivery of lacosamide attenuates cartilage degeneration and pain in osteoarthritis. Bioactive Materials, 61, 640–656. https://doi.org/10.1016/j.bioactmat.2026.02.045