This review examines the applications of natural coumarins in the context of bone and joint disorders. It provides comprehensive coverage of their fundamental pharmacology, the epidemiology and pathological mechanisms of osteoarticular diseases, as well as the pharmacological actions, clinical applications, future prospects, and ongoing challenges associated with these compounds. Through systematic analysis of relevant studies, we summarize the basic characteristics of natural coumarins, including their chemical structures, metabolic pathways, and pharmacological activities. We also examine their mechanisms of action in conditions such as osteoarthritis, rheumatoid arthritis, and osteoporosis, with a particular emphasis on their anti-inflammatory and cartilage-repairing properties. Furthermore, we summarize current clinical trials, formulation development, delivery strategies, and safety evaluations. We also explore potential new indications, combination therapies, and personalized treatment approaches. Several controversies and ongoing challenges are discussed, including variability in dose-dependent efficacy, divergent therapeutic outcomes across diseases, and concerns regarding long-term safety. This review aims to provide a foundational reference for further research and clinical application of natural coumarins in the treatment of bone and joint disorders.
Ma et al. (Fri,) studied this question.