My husband and I have been using SierraSil for approximately 6 years. I have been using it for a very long-standing hip pain, and my husband has used it to relieve arm and knee pains. We have both found it to be wonderfully effective. I have also found that it has eased pains in my wrist, knuckles and toes. I am almost never bothered by joint pain at all now. We have both found that SierraSil works best when taken in the middle of the night (upon getting up to use the washroom) or the early morning hours (i.e. several hours after and before eating). It appears to be most effective when taken on a truly empty stomach.