Osteoarthritis (OA) is the most common joint disease worldwide and its rising prevalence is supported by factors such as obesity and sedentariness. At molecular level, it is considered an inflammatory disease that leads to destruction of articular cartilage. An effective therapy to end the degenerative process of arthritis remains elusive, and most of the therapeutic tools prevent the progress or alleviate the symptoms. By now, medicines for OA are available for oral, topical or intra-articular (IA) therapy and include analgesics, nonsteroidal anti-inflammatory drugs, corticosteroids, hyaluronic acid. Compared with the conventional oral administration, IA therapy has multiple advantages in terms of bioavailability, efficacy and toxicity. This review aims at underlying the beneficial effect of herbal medicine in OA therapy and to open new research perspectives. Herbal medicine administered orally or topically exhibit pharmacological properties that could be relevant for their beneficial effect in OA, mainly anti-inflammatory and antioxidant effects. There are few studies regarding IA injections of plant extracts/ compounds and none related to any combination with agents used already in clinic. Designing natural pharmaceutical formulations with increased bioavailability, safe and lack of side effects, specifically tested, would be a plus for medicinal plant areas of research and a novelty for clinic.