Turmeric for pain relief - osteoarthritis

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Turmeric for pain relief - osteoarthritis

Healthylife Pharmacy10 May 2022|4 min read

Pain affecting any area of the body can be debilitating making it hard to perform normal daily activities. Curcumin obtained from the Turmeric longa plant root, can be used as a possible adjunct to pharmaceutical medicines, or used alone in some inflammatory and painful conditions, such as osteoarthritis.

Turmeric belongs to the Zingiberaceae family and contains different bioactive components, mainly curcumin and demethoxycurcumin, bis-demethoxycurcumin, and turmeric essential oils. It is a popular nutraceutical - a nutritional food which offers medicinal benefits- attributed to its anti-inflammatory, antinociceptive and antioxidant properties. As a supplement, turmeric is most commonly used as an extract containing standardized to 80-95% curcuminoids, primarily curcumin.

Anti-inflammatory action

When the body is injured, the immune system is activated and sends out initial responders – inflammatory cells and cytokines (substances that stimulate more inflammatory cells). This action begins the healing of damaged tissue.

It also results in swelling, redness, bruising and pain. Inflammation can be acute or chronic. Acute inflammation is the response that begins the healing process. Chronic inflammation is unresolved inflammation. The body continues to send inflammatory cells – even when the danger period is over. Chronic inflammation has been implicated in many diseases.

Curcumin has been shown through many different mechanisms to suppress inflammation in a similar action to non-steroidal anti-inflammatory drugs (NSAIDs). Curcumin modifies nuclear factor kappa B (NF-kB) signalling, proinflammatory cytokines and COX-2 activity. This results in a beneficial action on osteoarthritis. 

  • Nuclear factor kappa B (NF-kB) is recognised as a contributor to the development of osteoarthritis, shown to be abnormally activated in OA. Other nutrient able to inhibit NF-kB include green tea, rosehips and resveratrol.
  • Pro-inflammatory cytokines are involved in the process of pathological pain and inflammation.
  • COX-2 is induced in inflammation and repair.

Osteoarthritis

Osteoarthritis (OA) is a degenerative disease and the most common form of arthritis. It is a painful condition of the joints in which the protective tissue covering the ends of bones (cartilage) has worn down. Neck, hands, lower back, hips and knees are areas often affected. Pain is a common symptom. 

Deterioration of the cartilage is attributed to mechanical stresses – such as overuse, overload and joint injury. This can lead to cartilage degeneration, synovial inflammation,  thickening or hardening of the bone beneath the joint, and the formation of osteophytes (bone spurs). 

Inflammation is recognised as a major contributor to the development and advancement of osteoarthritis.

OA is most often seen in older people but can begin in earlier years if an injury has occurred to a joint.

Treatment goals

Current treatment focuses on reducing pain caused by inflammation, daily wear and tear and muscle strains. This is achieved through exercise and weight reduction, use of pharmaceutical medicines such as analgesics, steroids, and nonsteroidal anti-inflammatory drugs (NSAIDs). However, these medications are not recommended for long-term use. Introducing turmeric, offering the active ingredient curcumin.

Curcumin has not only been shown to reduce inflammation and pain, but also to have an inhibitory effect on changes to articular cartilage and the subsequent development of OA.

Turmeric can help with symptoms of osteoarthritis

Turmeric has been shown to:

  • Reduce joint inflammation and swelling
  • Alleviate pain
  • Reducing stiffness
  • Improving physical functions
  • Reduce exercise-induced inflammation and muscle soreness

Exercise is considered a key prescription in the treatment of arthritis, keeping joints mobile and lubricated. Muscles surrounding and supporting joints can be affected by inflammation due to oxidative stress resulting in symptoms of muscle soreness. Turmeric taken orally both before and after exercise was shown to increase antioxidant capacity in the blood and inhibited inflammatory mediators.  

Choosing a supplement

Turmeric has does not absorb well through the digestive process; it is metabolised rapidly and is quickly eliminated. This equals a poor bioavailability – meaning its potential medicinal value is lower. To achieve a more efficient bioavailability, curcumin maybe combined with components (such as black pepper (Piperine)), prepared as nanoparticles (small particles), or in liposomes, micelles and phospholipid complexes.

Evidence suggests Curcuma longa extract be supplemented for at least 12 weeks to achieve a benefit for osteoarthritis.

Safety precautions

Curcumin is generally considered a safe substance. It is a spice and may cause gastrointestinal discomfort in some people, as can formulas containing black pepper. Taking with food is recommended.

  • Avoid use in gall bladder disease or gallstones
  • Avoid use in pregnancy and/or breastfeeding
  • Use with caution with antiplatelet or anticoagulant medications (refer to health care provider)

Other turmeric attributes

Other benefits attributed to the properties of curcumin include antioxidant, antiviral, antibacterial, antifungal, antiprotozoal, immune modulating, antidiabetic and antifibrotic actions.

Although clinical trials are lacking to confirm the clinical efficacy of curcuma longa for many disordersits anti-inflammatory, pain-relieving properties and other attributes offer it as a possible adjunct or alternative therapy for many health conditions.  

References

  1. Curcumin, an active component of turmeric (Curcuma longa), and its effects on health https://pubmed.ncbi.nlm.nih.gov/26528921/
  2. Curcumin: A Review of Its Effects on Human Health https://www.mdpi.com/2304-8158/6/10/92/htm
  3. Nutraceutical - an overview | ScienceDirect Topics
  4. NF-κB Signaling Pathways in Osteoarthritic Cartilage Destruction https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6678954/
  5. Recent Developments in Delivery, Bioavailability, Absorption and Metabolism of Curcumin: the Golden Pigment from Golden Spice https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3918523/
  6. https://www.sciencedirect.com/topics/chemistry/micelle
  7. Therapeutic effects of turmeric or curcumin extract on pain and function for individuals with knee osteoarthritis: a systematic review https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7812094/
  8. A review of therapeutic potentials of turmeric (Curcuma longa) and its active constituent, curcumin, on inflammatory disorders, pain, and their related patents https://onlinelibrary.wiley.com/doi/10.1002/ptr.7224
  9. Efficacy of Turmeric Extracts and Curcumin for Alleviating the Symptoms of Joint Arthritis: A Systematic Review and Meta-Analysis of Randomized Clinical Trials https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5003001/
  10. Curcumin, the active substance of turmeric: its effects on health and ways to improve its bioavailability https://pubmed.ncbi.nlm.nih.gov/34143894/
  11. Bioavailable turmeric extract for knee osteoarthritis: a randomized, non-inferiority trial versus paracetamol https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7847013/
  12. Curcumin: A Review of Its Effects on Human Health https://www.mdpi.com/2304-8158/6/10/92/htm
  13. The efficacy and safety of Curcuma longa extract and curcumin supplements on osteoarthritis: a systematic review and meta-analysis https://pubmed.ncbi.nlm.nih.gov/34017975/
  14. The efficacy and safety of Curcuma longa extract and curcumin supplements on osteoarthritis: a systematic review and meta-analysis https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8202067/