By Michael Grenon
Curcumin and Its Uses
Turmeric is a spice used around the world for both medical and culinary purposes. Curcumin is a substance derived from the turmeric root system that contains medicinal properties that continue to be discovered. Curcumin can be consumed with food and in drinks. This substance can also be supplemented via oral capsules which can be purchased on nearly any grocery store.
According to a 2017 published review, this substance can be used as an antioxidant and anti-inflammatory as well as be used for the management of conditions such as hyperlipidemia, anxiety, and arthritis. This article will explain the effect of curcumin supplementation on the management or treatment of osteoarthritis, one of the most common progressive and autoimmune disorders in the United States.
Osteoarthritis Overview
Osteoarthritis is one of the most common chronic musculoskeletal disorders in the United States. A 2012 study found that his autoimmune condition is the leading cause of disability in the elderly population. Osteoarthritis is a progressive degeneration of articular cartilage together with the formation of osteophytes (bone spurs) within the joint spaces, subchondral bone remodeling, and physical changes to the joint capsules, ligaments, surrounding muscles, and even meniscal tears. Treatment options include physical therapy, oral nonsteroidal anti-inflammatory drugs (NSAIDs), intra-articular corticosteroid injections, oral supplementation, and eventually, joint replacement.
If osteoarthritis is left untreated, its’ progressive effect can be debilitating, often leading to sedentary lifestyles. According to the American College of Sports Medicine (ACSM), a sedentary lifestyle can lead to disability. This suggests the importance of regular exercise for an individual regardless of background or physical condition.
Curcumin vs. Ibuprofen
Researchers have been studying curcumin supplementation for its relative anti-inflammatory effects for several years. Ibuprofen, an NSAID that can be taken orally for the management of pain and inflammation experienced from osteoarthritis, has also been investigated. A 2014 study compared curcumin to ibuprofen on 367 primary knee osteoarthritis patients who reported a pain scale of at least 5.
This group of participants was randomly assigned to either an ibuprofen or curcumin regimen group. The groups were administered either 1,200 mg of ibuprofen or 1,500 mg of curcumin extract daily for a total of four weeks. Pain scale, joint stiffness, and functional scores were assessed throughout this study according to the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Statistically significant improvements were observed with no apparent superiority observed between either group.
However, there was a report of abdominal pain or discomfort experienced frequently among participants in the ibuprofen supplementation group. Curcumin was shown to be similarly effective to ibuprofen for the management of osteoarthritis with a reduced incidence of gastrointestinal distress. Findings from this study could encourage healthcare providers to be more comfortable advising patients to supplement curcumin into their regular diets.
Curcumin vs. Acetaminophen
Acetaminophen is another option for pain management among individuals with osteoarthritis. This medication is also known as Tylenol. Its analgesic properties make acetaminophen a reasonable option for the treatment of symptoms associated with osteoarthritis according to the National Center for Biotechnology Information. A 6-week 2021 study compared acetaminophen or turmeric extract and their effect on pain, physical function, and joint stiffness according to the WOMAC scale among individuals with knee osteoarthritis. 143 participants were randomly assigned to either a turmeric extract or acetaminophen supplementation group. Participants took a 500 mg capsule of turmeric extract twice daily or 650 mg of acetaminophen three times daily for a total of six weeks.
At the conclusion of the study, WOMAC scores were noted to be statistically significant among the turmeric extract group when compared to the acetaminophen group. There were also milder and fewer adverse events reported among the turmeric extract group. The results produced from this specific study suggested that turmeric extract may be as effective as acetaminophen for the reduction of pain and other related symptoms of knee osteoarthritis.
Curcumin vs. Diclofenac
Diclofenac is another NSAID considered for the management of symptoms from osteoarthritis. Known for its anti-inflammatory and analgesic properties, diclofenac can be taken orally or applied topically. In 2019, a randomized, open-label, parallel-arm study looked at the safety and effectiveness of curcumin supplementation versus diclofenac.
In this study, 139 participants diagnosed with knee osteoarthritis were randomized into either a curcumin or diclofenac supplementation regimen for 28 days. Those assigned in the curcumin group received a 500 mg capsule of curcumin three times daily. Participants assigned to the diclofenac supplementation received a 50 mg tablet two times daily.
Assessments of pain by a visual analog scale score were assessed at baseline, and on days 7, 14, and 28. Other assessments included a Knee Injury and Osteoarthritis Score (KOOS), anti-flatulent effect, anti-ulcer effect, and weight-lowering effect. Patient and physician global assessments of therapy were also performed in this 28-day study. Results from this study showed similar improvements made between both the curcumin and the diclofenac groups regarding the severity of pain, KOOS score, and patient to physician global assessment of therapy. No statistically significant superiority was observed. Anti-flatulent effects, anti-ulcer effects, and weight-lowering effects were also observed within the curcumin group.
Participants required additional medication for adverse gastrointestinal effects experienced during the diclofenac supplementation. The results suggest that curcumin is similarly effective as diclofenac for the management of chronic knee osteoarthritis. Fewer adverse side effects were endured by those who consumed curcumin. The results appear to support the relative effectiveness of curcumin supplementation for the treatment of symptoms experienced by chronic osteoarthritis.
Curcumin vs. Placebo
As shown, compared to other forms of oral medication, curcumin may be a viable option for the noninvasive management of osteoarthritis symptoms. Research continues to explore curcumin and its uses in the fields of health and wellness. A randomized, double-blind, and placebo-controlled 2021 study observed the effects of curcumin versus placebo for accurate measurements of efficacy. In this study, 101 adults diagnosed with knee osteoarthritis were randomized into a placebo or curcumin supplementation group for eight weeks.
For the curcumin supplementation group, participants orally consumed 500 mg of curcumin extract two times daily. The placebo group participants were given placebo capsules for the same frequency and duration. Assessments performed included the KOOS score, knee pain ratings, the Japanese Orthopedic Association Score of Osteoarthritic Knees (JOA).
Other performance-based testing included a 40-meter fast-paced walk test, six-minute walk test, a timed up-and-go test, and a 30-second chair stand test. At the conclusion of the eight-weeks, there were considerable improvements observed in the curcumin supplementation group. A statistically significant reduction in KOOS knee pain and numeric knee pain ratings were observed. The curcumin supplementation group exhibited greater improvements on the timed up-and-go test, six-minute walk test, and the JOA overall score.
The results of this study are important to ensure consistency and accuracy of studies previously mentioned. This study compared curcumin supplementation to virtually no supplementation at all. All participants tolerated the curcumin supplementation well with no adverse effects observed. These results continue to suggest support that curcumin supplementation may be a safe and effective option for the management of progressive osteoarthritis.
Health Risks Compared
In the previously mentioned research studies, curcumin has been identified as a useful method for pain and symptom management of chronic osteoarthritis. Prolonged use of nonsteroidal anti-inflammatory drugs such as ibuprofen and diclofenac may be harmful to the health of patients. In the studies mentioned above, adverse gastrointestinal effects were experienced among groups with the ibuprofen and diclofenac supplementation. A 2010 manuscript explained the health risks of chronic NSAID use. In this published article, the authors explain that adverse effects of chronic NSAID usage may increase the risk of peptic ulcer disease, acute renal failure, and stroke or myocardial infarction.
Extensive acetaminophen use can also induce other health complications. Although this medication can be useful for pain management, a 2021 study suggested the adverse effects of chronic acetaminophen use can lead to an increased risk of nephrotoxicity, anemia, nausea, vomiting, and eventually, potential liver failure. However, although turmeric is generally safe, nausea and diarrhea are common side effects if taken in high doses or if curcumin is consumed long-term.
Curcumin as an Option
Curcumin appears to be a viable option for symptom management of osteoarthritis. Its anti-inflammatory effect has been shown to be comparable to ibuprofen or diclofenac supplementation with similar improvements in joint stiffness, performance-based testing, and pain scale reports. The health risk of curcumin supplementation was noted to be less than the risk of either NSAID or acetaminophen consumption.
With the similar improvements using curcumin in those diagnosed with osteoarthritis, it could be considered an ancillary method of management. Clinicians may consider supplementation of this effective substance as it is readily available in grocery stores. Before considering curcumin supplementation, patients should consult with their physician for advice.
Curcumin is not recommended if an individual has medical conditions such as gallbladder or kidney disease, bleeding disorders, diabetes, or immunity problems. Because overmedication is a growing issue in the United States, curcumin supplementation could help reduce medication consumption.
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