Turmeric and Osteoarthritis
Arthritis is one of the most common human ailments. This word comes from the Greek words arthro and itis, which together mean “joint inflammation.” There are many types of arthritis, but osteoarthritis is the most common form of arthritis in adults. Osteoarthritis is also called degenerative joint disease. Osteoarthritis is caused by many factors including age, genetics, inflammation, and mechanical stress (wear and tear).
Despite years of research, doctors do not have a cure for osteoarthritis. Standard osteoarthritis treatment often involves treating the symptoms, not the underlying degenerative disease. Most doctors recommend oral NSAIDs (non-steroidal anti-inflammatory drugs) in addition to topical medications, a brace, weight loss, and exercise. However, side effects of NSAIDs are well known: stomach ulcers, gastrointestinal problems, kidney disease, high blood pressure, and cardiovascular disease. Patients should take caution when using NSAIDs long-term or in high doses.
Because of the limits of NSAIDs and traditional osteoarthritis treatments, patients have looked to alternatives for relief. The nutrition supplement industry has boomed. Turmeric is one option which has become popular lately.
Turmeric is a well-known spice. It is a plant native to Asia related to ginger root. Turmeric has a yellow-orange or golden color and it is widely used in Asian and Indian food. Turmeric has also been used in Chinese, Ayurvedic, and traditional Eastern Medicine for many centuries. There are several components in turmeric root, but curcumin is thought to have the biggest role in health. Curcumin has many anti-inflammatory properties, similar to NSAIDs. In some studies curcumin reduces COX-2 activity and modifies other pro-inflammatory pathways in the body. This is possibly how turmeric can reduce arthritis pain.
There have been many, many scientific studies evaluating turmeric (and curcumin extract) for treating osteoarthritis symptoms. At least 10 of these studies compare turmeric to a control group given a placebo (sugar pill). The majority of these studies report a significant reduction in pain. Some studies also show improved function in patients with knee osteoarthritis. More studies are recommended to confirm these results.
In these trials, the dosage of turmeric was not standardized. We therefore cannot conclude what is the best dose to take. However, many trials used 1000 mg per day of curcumin, and adverse events were uncommon at this dose. Very high doses are not advisable due to potential side effects.
Side effects from turmeric are uncommon and typically mild: nausea, diarrhea, and acid reflux. No serious side effects were listed in the studies reviewed for this article. Caution should be used in patients who are on strong blood thinners, such as coumadin (warfarin), because turmeric can act as a mild blood thinner.
The United States FDA does not monitor nutritional supplements in our country. What is listed on the bottle label may not be what is actually in the bottle. We have to take the manufacturer’s word for it. Some turmeric products have been shown to contain low-quality fillers and contaminants. When choosing a brand to buy, consider asking your pharmacist or using products that have been certified by third-party quality controls. Some patients have difficulty absorbing curcumin in the GI tract. Products which contain black pepper (piperine) can help with intestinal absorption.
Because turmeric (and curcumin extract) is safe and often effective in reducing osteoarthritis pain, it may be reasonable to try if deemed safe by your doctor. A hand surgeon can assist in offering treatment options and develop a comprehensive care approach with each patient with hand osteoarthritis.
Dr. John M. Erickson is a hand and upper extremity specialist at the Raleigh Hand Center. He trained in orthopedic surgery at the University of Michigan and completed a hand surgery fellowship at Vanderbilt University. He is an active member of the American Society for Surgery of the Hand (ASSH).