Turmeric for Arthritis Pain

Turmeric root and supplements
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Turmeric, the spice ground from the root of the Curcuma longa plant that gives curry its bright yellow color, may help relieve joint pain and inflammation associated with osteoarthritis (OA) and rheumatoid arthritis (RA).

Used for centuries in Ayurvedic medicine to treat arthritis, modern research has isolated the antioxidant curcumin as the key beneficial component in turmeric. A 2016 meta-analysis of research found curcumin may relieve pain as well as non-steroidal anti-inflammatory drugs (NSAIDs) in people with RA or OA.

How Turmeric May Help Arthritis

A relative of ginger, turmeric is a powerful anti-inflammatory that blocks cytokines and enzymes involved in the inflammation process.

Due to the lack of substantial supporting research, the National Center for Complementary and Integrative Health advises against using turmeric supplements to prevent or treat any health condition, including osteoarthritis and rheumatoid arthritis. 

However, there is at least some research supporting its use.

In laboratory studies, curcumin was shown to inhibit mediators of the inflammatory response—the same that are common targets of disease-modifying anti-rheumatic drugs (DMARDs) and anti-inflammatory medications. These include pro-inflammatory pathways such as nuclear factor-kappa B (NF-κB), mitogen-activated protein kinase (MAPK), and Janus kinase (JAK)/signal transducer.

In addition, curcumin reduces the secretion of tumor necrosis factor-alpha (TNF-α), interleukin-1 beta (IL-1β), and COX-2-induced prostaglandin G2 (COX-2).

Rheumatoid Arthritis

Rheumatoid arthritis is a chronic, inflammatory type of arthritis that primarily affects the lining of your joints. An autoimmune disorder, rheumatoid arthritis causes the body to mistakenly attack the joints, causing pain, swelling, and stiffness. It is commonly treated with DMARDs, corticosteroids, and non-steroidal anti-inflammatory drugs (NSAIDs).

Curcumin appears to work to treat RA by targeting the immune system using similar pathways as some DMARDs. These include: 

  • TFN-a antagonists: Remicade (infliximab), Enbrel (etanercept), Humira (adalimumab), Simponi (golimumab), and Cimzia (certolizumab)
  • JAK/signal transducers: Olumiant (baricitinib), Xeljanz (tofacitinib), and Rinvoq (upadacitinib).
  • IL-1B inhibitor: Kineret (anakinra)

Animal studies suggest curcumin works to combat rheumatoid arthritis by alleviating synovial hyperplasia (inflammation of the connective tissue that lines joints). To date, human studies investigating the effect of curcumin or turmeric in the treatment of RA are limited but show promise.

One study found curcumin may be as effective as the NSAID Voltaren (diclofenac sodium). In the 2012 paper, 45 people with RA took either 500 milligrams (mg) curcumin, 50 mg of Voltaren, or both. At the study's end, those taking curcumin showed the greatest improvement in RA symptoms.

A 2017 randomized controlled trial of a highly bioavailable form of curcumin found it safe and effective for relieving RA symptoms. Investigators gave 36 people with RA either 250 mg of curcumin, 500 mg of curcumin, or a placebo daily for 90 days. At the end of the study, both curcumin groups saw a statistically significant reduction in joint pain and inflammation compared to the placebo group.

While these studies are promising, more research and larger studies are needed before turmeric or curcumin can be recommended in the treatment of rheumatoid arthritis.

Osteoarthritis

The most common form of arthritis, osteoarthritis is a condition that leads to the breakdown of joint cartilage and bone. Turmeric shows promise in treating the pain associated with OA.

Turmeric and curcumin appear to help reduce pain and stiffness of OA by suppressing the production of COX-2, a therapeutic target of the NSAIDs Celebrex (celecoxib) and Bextra (valdecoxib), although other undiscovered pathways may also be involved.

Current research on the effects of curcumin in the treatment of osteoarthritis suggest the spice offers the following benefits:

  • Reducer pain
  • Improved physical function
  • Greater quality of life
  • Decreased use of NSAIDs and opioid pain relievers

A 2019 meta-analysis of five studies including a total of 599 people with osteoarthritis concluded curcumin could significantly improve scores on the Western Ontario and McMaster Universities Osteoarthritis Index scale (WOMAC), a 24-question assessment of pain, stiffness, and physical function used to evaluate hip and knee pain associated with OA. In addition, the researchers noted that the side effects of curcumin were no worse than ibuprofen. 

Turmeric may be as effective as an NSAID in relieving osteoarthritis pain, a 2014 paper found. In the study, people with knee osteoarthritis received either a turmeric extract or ibuprofen daily. At the end of the four-week trial, those taking the extract reported a similar reduction in pain as those taking ibuprofen, with fewer side effects.

Possible Side Effects

Turmeric is generally regarded as safe by the U.S. Food and Drug Administration (FDA) when used as a food additive. In larger, therapeutic doses, turmeric and curcumin may cause side effects, including: 

Of note, using turmeric or curcumin supplements can result in temporary body odor and strong-scented urine. 

Contraindications

Taking therapeutic doses of curcumin or turmeric is not recommend for people with certain conditions:

Interactions

Certain drugs can interact negatively with curcumin supplements. Curcumin may thin your blood and should not be used in conjunction with anti-coagulant or anti-platelet medications, including: 

Curcumin supplements are often combined with piperine (the active ingredient in black pepper), which may interact negatively with the following:

If you are considering using turmeric supplements, talk to your doctor first to discuss whether it's appropriate for you. This is especially important if you have a chronic condition or are taking any medications. If you have surgery scheduled, you may need to stop taking curcumin prior to your procedure. Speak to your surgical team for instructions.

Dosage

In clinical studies, the effective daily dose for the treatment of both OA and RA is about 1,000 mg of curcumin a day, commonly taken as one 500 mg capsule twice a day.

Unless otherwise direct by your doctor, follow the dosing instructions provided by the supplement manufacturer.

Selection

Widely available in the spice aisle of your local grocery store, it may be difficult to get enough curcumin through cooking. Curcumin makes up only a small part of turmeric and can be difficult to absorb. In addition, turmeric can be high in lead and lead to lead poisoning if taken in large doses.

For these reasons, curcumin extract supplements are recommended for therapeutic doses. Curcumin is sold in capsule and powder forms at health food stores, drug stores, and online.

Curcumin is poorly absorbed by the body when it is taken in any form. To boost absorption, choose supplement brands that use phospholipids, antioxidants, or nanoparticles, or contain piperine. According to a review of research published in the journal Foods, piperine has been found to increase the absorption of curcumin by up to 2,000%.

A Word From Verywell

Dietary supplements are not regulated by the FDA. Some products may have additives and contaminants that may not be listed on the label, such as fillers, food coloring, and heavy metals such as lead. Look for a well-known and well-respected supplement brand that adheres to standards set by ConsumerLabs, The U.S. Pharmacopeial Convention, or NSF International.

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