Osteoathritis (OA) is the most common type of arthritis. It is progressive degenerative joint disease that mostly affects people over 65 years old. OA is one of the leading causes of physical disability among older adults worldwide.
OA can affect any joint, but is most common in the knee, hip, spine and hands.
The development of OA is determined by the interactions between:
local factors (eg: obesity, misalignment, laxity, joint injury/surgery, overuse of joint, muscle weakness)
systemic factors (eg: genetic, age, gender, congenital/developmental abnormalities, diet)
OA has long been regarded as a wear and tear disease. However, research is increasingly showing that inflammation plays a role in the initiation and progression of the OA process.
Symptoms of OA include pain, aching, stiffness and reduced function in the affected joint.
By Centers for Disease Control and Prevention (NIH) (Centers for Disease Control and Prevention (NIH)) [Public domain], via Wikimedia Commons
There is no treatment to slow or halt the disease progression. The management of OA involves relieving symptoms with analgesics (acetaminophen), non-steroidal anti-inflammatory drugs (NSAIDs), cortisteroid and hyaluronan injections. Joint replacement surgery is the last resort.
Due to the inefficacy and long term side effects of drug medications, there is a surge of interest in the use of nutraceuticals as safer alternative and/or prevention therapies for OA. Curcumin, a biologically active phytochemical compound of turmeric, is one of the nutraceuticals that shows promising potential in clinical trials for management of osteoarthritis.
Curcuminoids/Curcumin (Turmeric) For Joint Health
Turmeric, a member of the ginger family, is a widely used spice in South and Southeast Asian cooking. It is also used as a colouring agent in foods and textiles, and in traditional Indian medicine.
Curcuminoids are polyphenolic compounds that give turmeric the distinctive yellow colour. Curcuminoids consist of curcumin (80%), demethoxycurcumin (18%) and bisdemethoxycurcumin (2%).
Curcumin is the primary curcuminoid that possesses wide ranging preventive and therapeutic properties.
Potential Therapeutic Effects of Curcumin in Osteoarthritis
The protective effects of curcuminoids/curcumin against OA are attributable to their broad spectrum of biological activities, such as:
Curcumin inhibits production of inflammatory mediators by chondrocytes.
Curcumin inhibits production of catabolic mediators by chondrocytes. This prevents cartilage degradation and promotes the accumulation of newly synthesized matrix components in the extracellular matrix.
Curcumin modulates oxidative stress by scavenging and reducing the formation of free radicals by abnormal chondrocytes.
Clinical Studies On Curcumin & Osteoarthritis
There have been a few clinical trials conducted on the effects of curcumin on OA.
1. The clinical effects of orally administered Theracurmin (a water-dispersible form of curcumin) was tested in 50 patients with knee OA for 8 weeks in a randomized, double-blind, placebo-controlled study.1 The treated group that received 6 capsules of Theracurmin (containing 180 mg of curcumin) per day, reported significantly reduced pain and stiffness in the knees. Theracurmin also significantly lowered dependence on celexib.
2. Two studies to evaluate the efficacy of Meriva (a curcumin-phosphatidylcholine complex) on OA showed positive results.
(i) In an earlier 3-month study2 of 50 patients with OA, Meriva significantly:
- improved joint pain, stiffness, function and mobility,
- reduced C-reactive protein (CRP) levels, and
- reduced the use of anti-inflammatory drugs, treatment and hospitalization, in the treated group.
(ii) In a later 8-month study3 of 100 patients with knee OA, Meriva significantly:
- reduced pain and stiffness,
- improved physical function, and
- reduced markers of inflammation, in the treated group.
The reduction in OA symptoms led to improvement in social and emotional wellbeing, and thus, better quality of life.
In both studies, treated patients received 1,000 mg/day of Meriva in 2 divided doses, corresponding to 200 mg curcumin/day.
3. The efficacy of dietary supplementation with C3 Complex (a bioavailability-boosted preparation of curcuminoids) was evaluated in 40 patients with mild-to-moderate knee OA for 6 weeks in a pilot randomised double-blind placebo-controlled parallel-group trial.4 The treated group that received 1500 mg/day of C3 Complex, in 3 divided doses, reported significant improvements in pain and physical function, and reduction in the use of NSAIDs/painkillers.
Curcumin (Turmeric) Dosage For Osteoarthritis
Based on the above studies, the dosages used for osteoarthritis were:
- Theracurmin: containing 180mg curcumin for 8 weeks
- Meriva: 1,000 mg/day of Meriva in 2 divided doses (corresponding to 200 mg curcumin) per day for 3 months and 8 months
- C3 Complex: 1500 mg/day in 3 divided doses, for 6 weeks.
There are serious side effects associated with the long term use of drug medications (steroidal and NSAID) for treating OA.
The findings from the above clinical studies suggest that curcumin could potentially be a used for complementary management of OA. It has a broad spectrum of biological activities against OA and a good safety profile.
(Photo by: fromcolettewithlove)
1. Nakagawa Y, Mukai S, Yamada S, Matsuoka M, Tarumi E, Hashimoto T, Tamura C, Imaizumi A, Nishihira J, Nakamura T. Short-term effects of highly-bioavailable curcumin for treating knee osteoarthritis: a randomized, double-blind, placebo-controlled prospective study. http://www.ncbi.nlm.nih.gov/pubmed/25308211
2. Belcaro G, Cesarone MR, Dugall M, Pellegrini L, Ledda A, Grossi MG, Togni S, Appendino G. Product-evaluation registry of Meriva, a curcumin-phosphatidylcholine complex, for the complementary management of osteoarthritis. http://www.ncbi.nlm.nih.gov/pubmed/20657536
3. Belcaro G, Cesarone MR, Dugall M, Pellegrini L, Ledda A, Grossi MG, Togni S, Appendino G. Efficacy and safety of Meriva®, a curcumin-phosphatidylcholine complex, during extended administration in osteoarthritis patients. http://www.ncbi.nlm.nih.gov/pubmed/21194249
4.Panahi Y, Rahimnia AR, Sharafi M, Alishiri G, Saburi A, Sahebkar A. Curcuminoid treatment for knee osteoarthritis: a randomized double-blind placebo-controlled trial. http://www.ncbi.nlm.nih.gov/pubmed/24853120