In this article published in the Annals of Internal Medicine, the authors found that curcumin, which is the active ingredient in the turmeric root, seems to help reduce the pain of knee osteoarthritis. Dr. Rakel, recommends 2,000-3,000 mg of curcumin per day and that the supplements have black pepper in them for better absorption. ~ Dr. Broussard
Curcuma Longa Effective for Knee Osteoarthritic Pain
October 01, 2020
Annals of Internal Medicine
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This randomized controlled trial examined the use curcumin over 12 weeks for treatment of osteoarthritis. Use of curcumin improved pain for patients, but did not improve effusion volumes or relaxation time of the lateral femoral cartilage when compared with placebo.
Curcumin is presented as a potential therapeutic option for osteoarthritis symptoms. Evidence from this article shows symptomatic improvement for patients without an increased risk of side effects.
– Andrea Dotson, MD, MSPH
Curcumin for Osteoarthritis of the Knee
A number of years ago when the Cox-2 inhibitor, rofecoxib (Vioxx) was taken off the market due to its CV risk, I had my patients switch to Turmeric 1 gm twice daily and it worked quite well. It is also quite tasty in curry dishes.
This study builds on a prior systematic review showing that curcumin (an ingredient within the turmeric root of the plant, Curcuma longa) reduced knee pain and improved quality of life in those with osteoarthritis of the knee. What makes this rather small study (n-70) unique is that they did baseline and follow-up MRI of the knee to see if it had disease modifying abilities with reduced synovial swelling.
The study used a two 500 mg tablets (1 gm daily) of Turmeric with 20% curcuminoids for 12 weeks compared to placebo. Like the prior systematic review, it again showed a moderate 10% reduction in pain with improvement in function and stiffness compared to placebo. The authors point out that the symptom reduction of turmeric is greater than that of acetaminophen. Unfortunately, it did not result in a reduction in synovial swelling on MRI.
Turmeric with curcuminoids is likely another symptom modifying agent that can be used with confidence for this common condition. Although maybe it needed more than 12 weeks to show an effect, it does not appear at this time to have disease modifying capabilities.
How to Prescribe Turmeric or Curcumin
Abstract
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BACKGROUND
Current pharmacologic therapies for patients with osteoarthritis are suboptimal.
OBJECTIVE
To determine the efficacy of Curcuma longa extract (CL) for reducing knee symptoms and effusion-synovitis in patients with symptomatic knee osteoarthritis and knee effusion-synovitis.
DESIGN
Randomized, double-blind, placebo-controlled trial. (Australian New Zealand Clinical Trials Registry: ACTRN12618000080224).
SETTING
Single-center study with patients from southern Tasmania, Australia.
PARTICIPANTS
70 participants with symptomatic knee osteoarthritis and ultrasonography-defined effusion-synovitis.
INTERVENTION
2 capsules of CL (n = 36) or matched placebo (n = 34) per day for 12 weeks.
MEASUREMENTS
The 2 primary outcomes were changes in knee pain on a visual analogue scale (VAS) and effusion-synovitis volume on magnetic resonance imaging (MRI). The key secondary outcomes were change in Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain and cartilage composition values. Outcomes were assessed over 12 weeks.
RESULTS
CL improved VAS pain compared with placebo by -9.1 mm (95% CI, -17.8 to -0.4 mm [P = 0.039]) but did not change effusion-synovitis volume (3.2 mL [CI, -0.3 to 6.8 mL]). CL also improved WOMAC knee pain (-47.2 mm [CI, -81.2 to -13.2 mm]; P = 0.006) but not lateral femoral cartilage T2 relaxation time (-0.4 ms [CI, -1.1 to 0.3 ms]). The incidence of adverse events was similar in the CL (n = 14 [39%]) and placebo (n = 18 [53%]) groups (P = 0.16); 2 events in the CL group and 5 in the placebo group may have been treatment related.
LIMITATION
Modest sample size and short duration.
CONCLUSION
CL was more effective than placebo for knee pain but did not affect knee effusion-synovitis or cartilage composition. Multicenter trials with larger sample sizes are needed to assess the clinical significance of these findings.
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