More than 350 million people have arthritis worldwide. CDC stats on arthritis: Over 54 million Americans have arthritis. Arthritis affects one in five American adults. Two-thirds of the people diagnosed with arthritis are under the age of 65. An estimated 67 million Americans will have arthritis by the year 2030.
Nearly 32. 5 million Americans have its most common form, osteoarthritis. Osteoarthritis (OA) results from the progressive degeneration of cartilage in synovial joints. Osteoarthritis is a condition caused by aging, injury, cartilage destruction, and an imbalance in inflammatory and anti-inflammatory pathways.
Rheumatoid arthritis (RA) is an autoimmune condition and is characterized by systemic inflammation throughout the body. The immune system mistakenly attacks your body tissues. The skin, eyes, lungs, and blood vessels may also be affected in RA. Unlike the wear-and-tear damage of osteoarthritis, rheumatoid arthritis affects the lining of your joints, tendons, and ligaments that hold the joints together. Eventually bone erosion and joint deformity develop.
Are there herbal-based products that substantially reduce inflammation, alleviate pain, and protect the cartilage in the joints as well? Fortunately there are!
Curcumin for Arthritis
Curcumin and Osteoarthritis
Curcumin from turmeric possesses potent anti-inflammatory, anti-oxidant, and analgesic properties. It inhibits inflammation in joints by at least five known mechanisms. Studies show that curcumin-phosphatidylcholine phytosome complex decreased joint pain and improved joint function in individuals with OA.1 Unlike NSAIDs (nonsteroidal anti-inflammatory drugs) and prescribed cox-2 inhibitors, curcumin has no gastrointestinal or cardiovascular side effects. Curcumin also protects the weight-bearing surface of the joint and the cartilage cells from breakdown.2
One comparative, randomized, double-blind, placebo-controlled study showed that a twelve-week use of curcumin complex or its combination with boswellic acid reduces pain-related symptoms in patients with OA. Curcumin in combination with boswellic acid is more effective. Combining curcuma along with boswellia serrata extracts increases the efficacy of OA treatment.3
More Evidence for Curcumin
The WOMAC score for arthritis evaluates arthritic pain in 5 positions, stiffness in the morning and evening, and physical functions in 17 different activities. A meta-analysis of five randomized controlled studies involving 599 patients showed curcumin could significantly improve the WOMAC score. In this meta-analysis, the side effect of curcumin was not higher than that of ibuprofen.4
Curcumin for RA
Curcumin blocks specific activities of T-memory lymphocytes involved in several autoimmune diseases including multiple sclerosis and rheumatoid arthritis (RA). One study found that 500 mg. of curcumin reduces RA’s signs and symptoms, including joint swelling and tenderness, significantly better than 50 mg. of diclofenac sodium, a non-steroidal anti-inflammatory drug.5 Curcumin exhibits some of the same activities similar to recently discovered alpha-tumor necrosis factor blockers and other developed drugs used for RA.6
Bonus Benefits of Curcumin
Periodontal disease is common, often severe, and present at all stages of rheumatoid arthritis including early disease.7 A triple-blind study evaluated the efficacy of mouthwash containing essential oils and curcumin (MEC) in women who had rheumatoid arthritis (RA) and chronic periodontitis. The women who used the curcumin-based mouthwash for six weeks experienced a significant reduction in objective measurement in periodontal and RA disease activity! 8
Additional Info on Curcumin
Unlike NSAIDS, the daily use of curcumin does not increase the risk of stroke. Exposure of turmeric to light destroys curcumin. It is not easily absorbed. Ingesting curcumin does not necessarily lead to the associated health benefits because of its poor bioavailability which appears to be primarily due to poor absorption, rapid metabolism, and rapid elimination. Several components can increase its absorption and bioavailability. Piperine from black pepper also increases curcumin’s bioavailability substantially. Curcumin is fat-soluble so taking it at meals with nuts, seeds, avocadoes, olives, or cold-pressed, extra virgin olive oil will also improve its absorption. Formulated curcumin in micellas, nanoparticles, liposomes, and phospholipid complexes also improve its absorption. Nano formulations of curcumin will increase its absorption.9
Consult your pharmacist first before using curcumin or turmeric medicinally if you take prescribed or over-the-counter medication. Individuals who have low blood platelets, take blood thinners, or have iron-deficient anemia should not take curcumin.
Boswellia to the Rescue!
A randomized, double-blind, placebo-controlled crossover study evaluated the efficacy, safety, and tolerability of Boswellia serrata Extract (BSE) in 30 patients with osteoarthritis of the knee. All patients receiving boswellia reported decreased knee pain, increased knee flexion, and increased walking distance. There was also a reduced frequency of swelling in the knee. Radiologically, there was no change. The subjects tolerated BSE well except for minor gastrointestinal ADRs (adenoma detected rate). 10
Other clinical studies have shown that Boswellia serrata extract has anti-inflammatory and anti-arthritis properties and improves pain and physical function. Based on current evidence, the recommended duration and dosage of treatment with boswellia and its extract is at least 100-250 mg for four weeks.11
Resveratrol Helps Joints
Resveratrol, a phytochemical found in red grapes and blueberries, possesses powerful antioxidant and anti-inflammatory compounds. It targets several inflammatory agents and cartilage destroying compounds involved in OA. 12,13 While resveratrol exerts potent anti-inflammatory and antioxidant actions, its low bioavailability is considered a major obstacle. Piperine from black pepper improves its bioavailability. So if you are considering using a resveratrol supplement, be sure it contains piperine. 14
Chamomile May Bring Relief
A randomized, placebo-controlled study demonstrated that drinking chamomile tea, two cups a day for 42 days, reduced the severity of rheumatoid arthritis symptoms.15Other studies showed that topical applications of chamomile oil reduced the pain and improved the physical function of individuals who had osteoarthritis in the knee.16
Animal studies suggest that the flavonoid quercetin inhibits inflammation and deterioration of the joint and slows down the progression of osteoarthritis.17 A double-blind, randomized controlled study showed that taking 500 mg of quercetin daily for eight weeks significantly reduced early morning stiffness and post-activity pain in women with rheumatoid arthritis. 18 Larger studies are warranted.
Onions, broccoli, cabbage, kale, red and yellow peppers, red apples, berries, and cherries contain a considerable amount of this valuable phytochemical.
Please consult with your pharmacist first before using any supplement or medicinal amounts of herbs if you are taking any medicine (including over-the-counter drugs) or have a serious medical condition. Pregnant or nursing women should consult with their health care providers. Individuals who have a low platelet count or take blood thinners should not use resveratrol, turmeric, or ginger as they are mild blood-thinners.
More Help Is Needed
As helpful as these supplements are, more measures are needed in combating arthritis.
- Adopt a plant based, anti-inflammatory diet. (See article entitled “The Anti-inflammatory Diet” on this web site.)
- Engage in appropriate daily exercise. Include stretching and range-of-motion exercises twice a day to improve flexibility.
- Physical therapy can help. Contrast baths are very beneficial for osteoarthritis.
- If pain persists, please consult an orthopedic physician.
- Efficacy and safety of Meriva®, a curcumin-phosphatidylcholine complex, during extended administration in osteoarthritis patients. Altern Med Rev. 2010 Dec;15(4):337-44
- Henrotin, Y., et al., Biological actions of curcumin on articular chondrocytes, osteoarthritis, Cartilage 2010 Feb; 18(2):141-9
- Haroyan A. Efficacy and safety of curcumin and its combination with boswellic acid in osteoarthritis: a comparative, randomized, double-blind, placebo-controlled study. BMC Complement Altern Med. 2018 Jan 9;18(1):7. https://pubmed.ncbi.nlm.nih.gov/29316908/
- Wu J, Lv M, Zhou Y. Efficacy and side effect of curcumin for the treatment of osteoarthritis: A meta-analysis of randomized controlled trials. Pak J Pharm Sci. 2019 Jan;32(1):43-51. PMID: 30772789. https://pubmed.ncbi.nlm.nih.gov/30772789/
- Chandran B, A randomized, pilot study to assess the efficacy and safety of curcumin in patients with active rheumatoid arthritis. Phytother Res. 2012 Nov;26(11):1719-25
- Aggarwal BB, Curcumin: the Indian solid gold. Adv Exp Med Biol. 2007; 595:1-75. Review
- Bingham, Clifton O 3rd, and Malini Moni. “Periodontal disease and rheumatoid arthritis: the evidence accumulates for complex pathobiologic interactions.” Current opinion in rheumatology vol. 25,3 (2013): 345-53. https://pubmed.ncbi.nlm.nih.gov/31745043/
- Anusha D. efficacy of a mouthwash containing essential oils and curcumin as an adjunct to nonsurgical periodontal therapy among rheumatoid arthritis patients with chronic periodontitis: A randomized controlled trial. Indian J Dent Res. 2019. Jul-Aug;30(4):506-511. https://pubmed.ncbi.nlm.nih.gov/31745043/
- Hall E. and Vale P. Turmeric: Helpful or Hyped. Sept. 22, 2021.https://wildwoodhealth.com/blog/turmeric-helpful-or-hyped/
- Kimmatkar N, Thawani V, Hingorani L, Khiyani R. Efficacy and tolerability of Boswellia serrata extract in treatment of osteoarthritis of knee–a randomized double-blind placebo-controlled trial. Phytomedicine. 2003 Jan;10(1):3-7. https://pubmed.ncbi.nlm.nih.gov/12622457/
- Yu, Ganpeng et al. “Effectiveness of Boswellia and Boswellia extract for osteoarthritis patients: a systematic review and meta-analysis.” BMC complementary medicine and therapies vol. 20,1 225. 17 Jul. 2020, doi:10.1186/s12906-020-02985-6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7368679/
- Khalifé S, Zafarullah M. Molecular targets of natural health products in arthritis. Arthritis Res Ther. 2011 Feb 3; 13(1):102
- Csaki, C. et al., Synergistic chondroprotective effects of curcumin and resveratrol in human articular chondrocytes: inhibition of IL-1beta-induced NF-kappaB-mediated inflammation and apoptosis. Arthritis Res Ther. 2009; 11(6):R165
- Ghazaly M. Potential anti-inflammatory action of resveratrol and piperine in adjuvant-induced arthritis: Effect on pro-inflammatory cytokines and oxidative stress biomarkers. Egyptian Rheumatologist Volume 42, Issue 1, January 2020, Pages 71-77.
- Pirouzpanah Saeed. The effect of chamomile tea consumption on inflammation among rheumatoid arthritis patients: a randomized clinical trial. Supplement: Nutraceutical and Medicinal Plants: Vol. 19 No. 1-S (2017). https://www.mattioli1885journals.com/index.php/progressinnutrition/article/view/5171
- Ruhollah Shoarah. Efficacy and safety of topical Matricaria chamomilla L. (chamomile) oil for knee osteoarthritis: A randomized controlled clinical trial. Randomized Controlled Trial Complement Ther Clin Pract. 2015 Aug;21(3):181-7. https://pubmed.ncbi.nlm.nih.gov/26256137
- Li W. Quercetin Alleviates Osteoarthritis Progression in Rats by Suppressing Inflammation and Apoptosis via Inhibition of IRAK1/NLRP3 Signaling. Original Research. Dove Press. 16 July 2021 Volume 2021:14 Pages 3393—3403.https://www.dovepress.com/quercetin-alleviates-osteoarthritis-progression-in-rats-by-suppressing-peer-reviewed-fulltext-article-JIR
- Javadi F. The Effect of Quercetin on Inflammatory Factors and Clinical Symptoms in Women with Rheumatoid Arthritis: A Double-Blind, Randomized Controlled Trial. J Am Coll Nutr. 2017 Jan;36(1):9-15.https://pubmed.ncbi.nlm.nih.gov/27710596/