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Curcumin or NSAIDS for Knee Arthritis and Heart Health?
Most doctors prescribe NSAIDs like celocoxib, diclofenac, meloxicam or naproxen for knee arthritis. Which is safer, curcumin or NSAIDs?
When medical students learn about the best way to treat osteoarthritis pain and inflammation, they inevitably hear that NSAIDs (nonsteroidal anti-inflammatory drugs) are the go-to medications. That’s why drugs like celecoxib, diclofenac, ibuprofen, indomethacin, meloxicam and naproxen are prescribed in such huge numbers. And that doesn’t even include OTC sales of NSAIDs such as Advil, Aleve or Motrin IB. Most medical schools don’t mention turmeric or the active ingredient curcumin. Which is better and safer — curcumin or NSAIDs when it comes to osteoarthritis of the knee?
Effectiveness of Curcumin or NSAIDs?
Ask most physicians in the US about turmeric or curcumin and you will likely get a blank stare. They never learned about this Ayurvedic medicine that has been part of the Indian system of healing for thousands of years.
American medical education often promotes the idea that FDA-approved pharmaceuticals are safe and effective. After all, they are FDA approved!
Herbal or plant-based compounds are mostly considered unproven and possibly dangerous. Given a choice between curcumin or NSAIDs, most conventionally trained MDs would go with NSAIDs every time.
What About the Data?
A study published in BMC Complementary Medicine and Therapies (Oct. 19, 2022) actually reviews the research on curcuminoids (the active ingredients in turmeric) for knee osteoarthritis. They analyzed data from 15 randomized controlled trials (RCTs) involving 1,670 patients.
The Bottom Line on Effectiveness of Curcumin or NSAIDs:
Let’s let the authors speak for themselves:
“The principal finding of our study was that CURs [curcuminoids] were associated with better effectiveness than placebo and not inferior to NSAIDs in terms of pain reduction and functional promotion for knee OA [osteoarthritis]. The pooled analyses found that CURs were more effective than placebo in the improvement of VAS [visual analog scale] for pain, WOMAC [Western Ontario and McMaster Universities Osteoarthritis Index] total score, WOMAC pain score, WOMAC function score and WOMAC stiffness score, while there was no significant difference found between CURs and NSAIDs.”
OK, that’s a lot of doctorspeak. Here is our translation. Curcumin and related compounds were more effective than placebo for relieving pain and stiffness.
The WOMAC score is a validated way for rheumatologists to study symptoms surrounding osteoarthritis. Another key finding was that curcuminoids were just as good (“not inferior”) as
NSAIDs at easing symptoms.
That’s impressive. This Ayurvedic medicine was just as good as nonsteroidal anti-inflammatory drugs for controlling pain and inflammation of the knee. We doubt that very many US-trained physicians are aware of that.
What About Side Effects When It Comes to Curcumin or NSAIDs?
Here is the BIG news!
Again, let’s allow the authors to state their findings:
“Among the included fifteen studies, two reported no AEs [adverse events] at the end of the trials. According to the data of the remaining thirteen studies (1569 patients), AEs were mainly concentrated in gastrointestinal symptoms including meteorism [bloating or gas], gastro-oesophageal reflux, dyspepsia, nausea, and stomach pain. There was no significant difference found between CURs and placebo group in the incidence of AEs, while a lower incidence of AEs was observed in CURs group when compared with NSAIDs group, but the pooled results were not statistically significant. Sensitivity analysis found that the difference between CURs and NSAIDs groups became statistically significant when the data of Gupte et al. were omitted.”
Curcumin Side Effects:
The bottom line appears to be that:
“Diarrhea and/or constipation and stomach pain (5.8% and 8.17%) were the most frequent mild AEs in CURs and control groups respectively.”
We have warned about other adverse effects of turmeric or curcumin at this link. Some people are allergic to turmeric. They can develop a serious skin rash. Liver enzyme elevations have also been reported with this natural remedy. And anyone taking anticoagulants should skip curcuminoids. This is especially true of the blood thinner warfarin!
NSAID Side Effects:
Contrast the side effects mentioned above with the potential adverse reactions associated with NSAIDs:
Ibuprofen Side Effects:
• Heartburn, abdominal pain, nausea, vomiting
• Ulcers, bleeding ulcers, perforated ulcers
• Headache, dizziness, drowsiness, disorientation
• Skin rash, sensitivity to sunlight, itching
• Fluid retention, high blood pressure
• Heart failure, heart attack, stroke
• Irregular heart rhythms (AFib)
• Ringing in ears, hearing changes
• Visual disturbances
• Liver damage, kidney damage
Remember, the FDA considers ibuprofen so safe that it can be sold without a prescription.
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