Supporting Healthy Joints with Curcumin & Boswellia
The impact of chronic inflammatory joint problems on overall health can be far-reaching; especially when activity levels start to decline due to pain, reduced mobility and inflammation. Here we take a closer look at why activity levels need to be fiercely protected at any age, and the key natural ingredients that every practitioner should have in their toolkit to support this.
The importance of maintaining activity levels
Joint pain and inflammation often feature strongly within the context of a client’s case history. All too often we see clients whose health started to deteriorate following the onset of a painful inflammatory problem such as osteoarthritis. A typical scenario might be a client who is overweight and arrives in clinic with some cardiovascular and pre-diabetic health concerns. Case history reveals they’d always been very active and a regular exerciser, until the onset of an inflammatory joint problem a few years previous, which has steadily got worse. Activity levels declined, mood dipped, intake of sugary snacks increased, joint problems worsened, and so on…
Unfortunately, this picture is all too common. It’s an over-simplified scenario, but isn’t too far from the real stories we hear in clinic every week. The crucial point is that painful inflammatory joint problems, if left unchecked, can soon set off a vicious cycle where healthy diet and lifestyle habits change, and health starts to decline. Before you know it, a few years have passed and the symptoms and effects of ill health really start to accrue.
Conventional treatments often involve NSAIDs (non-steroidal anti-inflammatory drugs), which unfortunately come with their own set of possible side effects; one of which is worsening of cartilage deterioration, and this further adds to the vicious cycle.1-8
How to break out of the vicious cycle
It all sounds a bit doom and gloom but thankfully there are ways to break out of the cycle.
Natural alternatives are key to supporting reduced pain, inflammation and improved mobility which can help to promote an upward, healthy trajectory once again.
Boswellia and curcumin both have a long history of traditional use in supporting healthy joints and balanced inflammation, and their benefits are also backed by recent scientific research. Here’s a brief look at two of the most effective natural ingredients to support healthy joints.
Boswellia serrata extract
Boswellia gum resin is derived from the Boswellia serrata tree. It is a traditional Ayurvedic remedy that has been used to support a wide range of chronic inflammatory health problems. The main constituents of the boswellic gum resin are boswellic acids, (including the most active acetyl-11-keto-b-boswellic acid (AKBA)) which have been shown to possess anti-inflammatory, pain-relieving, antioxidant and anti-arthritic activity in a variety of animal experimental models and human studies.9
A 2014 Cochrane review found moderate quality evidence for the benefits of Boswellia serrata in the treatment of osteoarthritis and with low risk of adverse events.10 A 2015 review and meta-analysis of ayurvedic interventions for osteoarthritis reported benefits of boswellia in relief of pain and improvement in function.11
A 2018 systematic review & meta-analysis published in the British Journal of Sports Medicine found that supplementation with curcumin and Boswellia serrata demonstrated large and important effects for pain reduction in osteoarthritis at short term.12 Boswellia has been found to be safe and well tolerated.13
Turmeric extract (Curcuma longa)
Curcumin is the main active component of turmeric powder, extracted from the rhizome of the Curcuma longa plant and is known to deliver many health benefits. It is best known for powerful and widespread anti-inflammatory and antioxidant activity and is effective for natural pain relief. Research has shown that curcumin has the ability to modulate many inflammatory pathways in the body, making it a potentially useful therapeutic for a wide range of health problems including arthritis.14 The main active constituents of the Curcuma longa plant are curcuminoids and turmerones. Turmerones are known to improve absorption of curcuminoids.
Curcumin has been shown to be safe and effective for reducing pain and improving function in patients with osteoarthritis. Multiple studies have demonstrated that curcumin is significantly more effective than placebo in relieving the symptoms of knee osteoarthritis, and does not pose significant safety risks. Results also show that curcumin formulations have comparable efficacy profiles to NSAID treatments, with significantly fewer adverse events.15-20
In a 2014 study involving 367 patients, curcumin supplementation improved osteoarthritis index scores, and levels of efficacy were found to be comparable to ibuprofen.21 These results are backed by a recent meta-analysis assessing the efficacy of curcumin formulations which found significant benefits of curcumin on pain and function in knee osteoarthritis.22
Some studies have focused on exploring the value of curcumin as adjuvant therapy. One study, conducted in a larger number of patients, found statistically significant benefits in patients who used combination treatment with Curcuma longa extract and Diclofenac compared to patients using Diclofenac and Placebo. 23
In a 2021 review published in Reviews of Physiology, Biochemistry & Pharmacology, researchers assessed the effects of curcumin in rheumatoid arthritis (RA). They found that curcumin improved RA complications through modulating inflammatory and autoreactive responses in immune cells and synovial fibroplast cells. The researchers concluded that treatment with curcumin has therapeutic potential to improve the clinical symptoms of RA.24
Temporomandibular joint osteoarthritis (TMJ OA) is a complex health problem that can be induced by inflammation and oxidative stress. In a 2020 in vivo experimental study, researchers evaluated the effects of curcumin treatment in TMJ OA. They found that curcumin induced anti-inflammatory, antioxidant and cartilage-protective effects.25
Protecting activity levels at every age
Painful inflammatory joint problems often don’t occur in isolation and can soon set off a vicious cycle where habits change and wider health starts to suffer as a result. Understanding the significance of protecting activity levels at every age and having access to effective natural ingredients such as curcumin and boswellia, that can provide effective support, and are generally safe and well tolerated, is key for all healthcare practitioners concerned with long-term optimal health.
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4. Dingle JT. Prostaglandins in human cartilage metabolism. Journal of Lipid Mediators.1993; 6:303-312.
5. Dingle JT. The effect of nonsteroidal anti-inflammatory drugs on human articular cartilage glycosaminoglycan synthesis. Osteoarthritis and Cartilage.1999; 7:313-314.
6. Dingle JT. The effects of NSAIDs in human articular cartilage GAG synthesis. European Journal of Rheumatology.1996; 16:47-52.
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8. McAlindon TE, Bannuru RR, et al. OARSI guidelines for the non-surgical management of knee osteoarthritis. Osteoarthritis Cartilage.(2014) 22:363–88.
9. Ammon HP. Boswellic acids and their role on chronic inflammatory diseases. Adv Exp Med Biol. 2016; 928: 291-327
10. Cameron M, Chrubasik S. Oral herbal therapies for treating osteoarthritis. Cochrane Database Syst Rev 2014: Cd002947.
11. Kessler C, Pinders L, Michalsen A, Cramer H Ayurvedic interventions for osteoarthritis: a systematic review and meta‑analysis Rheumatol Int (2015) 35:211–232
12. Liu X, Machado GC. et al. Dietary supplements for treating osteoarthritis: a systematic review and meta-analysis. Br J Sports Med. 2018 Feb; 52(3): 167-175
13. Krishnaraju AV, Sundararaju D, et al. Safety and toxicological evaluation of Aflapin®: A novel Boswellia-derived anti-inflammatory product. Toxicology mechanisms and methods. 2010 Nov 1;20(9):556-63.
14. Kunnumakkara AB, Bordoloi D et al. Curcumin, the golden nutraceutical: multi-targeting for multiple chronic diseases. Br J Pharmacol. 2017 Jun; 174(11): 1325-1348
15. K. Madhu, K. Chanda, M.J. Saji Safety and efficacy of Curcuma longa extract in the treatment of painful knee osteoarthritis: a randomized placebo-controlled trial. Inflammopharmacology, 21 (2013), pp. 129-136
16. Y. Panahi, A.R. Rahimnia, M. et al. Curcuminoid treatment for knee osteoarthritis: a randomized double-blind placebo-controlled trial. Phytother Res, 28 (2014), pp. 1625-1631
17. Y. Nakagawa, S. Mukai, S. Yamada, et al. Short-term effects of highly-bioavailable curcumin for treating knee osteoarthritis: a randomized, double-blind, placebo-controlled prospective study. J Orthop Sci, 19 (2014), pp. 933-939
18. Y. Moharamzad, Y. Panahi, et al. Clinical efficacy of curcumin in knee osteoarthritis: a double-blind randomized clinical trial, Baqiyatallah Medical Sciences University (2011)
19. A. Haroyan, V. Mukuchyan, N. Mkrtchyan, et al. 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, 18 (2018), p. 7
20. V. Kuptniratsaikul, S. Thanakhumtorn, et al. Efficacy and safety of Curcuma domestica extracts in patients with knee osteoarthritis. J Altern Complement Med, 15 (2009), pp. 891-897
21. Kuptniratsaikul V, Dajpratham P et al. Efficacy and safety of Curcuma domestica extracts compared with ibuprofen in patients with knee osteoarthritis: a multicenter study. Clin Interv Aging 2014 9: 451–458.
22. I.J. Onakpoya, E.A. Spencer, R. et al. Effectiveness of curcuminoids in the treatment of knee osteoarthritis: a systematic review and meta-analysis of randomized clinical trials. Int J Rheum Dis, 20 (2017), pp. 420-433
23. P. Pinsornsak, S. Niempoog The efficacy of Curcuma longa L. extract as an adjuvant therapy in primary knee osteoarthritis: a randomized control trial. J Med Assoc Thai, 95 (Suppl 1) (2012), pp. S51-S58
24. Mohammadian Haftcheshmeh S, Khosrojerdi A, et al. Immunomodulatory Effects of Curcumin in Rheumatoid Arthritis: Evidence from Molecular Mechanisms to Clinical Outcomes. Rev Physiol Biochem Pharmacol. 2021 Jan 7.
25. Jiang C, Luo P, et al. Nrf2/ARE is a key pathway for curcumin-mediated protection of TMJ chondrocytes from oxidative stress and inflammation. Cell Stress Chaperones. 2020 May; 25(3): 395-406.
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