Pain is a warning sign that there is something wrong in the body and you should do something to fix it. Acute pain, that your experience from an injury, broken bone, burn or indigestion, typically goes away after you have healed.
For some, dealing with pain could be an on-going struggle. Individuals with conditions such as fibromyalgia, arthritis, sciatica, migraines, and inflammatory bowel syndrome suffer from chronic pain that affects their physical as well as mental well-being. Such kind of pain affects work, personal relationships and overall quality of life.
Despite their adverse effects, over the counter medications, NSAIDs, opioids and antidepressants are often the first line of treatment to get rid of chronic pain. What about using natural compounds like curcumin?
Curcumin has been tagged as one of the most powerful anti-inflammatory substances with pain-relieving properties. In fact, studies show that curcumin’s ability to reduce pain and inflammation rivals those of prescription and over-the-counter medications.
In this article, we are going to discuss how curcumin relieves pain.
Chronic Pain and Inflammation
National Center for Complementary and Integrative Health describes chronic pain as any pain that lingers for more than 3 to 6 months.
In people with chronic pain, their body persistently send signals to your brain, even long after it has healed from an injury or illness. It reduces range of motion and function. And for some people even performing simple activities can become too exhausting.
What causes chronic pain?
Several conditions can cause chronic, wide-spread pain:
- Chronic fatigue syndrome (CFS)
- Rheumatoid arthritis, osteoarthritis and tendinitis
- Inflammatory bowel disease
- Trauma or injury
- Headaches and migraines
- Slipped disc
- Diabetic neuropathy
Chronic low-grade inflammation and pain go hand in hand. Inflammation begins when there is some form of tissue damage or injury. Your immune system sets off a series of biochemical reactions that makes your body ready for repair and healing. Pain, redness and swelling that you experience at the site of injury, are all signs that your body is being primed for healing.
During this process, your immune cells release several different types of proteins and chemicals like cytokines and prostaglandins. These inflammatory chemicals send pain signals. Sensing pain alerts you of the injury. In chronic, long-term inflammation, your immune system is continuously releasing these pro-inflammatory chemicals, leading to a heightened sensation of pain and increased redness and swelling at the site.
Worse yet, living with chronic pain increases stress that adversely affects the immune system, adding to the inflammatory burden on the body. Your body gets stuck in this vicious circle of increased inflammation and pain. Over a period of time, persistent inflammation gives rise to chronic diseases such as heart disease, diabetes, obesity, depression, Alzheimer’s disease, osteoarthritis and rheumatoid arthritis.
So, what next?
Most of us reach out for anti-inflammatory drugs to get immediate pain relief. NSAIDs, analgesics, steroids, antidepressants and opioids are some commonly used drugs to reduce pain and inflammation in most conditions.
While these drugs are effective in acute pain, their long-term use is marred by mild to severe side effects such as nausea, dizziness, sleepiness, stomach ulcers, increased risk of heart disease, increased risk of bleeding, poor immunity, liver damage, kidney damage and addiction. Prolonged use of painkillers also makes the body build tolerance, reducing their efficacy.
Considering these complications, chronic pain sufferers are always searching for safer ways to manage their pain. Let’s see how curcumin fits the bill.
How Curcumin Works in Pain Relief
Molecules like cytokines, prostaglandins, NF-κB, and various enzymes have been implicated in pain and inflammation. NF-κB, for example, is a transcription factor, a protein that regulate the expression of certain genes. NF-κB switches on genes that make inflammatory proteins.
Similarly, cyclooxygenase (COX) is an enzyme that produce chemicals like thromboxane and prostaglandins, known to cause inflammation, pain and fever. Painful cramps in the lower abdomen during periods is caused by prostaglandins, released by the lining of uterus. Substances or drugs that can inhibit COX can help in reducing pain and inflammation in the body and that is how most NSAIDs work.
Now, we have two types of cyclooxygenase, COX-1 and COX-2. While both these enzymes make prostaglandins, COX1 produces prostaglandins that protect the mucosal lining of the stomach and intestines, protect the lining of blood vessels, activate platelets and maintain kidney function. Useful COX1 are produced all the time in the body whereas production of COX2 is triggered by cytokines released during inflammation.
NSAIDs block the synthesis of COX and in the process also affects COX1. This reduces protective prostaglandins, causing gastrointestinal ulcers, increased risk of bleeding, and kidney damage.
Curcumin is an anti-inflammatory substance. It lowers pain and inflammation by blocking the synthesis and activity of various molecules, such as NF-κB, cytokines and prostaglandins. These molecules have been implicated in arthritis (including rheumatoid arthritis and osteoarthritis), menstrual cramps and many other conditions that cause pain. Research shows that cytokines and enzymes like cyclooxygenase cause inflammation in joints that eventually destroys cartilage and bone.
Curcumin can regulate these inflammatory pathways and provide pain relief without any unwanted side effects. Most importantly, curcumin limits the activity of COX2 enzyme. This reduces the risk of gastric ulcers, kidney damage and heart disease.
Also, as an anti-oxidant, it also curbs oxidative stress that causes degradation of the joint cartilage though abnormal immune activation.
In fact, studies show that curcumin matches or even surpasses the effects of common anti-inflammatory and analgesics such as ibuprofen and diclofenac sodium, in treating various forms of arthritis.
There is yet another important benefit of using curcumin in pain management. It protects your stomach and gut health against the side effects caused by NSAIDs. Curcumin is an antioxidant and it reduces the formation of free radicals and inflammation induced by excessive use of medications, reducing the risk of ulcers. Curcumin also stimulates mucus secretion in the stomach, which protects the stomach lining from harsh acids and other digestive elements.
This 2018 review of pre-clinical and clinical studies found that curcumin could be very effective in managing pathological pain. It is a kind of pain caused by tissue or nerve damage and resulting inflammation. It concluded that, “Although the mechanisms of pain mitigating effects are not very clear, there is compelling evidence proved that curcumin plays an essential role.” 
Curcumin in Osteoarthritis
According to the Arthritis Foundation, “osteoarthritis (OA) is the most common chronic condition of the joints”.
It is the most common form of arthritis, where cartilage breaks-down. A cartilage is a flexible connective tissue that covers the joints between bones. It works as a cushion that protects the ends of the bones from rubbing against each other. This helps to smooth movement of joints without any friction.
Age, daily wear and tear, obesity and injury are major risk factors for OA. And now, there is compelling evidence of chronic inflammation and its components playing an integral role in the development of osteoarthritis.  
As the disease progresses, loss of cartilage occurs. This causes bones to rub against each other, causing painful symptoms. This also leads to the break-down of bones. The fragments of broken cartilage irritate the joints and surrounding structures. This activates the immune system and results in the release of inflammatory cytokines, that cause further damage, joint inflammation and degeneration.
OA commonly affects the joints in the hips, knees, spine and hands.
Nevertheless, it can affect any joint.
Common symptoms of osteoarthritis
- Joint pain
- Joint stiffness, in the morning, after a prolonged period of rest such as sleeping
- Reduced movement around the affected joint
- Tenderness and swelling in joints and surrounding areas
Many clinical trials have investigated the effectiveness and safety of curcumin in osteoarthritis. The findings suggest that curcumin reduces pain and improves physical functions and quality of life in this condition. In addition, use of curcumin was also associated with reduced usage of painkillers and less side effects. 
A 2014 study, published in the journal of Clinical Interventions in Aging, found that turmeric extract was as good as ibuprofen in reducing pain and improving joint function in people with knee osteoarthritis. In addition, the group who received 1200 mg of ibuprofen per day experienced more events of abdominal pain and discomfort. 
A 2018 study suggested that the combination of curcumin and Boswellia could be very effective in the treatment for osteoarthritis. Boswellia extract comes from the Boswellia serrata tree. Like curcumin, Boswellia is also a powerful anti-inflammatory and has been found to be useful in easing symptoms in osteoarthritis, rheumatoid arthritis and inflammatory bowel disease. Both these components are known to work synergistically to regulate inflammatory pathways that worsen disease symptoms and are linked with the progression of OA. 
Curcumin in Rheumatoid Arthritis
Rheumatoid arthritis is an autoimmune disease, wherein your body’s immune system attacks and inflames the synovium, a membrane that lines the inner surface of your joints and tendons. Synovium makes synovial fluid that lubricates and cushions the cartilage and other tissues during movement.
As the disease progresses, the inflamed synovium releases inflammatory chemicals that gradually destroys cartilage, bone and other tissues. This causes painful and deformed joints. RA usually affects the same joints on both sides of the body.
RA commonly affects the joints in fingers, wrist, feet, ankles, knees and elbows. But it damages more than just joints. Chronic inflammation associated with RA can also damage your respiratory system, eyes, kidneys, blood vessels and heart.
Common symptoms of rheumatoid arthritis
- Joint pain which feels worse in the mornings and after a period of inactivity
- Swelling, warmth and redness around affected joints
- Stiffness, which is often more severe in the morning and after being inactive for a while
- Reduced mobility
- Fatigue and poor energy levels
- Poor appetite
- Weight loss
- Dry, inflamed eyes
- Trouble breathing
Rheumatoid arthritis (RA) can’t be cured. Any treatment for RA involves easing symptoms like pain and inflammation.
A pilot clinical study showed that curcumin was superior to diclofenac in its ability to reduce tenderness and swelling in joints in patients with active rheumatoid arthritis. In addition, curcumin didn’t result in any adverse effect.
Diclofenac is a NSAID commonly used to treat painful, inflammatory conditions such as rheumatoid arthritis, gout, muscle sprain, painful period cramps and migraines. It is associated with damage to the heart and stomach lining, putting you at an increased risk of heart attack, blood clots, heart burns and ulcers.
The researchers wrote that “Our study provides the first evidence for the safety and superiority of curcumin treatment in patients with active RA.” 
Curcumin in Premenstrual Syndrome (PMS)
PMS symptoms are associated with changes in certain hormones and production of prostaglandin E2 by the cells of the uterus. Prostaglandins makes the uterus contract so that it can shed its lining. High levels of prostaglandins not only cause intense uterine cramping but also result in dizziness, vomiting, headaches and even diarrhea.
We know how COX2 enzymes release pain and inflammation causing prostaglandins. Curcumin targets these enzymes and other molecules, reducing the levels of inflammatory chemicals. The anti-inflammatory polyphenol also regulates some neurotransmitters involved in troubling PMS symptoms.
A randomized, double-blind, placebo-controlled trial showed how curcumin may help reduce the severity of PMS symptoms. It concluded that, “Our results for the first time showed a potential advantageous effect of curcumin in attenuating the severity of PMS symptoms, which were probably mediated by modulation of neurotransmitters and anti-inflammatory effects of curcumin.” 
Curcumin and other health conditions
Since curcumin is incredibly effective in reducing inflammation, pain and oxidative damage, this natural compound has been found to reduce the risk of heart disease and prevent premature ageing and inflammation in the brain.
Using Curcumin supplements
Curcumin supplements can be used to manage chronic pain. But they are not very effectively absorbed by the body, an issue that can be either resolved by taking your supplements with piperine and some healthy fat or by using liposomal curcumin supplements.
Are there any side effects?
Curcumin supplements are fairly safe to use. But it can cause side effects like skin rashes, nausea and diarrhea in some people if directions are not followed.
Who should avoid curcumin supplements?
- Pregnant or breastfeeding women
- Those taking blood thinners like warfarin
- Those with gallbladder disease or kidney stones
As always, we recommend buying a high-quality curcumin supplement that is free of pesticides and heavy metals. And don’t forget to consult your health care professional before taking curcumin or any other supplement.
- Sun et al. Role of curcumin in the management of pathological pain. Phytomedicine. 2018
- Rahmati et al. Inflammatory mediators in osteoarthritis: A critical review of the state-of-the-art, current prospects, and future challenges. Bone. 2016
- Kalaitzoglou et al. Innate Immune Responses and Osteoarthritis. Curr Rheumatol Rep. 2017
- Chin KY et al. The spice for joint inflammation: anti-inflammatory role of curcumin in treating osteoarthritis. Drug Des Devel Ther. 2016
- V Kuptniratsaikul et al. Efficacy and safety of Curcuma domestica extracts compared with ibuprofen in patients with knee osteoarthritis: a multicenter study. Clin Interv Aging. 2014
- Bannuru et al. Efficacy of curcumin and Boswellia for knee osteoarthritis: Systematic review and meta-analysis. Semin Arthritis Rheum. 2018
- Chandran et al. A randomized, pilot study to assess the efficacy and safety of curcumin in patients with active rheumatoid arthritis. Phytother Res. 2012
- Khayat et al. Curcumin attenuates severity of premenstrual syndrome symptoms: A randomized, double-blind, placebo-controlled trial. Complement Ther Med. 2015