A groundbreaking clinical trial found a turmeric, black pepper and ginger formulation as effective as naproxen (e.g. Advil) for osteoarthritis, without NSAID side effects. Shows promise as a natural, herbal alternative.
Osteoarthritis afflicts over 30 million U.S. adults, causing joint inflammation that erodes cartilage and brings chronic pain5. Many rely on non-steroidal anti-inflammatory drugs (NSAIDs) like naproxen to reduce swelling. But study after study confirms NSAIDs cause alarming side effects like ulcers, bleeding, heart attacks and strokes in up to 25% of users6,7,8. These safety issues prompt important questions on safer options.
How Do NSAIDs Like Naproxen Work?
Naproxen belongs to the NSAID class along with ibuprofen and aspirin. NSAIDs reduce pain and inflammation by inhibiting cyclooxygenase enzymes COX-1 and COX-2. These enzymes normally produce lipid compounds that trigger inflammation during injury and stresses9. But long-term inhibition drives substantial collateral damage, some of which the mechanisms are known, but many of which still remain a mystery.
Studies show NSAID users face 2-4 times higher risk of dangerous ulcers in their stomach lining that can bleed severely10. The drugs also raise blood pressure, cause fluid retention, and impair kidney function11. Most alarmingly, NSAID use heightens the chance of heart attacks by 19% and strokes by 22% versus non-use12.
The FDA warns NSAID heart risks start within the first weeks of use, and may double by month two8. While doctors view NSAIDs as the go-to quick fix, their safety issues render them unsuitable for long-term reliance. But osteoarthritis demands steadier solutions.
Tastier Anti-Inflammatory Alternatives Emerge
Seeking safer long-term options for joint pain beyond NSAIDs, researchers recently put three anti-inflammatory culinary spices to the test – turmeric, ginger, and black pepper. These kitchen staples contain potent plant compounds that mute inflammation naturally.
Curcumin from turmeric modulates inflammatory pathways like NF-kB and cytokines equal to over-the-counter drugs13. Gingerols within ginger disable COX-2 enzymes similar to NSAIDs but gentler on the stomach lining14. And piperine from black pepper enhances absorption of turmeric by up to 2000%15. Combined, this anti-inflammatory trio challenges NSAIDs.
In a 2022 double-blind randomized controlled trial, researchers gave 60 osteoarthritis patients either 500 mg naproxen tablets twice daily or herbal capsules with 500 mg turmeric extract, 7.5 mg gingerols, and 3.75 mg piperine twice daily for a month4.
Remarkably, the spices relieved joint inflammation and pain on par with the potent NSAID. But the herbs generated no adverse effects whatsoever unlike the drug. Patients also rated the spices equivalent or better than naproxen for efficacy and tolerability.
While more research should continue confirming their long-term safety, anti-inflammatory herbs and spices like turmeric, ginger and black pepper offer hope for those seeking crises care comfort free of NSAID side effects.
For more information on the harms of NSAIDs, consult our database on the subject linking the use of these drugs with over 200 adverse effects and health conditions.
For more evidence-based solutions for Osteoarthritis, consult our database on the subject on over 200 natural substances researched for their potential therapeutic value in preventing or treating the condition.
References:
Smolinski KM, Yan J, Pang L. Risk of gastrointestinal complications associated with NSAIDs: a retrospective cohort study in a large managed care organization. Pharmacotherapy. 2011 Mar;31(3):210-7.
Coxib and traditional NSAID Trialists' (CNT) Collaboration. Vascular and upper gastrointestinal effects of non-steroidal anti-inflammatory drugs: meta-analyses of individual participant data from randomised trials. Lancet. 2013 Aug 31;382(9894):769-79.
Jones GM, Sebba A, Lichtenstein DR. Efficacy and safety of naproxen sodium gastro-resistant tablets compared to prescription strength ibuprofen: a randomized, double-blind study in patients with osteoarthritis. Curr Med Res Opin. 2013 Nov;29(11):1457-64.
Amirghofran Z, Bahmani M, Azadmehr A, Javidnia K, Miri R. Herbal Treatment in Comparison with Naproxen in Patients with Knee Osteoarthritis: A Randomized, Double-Blinded, Placebo-Controlled, Clinical Trial on Efficacy and Safety. Phytother Res. 2022 Jun;36(6):2719-2729.
Barbour KE, Helmick CG, Boring M, Brady TJ. Prevalence of Doctor-Diagnosed Arthritis and Arthritis-Attributable Activity Limitation - United States, 2013-2015. MMWR Morb Mortal Wkly Rep. 2017 Mar 10;66(9):246-253.
Smolinski KM, Yan J, Pang L. Risk of gastrointestinal complications associated with NSAIDs: a retrospective cohort study in a large managed care organization. Pharmacotherapy. 2011 Mar;31(3):210-7.
Massó González EL, Patrignani P, Tacconelli S, García Rodríguez LA. Variability among nonsteroidal antiinflammatory drugs in risk of upper gastrointestinal bleeding. Arthritis Rheum. 2010 Jun 15;62(6):1592-601.
Food and Drug Administration (2005) Public health advisory for non-steroidal anti-inflammatory drugs. http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/ucm125222.htm
Dannhardt G, Kiefer W. Cyclooxygenase inhibitors--current status and future prospects. Eur J Med Chem. 2001 Mar;36(2):109-26. Review.
Patrono C, Baigent C. Nonsteroidal anti-inflammatory drugs and the heart. Circulation. 2014 Oct 28;130(18):1580-9.
Whelton A, Hamilton CW. Nonsteroidal anti-inflammatory drugs: effects on kidney function. J Clin Pharmacol. 1991 Jul;31(7):588-98.
Coxib and traditional NSAID Trialists' (CNT) Collaboration. Vascular and upper gastrointestinal effects of non-steroidal anti-inflammatory drugs: meta-analyses of individual participant data from randomised trials. Lancet. 2013 Aug 31;382(9894):769-79.
Daily JW, Yang M, Park S. Efficacy of Turmeric Extracts and Curcumin for Alleviating the Symptoms of Joint Arthritis: A Systematic Review and Meta-Analysis of Randomized Clinical Trials. J Med Food. 2016 Aug;19(8):717-29.
Lantz RC, Chen GJ, Sarihan M, Sólyom AM, Jolad SD, Timmermann BN. The effect of extracts from ginger rhizome on inflammatory mediator production. Phytomedicine. 2007 Feb;14(2-3):123-8.
Shoba G, Joy D, Joseph T, Majeed M, Rajendran R, Srinivas PS. Influence of piperine on the pharmacokinetics of curcumin in animals and human volunteers. Planta Med. 1998 May;64(4):353-6.
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