Let’s get back to our ‘patient’. Norma decided to start curcumin daily and since then her swelling has resolved and her knee pain is gone. She has normal function now and has no further limitations to her activities. Here are a few questions…
Did Norma need an MRI to confirm the clinical diagnosis of knee degenerative changes and chronic inflammation and swelling?
Could Norma have started on curcumin earlier?
Curcumin has been shown to be safe to use. Bioavailability is a concern and certain forms of curcumin, or the addition of piperine or black pepper extract, is needed to increase its absorption. Different forms of curcumin have different absorptions or bioavailability. The key is to use turmeric with higher levels of curcumin with an enhanced delivery system for improved absorption.
TIPS WHEN CHOOSING A TURMERIC SUPPLEMENT
Look for curcumin
Curcumin (or diferuloylmethane) is the active part of turmeric, a root that is part of the ginger family. It is one of three curcuminoids in the turmeric root.
“Turmeric contains curcumin, a substance with powerful anti-inflammatory and antioxidant properties. Most studies used turmeric extracts that are standardized to include large amounts of curcumin.”
Read the label
Most issues with turmeric curcumin are related to the added ingredients.
Keep it simple. Look for the least amount of ingredients.
Piperine or black pepper
Piperine or black pepper, Bioperine, increases the absorption of curcumin.
Piperine can affect some medications as well as blood platelets. Consult your doctor when picking curcumin with Bioperine or black pepper extract.
Curcumin and Fat
Curcumin is fat soluble, taking curcumin with a fatty meal can help its absorption.
Lipophilic molecules have been used to ‘coat’ the curcumin molecule and enhance absorption.
Higher doses of turmeric can cause nausea and diarrhea. Some companies add ginger extract to reduce these side effects.
Ginger has some anti-inflammatory effects similar to turmeric.
Consult your doctor regarding the addition of Black Pepper Extract, Bioperine or piperine, with your turmeric supplement.
TREAT THE CAUSE
The knee is a biomechanical system, affected by the hip as well as the foot and ankle. An evaluation of lower extremity biomechanics, with the goal of treatment to improve joint and muscle mobility and function through manual therapy, is recommended.
Effectiveness of manual physical therapy and exercise in osteoarthritis of the knee: a randomized, controlled trial.
TIPS WHEN ASSESSING KNEE PAIN AND SWELLING
Is there a loss of knee motion?
Loss of knee motion or extension changes our gait and knee mechanics.
This can cause continued knee swelling.
Look at knee mobility and mechanics.
Is there fluid on the knee?
Swelling on the knee inhibits quadriceps activation.
This causes increased soleus firing and calf trigger points are common.
Knee swelling can be picked up with clinical testing and through diagnostic ultrasound.
Is there a hip or ankle problem?
A sacroiliac joint problem creates a muscle firing imbalance around the hip, causing iliotibial band tension.
Stiffness to the foot joints can put abnormal strain on the knee.
Check for sacroiliac joint pain and stiffness to the ankle or forefoot.
Is there lateral thigh or IT Band tension?
Outside thigh tension is caused by a hip muscle imbalance.
This causes an outward pull on the kneecap and can cause chronic swelling due to poor mechanics.
Hip muscle firing problems occur with a sacroiliac joint injury and loss of motion.