Complementary treatments and arthritis - from turmeric to cannabis oil

Flowers, a bottle and a pepette signifying complementary and alternative medicines.

Why do people use complementary medicines?

People use complementary medicine for many different reasons, including:

  • wanting to use more natural treatments
  • their symptoms aren’t fully controlled by conventional medicine.

Read more about practical complementary therapies which can help to ease the symptoms of arthritis, from yoga to meditation.

Are they right for me?

As with all complementary treatments, different things work for different people and it isn’t possible to predict which might be the most useful or effective.

There are some key points to consider if you’re thinking about using any complementary treatments.

  • What are you hoping to achieve? Pain relief? More energy? Better sleep? Reduction in medication?
  • What are the financial costs?
  • Is there any evidence for their effectiveness?

Are complementary medicines safe?

Complementary medicines are relatively safe, although you should always talk to your doctor before you start any new treatment. 

In specific cases they may not be recommended, for example, if you are pregnant or breastfeeding, or they may interact with certain medication.

A starter for five 

Here we share a spotlight on the most popular complementary medicines that people call our helpline about.

Turmeric

It’s thought that turmeric can possibly reduce inflammation, which could help people with arthritis.

People with knee osteoarthritis who took part in a research trial (2009) reported improvements to their pain levels after taking turmeric. The evidence is limited however, as it is from just one trial. What evidence there is suggested that people only had minor side-effects after taking turmeric.

There is no evidence about the effectiveness of turmeric to treat the symptoms of any type of arthritis other than osteoarthritis.

Turmeric can be bought from health food shops, pharmacies and supermarkets in the form of powder.

Glucosamine

Glucosamine sulphate and glucosamine hydrochloride are nutritional supplements. Animal studies have found that glucosamine can both delay the breakdown of and repair damaged cartilage.

The results for the use of glucosamine for osteoarthritis are mixed and the size of the effect is modest. There’s some evidence that more recent trials and those using higher-quality methods are less likely to show a benefit.

If you’re allergic to shellfish, you should make sure that you take the shellfish-free variety.

You should also be cautious about taking glucosamine if you have diabetes. Glucosamine might increase your blood sugar level and it may mean that you need to adjust your treatment to make sure it carried on working.

Capsaicin

Capsaicin is taken from chilli peppers. It works mainly by reducing Substance P, a pain transmitter in your nerves. Results from randomised controlled trials assessing its role in treating osteoarthritis suggest that it can be effective in reducing pain and tenderness in affected joints, and it has no major safety problems. Evidence for its effectiveness for fibromyalgia is related to a single trial.

Other names: Axsain®, Zacin®, chilli, pepper gel, cayenne

Capsaicin is licensed in the UK for osteoarthritis and you can get it on prescription in the form of gels, creams and plasters.

There are no major safety concerns in applying capsaicin gel/cream. A review of capsaicin applied to the skin to treat chronic pain (not specifically related to osteoarthritis, rheumatoid arthritis or fibromyalgia) concluded that around one third of people experience a reaction around the area where the treatment is applied. It’s important to keep capsaicin away from your eyes, mouth and open wounds because it will cause irritation. There have been no reported drug interactions.

Read more about capsaicin cream shortages: what you can do.

Fish oils

Fish oils are rich in omega-3 essential fatty acids, which have strong anti-inflammatory properties. Fish liver oil is also a rich source of vitamin A (a strong antioxidant) and vitamin D (which is important for maintaining healthy joints).

Evidence suggests that fish body oil can improve the symptoms of rheumatoid arthritis. Unconfirmed evidence also suggests a combination of fish body and liver oils might also be useful in the long term, particularly in reducing the use of non-steroidal anti-inflammatory drugs (NSAIDs). There isn’t enough evidence for the use of fish liver oil for osteoarthritis.

Omega-3 fatty acids also play a role in lowering cholesterol and triglyceride levels in your blood, so they can reduce the risk of heart disease and stroke in people with inflammatory arthritis.

In the UK, dietary guidelines recommend eating two portions of fish a week, including one oily. Fish oil is considered to be well tolerated at this dose. However, certain environmental chemicals such as methylmercury and polychlorinated biphenyls (PCBs) can contaminate fish supplies and there’s a concern that taking very high doses of fish oil can cause a build-up of these chemicals in the body.

At the correct doses, side-effects are usually minor and uncommon.

Cannabis oil (CBD)

CBD is type of cannabinoid – a natural substance extracted from the cannabis plant and often mixed with an oil (such as coconut or hemp) to create CBD oil. It does not contain the psychoactive compound called tetrahydrocannabidiol (THC) which is associated with the feeling of being ‘high’.

Research in cannabinoids over the years suggests that they can be effective in treating certain types of chronic pain such as pain from nerve injury, but there is currently not enough evidence to support using cannabinoids in reducing musculoskeletal pain. We welcome further research to better understand its impact and are intently following developments internationally.

CBD oil can be legally bought as a food supplement in the UK from heath food shops and some pharmacies. However, CBD products are not licensed as a medicine for use in arthritis by MHRA (Medicines and Healthcare products Regulatory Authority) or approved by NICE (National Institute for Health and Care Excellence) or the SMC (Scottish Medicines consortium).

We know anecdotally from some people with arthritis, that CBD has reduced their symptoms. If you’re considering using CBD to manage the pain of your arthritis, it’s important to remember it cannot replace your current medicines, and it may interact with them, so please do not stop/start taking anything without speaking to a healthcare professional.

Got a question?

For more information call our helpline 0800 5200 520 or check out our complementary treatment pages.