In this study they specifically took about 150 people and divided them up into a group that got fish oil, a group that got fish oil plus very low dose curcumin, and a group that received nothing. The dosage of curcumin or turmeric that they received was really low and really not enough to really make any kind of sizable difference. But what they found was that when it came to osteoarthritis pain that there was a significant improvement in those folks who were taking fish oil.
Again really helpful and interesting because as we try to find other low risk options for our patients who’ve got chronic pain, we really want to minimize and avoid things that can cause more problems and issues. So number one what I really liked was that they were able to avoid taking antiinflammatory medications. Personally, I recommend over the counter supplements for my patients if they have osteoarthritis pain including glucosamine chondroitin, omega-3, and turmeric. So what I like about this study is the omega-3 component, which they’re receiving from fish oil, makes a significant difference in this cohort of people that we’re recommending this to.

Number two is the importance of emphasizing how inflammation plays a role in the musculoskeletal system and pain, even in osteoarthritis wear and tear arthritis. And we know that omega-3 works as an anti-inflammatory. So the ability to work not only at a joint level but possibly also at a systemic level in wear and tear arthritis patients is very helpful to know as well. We know that omega-3 in rheumatoid arthritis in high enough dosages is enough to help with pain, stiffness, and function. So it’s nice to find that you can get a similar benefit even in osteoarthritis as well.
The other component that is really great is how would this work on the metabolic system. I presented on Monday how there is evidence that if you have metabolic syndrome, which makes you more prone to heart disease and diabetes, that there’s also evidence that metabolic syndrome can actually cause cartilage breakdown. And that there’s a biomarker that you can actually follow for that. We know that omega-3, because it has that anti-inflammatory component, is appropriate for metabolic syndrome as well. Here is another way that we can look at metabolic syndrome and actually treat that. Again in a conservative way to help preserve and protect the joints as well. Another really nice way to think about how we can connect joints, musculoskeletal issues, pain, and with that total body approach to treating somebody. Where it’s not just looking at this as a structural issue but looking at it as a total biologic issue biochemical issue, nutritional issue, metabolic issue, and how can you treat all those things. Great because if you want to help somebody with pain, let’s make sure we’re not only thinking, “Hey, you’ve got a fixed problem here.” Meaning you’ve got bone on bone arthritis. Let’s think about all the variables and factors that we can actually make a difference on. I think taking that kind of positive approach makes a big difference for people as well.

The last point to this is that omega-3 you can get it in a couple of different things but the two main ones that you can find it in over the counter are in fish oil supplements as well as flaxseed oil. The reality is that the majority of studies that look at the effectiveness of omega-3 when it comes to joint health are actually done utilizing fish oil. So if you’re being really strict by the rules, you’d want to use fish oil supplements. The other aspect to that is if you are someone who has a nutritional preference or you want to avoid fish, then flaxseed oil can give you a high dose of omega-3. But again, we don’t actually know if flaxseed oil can give the same kind of results in terms of clinical response and pain relief.

The last thing to note is that in this study they utilize a total dosage of omega-3 2,400 milligrams. In rheumatoid arthritis studies, they utilize up to 3000 milligrams or higher. That’s a really high dosage. You’re not going to be able to get that on your own from just nutritional ingestion, just from fish ingestion, unless you are an Eskimo and you’re actually using Whale blubber as a condiment. You’re just not going to be getting enough omega-3 on your own. So I think as an option, low-risk option to treat your osteoarthritic pain related issues and just general musculoskeletal pain related issues, I would recommend omega-3 aiming for roughly 3000 milligrams per day.

Great. Well, thank you for your time. This one is relatively brief today and I hope that was helpful. Send me your questions or thoughts. If you have any, as a reminder, we do this on Mondays and Wednesdays live broadcast discussing issues that are relevant to what we do here at Chicago Arthritis and Regenerate Medicine where we focus on nonsurgical management and treatment of arthritis, tendinitis, injuries, and back pain. And until next time I hope everyone does well, has a good day, and live well. Bye bye.