Ginger

Ginger extracts are available over the counter in pharmacies in the form of capsules and oil. In theory, ginger can reduce the activity of several chemical substances that promote joint inflammation. Results from RCTs assessing its role in treating participants with osteoarthritis found that it has a high safety profile and can have moderately beneficial effects in reducing pain and disability.

• Family: Herbal medicine of the ginger (Zingiberaceae) family
• Scientific name: Zingiber officinale
• Other names: Gan Jiang, zingiber, EV.EXT35, African ginger, black ginger, chayenne ginger, Zinaxin®

Ginger is a plant native to China, South East Asia, West Africa and the Caribbean. The herbal preparation is taken from part of the plant’s stem (the rhizome). You can buy it from high-street retailers.

Some laboratory and animals studies have found ginger extracts can reduce the production of several chemical substances (including leukotrienes) that promote joint inflammation. Ginger also contains salicylates, which your body transforms into a chemical substance called salicylic acid. Salicylic acid prevents your nerves making certain prostaglandins and this eases pain and discomfort.

Ginger is a relatively well-tolerated herbal remedy with minor side-effects. The most commonly reported side-effects are stomach upset and mouth irritation. You should take ginger with care if you use anticoagulants because ginger might increase the risk of bleeding.

No recommended safe and effective doses have been found for use in musculoskeletal conditions. Doses ranging from 510–1,000 mg a day have been used in RCTs.

Trial 1

In this trial, 67 participants with osteoarthritis of the hip or knee were given one of the following treatments three times a day for three weeks:

• 170 mg capsules of ginger extract
• 400 mg ibuprofen tablets
• a placebo.

Participants were given paracetamol as a ‘rescue drug’ for pain relief during the study.

• Participants who were given ibuprofen or ginger had a significant reduction in pain scores and reported taking less paracetamol compared to those who got placebo tablets.
• Ibuprofen was more effective than ginger in both treatment outcomes.

Trial 2

Trial 2 included 29 people with knee osteoarthritis. Participants were given either 250 mg of ginger capsules or placebo capsules four times a day for 3 months (phase A). The groups then swapped treatments for three months (phase B).

• At the end of phase A, participants who were treated with ginger had a significant reduction in pain and disease-related disability when compared to participants who were allocated a placebo during the same phase.
• No significant difference between treatment groups was observed at the end of phase B.

Trial 3

In the final trial, 247 participants with knee osteoarthritis were given either 255 mg of ginger capsules or placebo capsules twice a day for six months. Paracetamol was given as a rescue drug for pain relief during the study.

• 63% of the participants who were treated with ginger had significant reduction in knee pain compared to 50% of the placebo group.
• The severity of pain and overall improvement of osteoarthritis-related symptoms were also significantly reduced in the group taking ginger compared to the placebo group.
• Both groups were similar with respect to their perceived improvement in quality of life.
• The ginger group reported more gastrointestinal side-effects (like heartburn), but they were relatively mild and tolerable.