Ginger and OA

Bartels EM et al. Efficacy and safety of ginger in osteoarthritis patients: a meta-analysis of randomized placebo-controlled trials. Osteoarthritis and Cartilage: 2015
  • With the growing interest in herbal and phytochemical products in the treatment of OA, the purpose of this study was to examine the clinical evidence of efficacy and safety of oral ginger in the symptomatic treatment of OA 
  • Previous research has shown that ginger acts as a COX-2 inhibitor (similar to several anti-inflammatory medications) and inhibits lipo-oxygenase, which results in the suppression of various inflammatory leukotrienes. Ginger extracts have also been found to inhibit the expression of TNF-a and was shown to be as effective an anti-inflammatory agent as betamethasone.
  • In total, 593 pts from the 5 studies were included in the primary analysis. The daily dose of dinger was b/w 500-1000 mg/day and trial duration ranged from 3-12 weeks.
  • Using both pain and reported disability as outcome measures, there was a statistically significant difference b/w the ginger group and placebo. The change in pain with use of ginger is similar to that in studies looking at use of acetaminophen and the effect size is in the middle of the range of NSAIDs, all when compared to placebo. 
  • ginger appears to be a better treatment option than NSAIDs judged on its reasonable effect size for pain and disability coupled with the concerns of well-known serious side effects from NSAIDs
  • The American College of Rheumatology provides only weak (conditional) recommendation for most pharmacologic modalities for the initial treatment of pts with knee OA including acetaminophen, oral and topical NSAIDs, tramadol, and intra-articular injections including corticosteroids, hyaluronate, and opioids. 
  • This meta-analysis demonstrates that ginger is not only safe but has a superior effect on pain and disability compared to placebo w/o adverse events and similar to the positive effects of acetaminophen. 
  • The authors conclude that ginger may be considered as part of the treatment of OA, especially when the pt is motivated for trying herbal remedies. 
  • However, as with other complementary and alternative therapies further studies from independent researchers would be able to show if the effects suggested by this current study hold up.