Can ginger help your joint pain?

Marion Hauser, MS, RD

The medicinal value of ginger has been known for thousands of years. In this article, we will look at ginger and how it can help the problems of osteoarthritis.

Every day at our clinic, we see a lot of people with significant joint pain. Following treatment, many will ask our staff about nutrition. Nutrition, of course, is a very important element in healing. The right food stimulates healing, the wrong food can cause inflammatory reactions and hinder healing.

Often, a patient will say “I have heard a lot of good things about ginger. Should I take it?”

Ginger has shown itself to be a very beneficial herb. The good things that people have heard about ginger typically surround the problems of diabetes and cholesterol and have been substantiated in research.

Ginger is the subject of research in the fields of cancer and Alzheimer’s disease. But as we are involved in the problems of musculoskeletal pain, we will explore ginger’s impact on joint and spine health.

“Mighty” and “Amazing” are words you usually do not see in scientific papers, but extraordinary claims can be made when they are backed and supported by extraordinary evidence

There is outstanding research behind the medicinal value of ginger. For a book to make it to the National Center for Biotechnology Information bookshelf, it has to be well versed in the science of its subject matter. In the book Herbal Medicine: Biomolecular and Clinical Aspects. 2nd edition, authors Ann M. Bode and Zigang Dong wrote a remarkable chapter called: The Amazing and Mighty Ginger. (4)

Here are the learning points of this chapter as it relates to joint pain:

Ginger is doing a lot of anti-inflammatory work. It is easy to see why this research ends with the conclusion “Ginger appears to be safe and its effects are mighty and amazing in its many applications.”

The evidence that adding the mighty and amazing ginger to your diet can help your joint pain. Researchers look at 500 mg of ginger supplements.

Here is more research. University hospital researchers writing in the Journal of Nutrition in Gerontology and Geriatrics (5) examined the effects of 500 mg of ginger supplements on older patients with osteoarthritis. Here are their findings:

Comment: 500 mg of ginger for 3 months, reduction of inflammation in older patients

Simultaneously, members of the same research team examined serum concentration of nitric oxide and hs-C reactive protein after the ginger supplementation and published their results in the Journal of Traditional and Complementary Medicine. (6)

Nitric Oxide is another of our body’s Dr. Jeykll/Mr. Hyde molecules. In a normal joint environment, nitric oxide regulates inflammation as a healing agent. In an abnormal toxic non-healing joint environment, nitric oxide production gets stuck in the “open,” position creating chronic damaging inflammation.

Elevated hs-C reactive protein markers are considered a general indication of inflammatory disease.

Comment: 1000 mg of ginger for 3 months, reduction of inflammation in knee osteoarthritis patients.

Ginger may help reduce rheumatoid arthritis inflammation

A December 2019 (7) study found that “ginger powder decreases (inflammatory markers) High-sensitivity C-reactive Protein and Interleukin 1 beta (IL-1β) in patients with active rheumatoid arthritis and it seems that ginger can improve the inflammation in the rheumatoid arthritis patients by decreasing inflammatory factors.

November 2020 in the journal Phytotherapy Research (8) explains the science. Explanatory notes have been added in parenthesis.

“Inhibition of prostaglandins via COX and LOX pathways.” (Prostaglandins are lipids that are produced at the site of injury to deal with tissue damage. They are also produced to fight off infection. They help regulate and take part in the inflammatory process. They help bring inflammation to the injury site by way of increasing blood circulation.)

The COX pathway makes prostaglandins through the conversion of arachidonic acid, a fatty acid.

While the COX pathway sounds beneficial for healing, stopping the production of prostaglandins is seen as an anti-inflammatory treatment. Let’s look at two more papers and then get back to the ginger connection.

The two papers are separated by 17 years.

First, in 2004 a paper published in the journal Rheumatology wrote (9): “The development of osteoarthritis may be accompanied by increased production of leukotrienes (immune responders that make inflammation, specifically in allergy, asthma, and rheumatoid issues) and prostaglandins from arachidonic acid. These products contribute to joint damage, pain, and inflammation. . . (Reducing prostaglandins) by non-steroidal anti-inflammatory drugs and selective COX-2 inhibitors reduces the levels of prostaglandins, resulting in a reduction in pain and inflammation. However, this inhibition can cause alternative processing of arachidonic acid via the 5-lipoxygenase (5-LOX) pathway, resulting in increased production of proinflammatory and gastrotoxic leukotrienes.

What does this mean?

Nature always finds a way to bypass anti-inflammatory medications if it thinks your joints need inflammation to heal or to be protected from further damage (This would be the swelling of your joints).

Now, let’s look at a 2021 paper (10) that cited this 2004 research. It explains that Nature remains tricky and elusive and does not want to shut down your inflammation.

“Anti-inflammatory drugs inhibit cyclooxygenases (COX), which are involved in the biosynthesis of prostaglandins that promote inflammation. The conventional non-steroidal anti-inflammatory drugs (NSAIDs) are associated with gastric and renal side-effects . . . The majority of selective COX-2 inhibitors (COXIBs) are without gastric side-effects but are associated with cardiac side-effects on long-term use. . . The search for anti-inflammatory drugs without side-effects, therefore, has become a dream and ongoing effort of the Pharma companies.”

Back to ginger.

 

And back to the November 2020 paper to tie this all in: “Some (researchers) attributed (ginger’s) anti‐inflammatory activity to the inhibition of pro‐inflammatory cytokines and Lipopolysaccharide‐activated macrophages antigen presentation. (In simplest terms, the creators of fever and run-away inflammation.)

What does this mean? Ginger can help reduce inflammation, possibly runaway inflammation. However, ginger should not be seen as a single miracle compound. Many people take ginger for years and they still have a lot of inflammation. 

The impact on bone growth and inflammation

University researchers published in the Brazilian Journal of Medical and Biological Research found 6-gingerol (the chemical component of fresh ginger)  stimulated osteoblast differentiation (bone turnover that creates new bone) in normal physiological and inflammatory settings, and therefore, 6-gingerol represents a promising agent for treating osteoporosis or bone inflammation. (11)

A July 2018 study in the Internation Journal of Molecular Sciences (12) found that 6-gingerol (a component of ginger) inhibits IL-1-induced (inflammatory induced) osteoclast differentiation (bone loss) through down-regulation of RANKL expression in osteoblasts by suppressing prostaglandin synthesis  (the inflammatory response at the site of tissue damage). The research team noted: “Given the important roles of prostaglandin synthesis  in inflammatory diseases, the inhibitory action of 6-gingerol on prostaglandin synthesis may provide a molecular basis for its anti-inflammatory effects and its potential use in treating inflammatory bone loss.”

A brief and further understanding of bone disintegration and RANKL inhibitors

Natural joint repair is through two mechanisms:

For those of you who have been prescribed RANKL inhibitors, it may have been explained to you that your body is producing too much of this protein from the Tumor Necrosis Family, (a family of cells that cause cell death.) What RANKL does is secrete acids to disintegrate bone. This is a beneficial function when controlled, as explained above, it is simply out with the old bone, in with the new, the skeletal system grows and gets stronger through this function. It is not beneficial when too much material is removed, thus the prescriptions for RANKL inhibitors.

If you would like to learn more about RANKL in our treatment programs, please see our article: Can you repair a bone-on-bone knee without surgery?

Ginger protects cartilage

University researchers in Thailand writing in the journal Planta Medica, (13) made these observations in their February 2017 study:

Topical Ginger Rub

According to research, you do not have to eat ginger to get the benefits although ginger is very tasty. University researchers in Thailand writing in the Journal of the Medical Association of Thailand (14) took 60 patients age 50 to 75 with knee osteoarthritis and gave them ginger extract to use as a topical rub three times a day for 12 weeks. The doctors recorded statistically significant improvement in the patients’ scores for knee joint pain, symptoms, daily activities, sports activities, and quality of life.

Ginger helps with exercise-induced muscle pain

In a January 2019 study in the journal Sports Medicine – Open (15) researchers speculated that regular consumption of ginger may act to mitigate post-exercise soreness Ginger exerts analgesic effects by modulating COX signaling and inhibiting prostaglandin synthesis. We discussed this above. Ginger may work as a natural COX-2 inhibitor (COX, or cyclooxygenase, which are two enzymes (COX-1 and COX 2) that promote inflammation).

In this study, the researchers cited previous studies that suggested:

Supporting a better healing experience

When you get medical treatment, any medical treatment, healing requires a strong immune system and a healthy lifestyle. We often tell patients that his/her diet contributes to their joint pain and that they should explore working with nutritionists to enhance their healing capabilities.

Do you have questions about chronic joint pain? You can get help and information form our Caring Medical Staff

1 Arzati MM, Honarvar NM, Saedisomeolia A, Anvari S, Effatpanah M, Arzati RM, Yekaninejad MS, Hashemi R, Djalali M. The Effects of Ginger on Fasting Blood Sugar, Hemoglobin A1c, and Lipid Profiles in Patients with Type 2 Diabetes. International journal of endocrinology and metabolism. 2017 Oct;15(4). [Google Scholar]
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4 Mozaffari-Khosravi H, Naderi Z, Dehghan A, Nadjarzadeh A, Fallah Huseini H. Effect of Ginger Supplementation on Proinflammatory Cytokines in Older Patients with Osteoarthritis: Outcomes of a Randomized Controlled Clinical Trial. Journal of nutrition in gerontology and geriatrics. 2016 Jul 2;35(3):209-18. [Google Scholar]
5 Naderi Z, Mozaffari-Khosravi H, Dehghan A, Nadjarzadeh A, Huseini HF. Effect of ginger powder supplementation on nitric oxide and C-reactive protein in elderly knee osteoarthritis patients: A 12-week double-blind randomized placebo-controlled clinical trial. J Tradit Complement Med. 2015 Jan 28;6(3):199-203. doi: 10.1016/j.jtcme.2014.12.007. PMID: 27419081; PMCID: PMC4936657. [Google Scholar]
6 Fan JZ, Yang X, Bi ZG. The effects of 6-gingerol on proliferation, differentiation, and maturation of osteoblast-like MG-63 cells. Brazilian Journal of Medical and Biological Research. 2015 Jul;48(7):637-43. [Google Scholar]
7 Aryaeian N, Mahmoudi M, Shahram F, Poursani S, Jamshidi F, Tavakoli H. The effect of ginger supplementation on IL2, TNFα, and IL1β cytokines gene expression levels in patients with active rheumatoid arthritis: A randomized controlled trial. Med J Islam Repub Iran. 2019 Dec 27;33:154. doi: 10.34171/mjiri.33.154. PMID: 32280660; PMCID: PMC7137811. [Google Scholar]
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9 Brune K. Safety of anti-inflammatory treatment—new ways of thinking. Rheumatology. 2004 Feb 1;43(suppl_1):i16-20. [Google Scholar]
10 Hwang YH, Kim T, Kim R, Ha H. The Natural Product 6-Gingerol Inhibits Inflammation-Associated Osteoclast Differentiation via Reduction of Prostaglandin E2 Levels. International journal of molecular sciences. 2018 Jul;19(7):2068.  [Google Scholar]
12 Ruangsuriya J, Budprom P, Viriyakhasem N, Kongdang P, Chokchaitaweesuk C, Sirikaew N, Chomdej S, Nganvongpanit K, Ongchai S. Suppression of Cartilage Degradation by Zingerone Involving the p38 and JNK MAPK Signaling Pathway. Planta medica. 2017 Feb;83(03/04):268-76. [Google Scholar]
13 Taneepanichskul S, Niempoog S. Improving of Knee Osteoarthritic Symptom by the Local Application of Ginger Extract Nanoparticles: A Preliminary Report with Short Term Follow-Up. J Med Assoc Thai. 2015;98(9):871-7. [Google Scholar]
14 Harty PS, Cottet ML, Malloy JK, Kerksick CM. Nutritional and Supplementation Strategies to Prevent and Attenuate Exercise-Induced Muscle Damage: a Brief Review. Sports medicine-open. 2019 Dec 1;5(1):1. [Google Scholar]

This article was updated May 21, 2021

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