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.

A 2017 study in the International Journal of Endocrinology and Metabolism (1) found oral ginger supplementation decreased the levels of fasting blood sugar, Hemoglobin A1C (blood glucose levels), and LDL/HDL cholesterol ratio in subjects with type 2 diabetes. Please see my article: What to do about knee pain being caused by your unmanaged or uncontrolled Type 2 diabetes for more information.
A January 2018 study in the journal Evidence-based Complementary and Alternative Medicine (2) found that ginger offered obvious ameliorative (reduction) effects on glucose control, insulin sensitivity, and lipid profile. The study concluded: “ginger may be a promising adjuvant therapy for type 2 diabetes and metabolic syndrome.” Please see my article: Your bad diet and weight is destroying your knees and will send you to a nursing home. For more information on this subject.
A comprehensive review (January 2020) of the medical research surrounding the beneficial aspects of ginger was published in the medical journal Nutrients. (3) Here researchers wrote: “The clinical effects of ginger have been introduced as six subsections:
- nausea and vomiting,
- gastrointestinal function,
- pain,
- inflammation,
- metabolic syndromes, and
- other symptoms.”

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:

One of the many health claims attributed to ginger is its ability to decrease inflammation, swelling, and pain. Research showed ginger extracts exhibited analgesic (pain relief) and potent anti-inflammatory effects.
Some studies suggested ginger worked on a molecular level to reduce the chemical signaling that created inflammation and a toxic joint environment.
- Ginger may reduce chronic inflammation by restricting the use of blood vessels in prostaglandin and leukotriene biosynthesis.
  - (Imagine that inflammation uses a four-lane highway to bring chronic and toxic pro-inflammatory factors into your joint (prostaglandin and leukotriene biosynthesis). Ginger closes down some of those lanes and snarls up that traffic a bit so all the inflammation does not get through.)
- Ginger may inhibit arachidonate 5-lipoxygenase, a key inflammatory agent in rheumatoid arthritis, diseases of chronic inflammation, heart disease, and those inflammatory factors in joint pain.
- Ginger may suppress the activation of tumor necrosis factor α (TNF-α) Tumor-Necrosis factor (TNF‑α) is a cell-signaling protein (cytokine), which communicates the commands to create inflammation in arthritis joint swelling. The medical thinking is if you can block TNF and other inflammatory factor production or at least inhibit it, the joint swelling will be reduced and hopefully, the amount of articular cartilage breakdown resulting from a toxic, over the inflamed joint environment will be slowed.
- Ginger may work as a natural COX-2 inhibitor (COX or cyclooxygenase, which are two enzymes (COX-1 and COX 2) that promote inflammation). COX inhibitors shut off inflammation and directly cause suppression of cartilage cell growth and natural repair of articular cartilage growth

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:

The doctors sought to provide evidence that ginger powder consumption can relieve pain and inflammation in older arthritis patients.
One hundred and twenty patients were divided into two groups. Sixty would receive the ginger supplement and 60 would receive a placebo for three months.
At 3 months, inflammatory-causing cytokines (cell signaling chemicals involved in chronic inflammation) decreased in the ginger group.
The results of this study indicate that ginger supplementation may have promising benefits for knee osteoarthritis and may, therefore, may warrant further study.

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.

After 12 weeks of 500 mg of ginger supplements, serum concentration of nitric oxide and hs-C reactive protein declined.
Ginger powder supplementation at a dose of 1 gram/day can reduce inflammatory markers in patients with knee osteoarthritis, and it thus can be recommended as a suitable supplement for these patients.

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:

(1) removing bone damage to make way for
(2) new bone remodeling.

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:

Zingerone, an active compound that is present in cooked ginger, has been claimed to be a bioactive ingredient that holds the potential of preventing and/or treating diseases involving inflammation.
From the results of this study, it can be concluded that zingerone potentially reduced cartilage degradation
This finding supports the contention that ginger holds positive pharmaceutical effects against osteoarthritis..

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:

Research participants who consumed 2 grams of raw or heat-treated ginger per day for 11 days reported less pain after performing exercises surrounding the elbow than the placebo group
Researchers found that male and female subjects who consumed 4 grams of ginger per day for 5 days prior to damaging eccentric elbow flexion exercise experienced faster recovery of elbow flexor.

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

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This article was updated May 21, 2021