Caring Medical - Where the world comes for ProlotherapyCan ginger help 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 problems of osteoarthritis.

Everyday we open the doors at our clinics, 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.

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.”

Ginger is the subject of research in the fields of cancer, Alzheimer’s disease, digestion, and others. 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 the 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.(3)

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 suppresses the activation of tumor necrosis factor α (TNF-α) Tumor-Necrosis factor (TNF‑α) is cell signalling 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 inflamed joint environment will be slowed.
    • Ginger may work as a natural COX-2 inhibitor (COX or cyclooxygenase, 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 in Iran writing in the Journal of nutrition in gerontology and geriatrics (4) 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 who would receive the ginger supplement and 60 who would receive a placebo for three months.
  • At 3 months, inflammatory causing cytokines (cell signalling chemicals involved in chronic inflammation) decreased in the ginger group.
  • The results of this study indicate that ginger supplementation may have a 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.

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.(5)

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

The impact on bone growth and inflammation

University researchers in China publishing 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.(6)

A July 2018 study in the Internation journal of molecular sciences (7) found that 6-gingerol (a componet 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 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 on 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: Stem cell therapy and advanced knee osteoarthritis

Ginger protects cartilage

University researchers in Thailand writing in the journal Planta medica, (8) 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 (9) 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 statistical 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 (10) 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, 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 a 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]
2 Zhu J, Chen H, Song Z, Wang X, Sun Z. Effects of Ginger (Zingiber officinale Roscoe) on Type 2 Diabetes Mellitus and Components of the Metabolic Syndrome: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Evidence-Based Complementary and Alternative Medicine. 2018;2018. [Google Scholar]
3 Bode AM, Dong Z. The amazing and mighty ginger. Herbal medicine: Biomolecular and clinical aspects. 2011 Mar 28;2. [Google Scholar]
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 Zaderi 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. Journal of traditional and complementary medicine. 2016 Jul 31;6(3):199-203. [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 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]
8 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]
9 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]
10 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]

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