Osteoarthritis also known as degenerative joint disorder is one type of arthritic form, characterized by symptoms such as pain, joint swelling and inflammation.
These disease mainly affect the weight bearing joints such as joints of knees, hips, hand and spine which get worst with the time.
Osteoarthritis is found more prevalent in older people who are mostly at the age of 45 or above, although it can affect young generation too. Reports have shown this disease occurs in more than 25% of Australian population over the age of 65.
Osteoarthritis is a chronic disease which gradually become worst with time if kept untreated. Hence treatment of this disease is very important to prevent further complications and pain in patients.
There are number of treatment for osteoarthritis other than medications such as adequate rest, proper physical exercises, weight management and proper intake of diet.
Many of the conventional treatment involving use of analgesic and non-steroidal anti- inflammatory drugs (NSAIDS) have shown effect in decreasing the pain and inflammation in arthritis patients, but unfortunately these medicines are also associated with number of side effects on human body such as stomach ulcers and intestinal problems.
Therefore there long term use is not recommended and scientist are in search of other alternative methods such as herbal remedy which are effective as well safer in treatment of osteoarthritis.
Ginger for Osteoarthritis – How it can help?
Ginger (Zingiber officinale), belonging to Zingiberaceae family is a tropical plant which is native to Southeast Asia and mainly grown in the United States, China, India and other tropical regions.
Ginger is a perennial plant that produces green or purple color flowers and aromatic roots (also known as rhizomes). The ginger root has found its importance in treatment of various health related problems as a part of herbal medicines from ancient times and was found to have excellent reputation in Indian and Chinese traditional medicines.
Ginger plants is an herb and its roots (rhizome) are mainly used as a spice in cooking from ancient times. The ginger root is firm with striated texture and is fibrous yellow or light red in color. The skin is brownish which is thin or thick in texture depending when the root is harvested.
The root can be used as fresh, dried, as powder or as a juice or in oil form for cooking purpose. Although the root has beautiful aroma which add zest flavour to many dishes, its medicinal properties are vast and therefore is found to be effective in alleviating symptoms of stomach ache, cough, morning sickness, anorexia, gas, nausea and diarrhoea.
Even though it was mainly used in treatment of various types of stomach aches as a home remedy from ages, it has grown its importance too in reducing the pain associated with other illness such as menstrual cramps, upper respiratory tract infection, bronchitis, muscle soreness, lower back pain, chest pain and also arthritis problems.
There are number of varieties in ginger family but one variety of ginger known as “Jamaican” is considered to be the most pungent one, due to the presence of highest concentrations of all these three gingerols i.e. -, - and [10- gingerol in it.
These gingerol components which are homologous phenolic ketones present in fresh ginger are found to be thermally unstable and hence get converted easily into their corresponding shogaols that is found in dried ginger.
The presence of these phenolic compounds which imparts ginger the properties of anti-inflammatory, carminative (prevent gas formation in stomach), anti-flatulent and anti-microbial, made this spice as a powerful herbal remedy in traditional medicines from ages.
The ginger root is also rich source of essential oils such as gingerol, zingerone, shogal, farnesene and other small content of B-phelladrene, cineol, and citral.
Studies have shown that the major phenolic compound found in ginger extracts known as gingerol as compared to other components has maximum anti-inflammatory, analgesic, anti-pyretic, antibacterial, anti-tumour and nerve soothing properties.
4 Benefits of Ginger In Osteoarthritis
Ginger has active constituents which aid in reducing inflammation and pain. It also remedies stomach issues.
1. Ginger is therapeutic in osteoarthritis
A review study revealed that oral ginger treatment in osteoarthritis led to significant reduction in pain and disability and ginger was a moderately safe treatment.
A study was conducted where individuals were treated with diclofenac (a painkiller) or ginger or both for 12 weeks. All 3 groups showed improvement but maximum improvement was seen in combination group.
It was observed that ginger has an additive effect on osteoarthritis treatment and safely potentiates the effects of painkillers.
Topical application of ginger extract nanoparticles is found to reduce pain and improve daily activities and joint function in those suffering from osteoarthritis. A case study reveals that ginger therapy progressively reduces osteoarthritis symptoms in 24 weeks.
Topical ginger treatment in the form of compress or patch progressively reduces symptoms of osteoarthritis and brings about 48% reduction in pain. Also this study reported 70% health satisfaction in comparison to 80% dissatisfaction that was reported earlier.
Ginger is included in herbal preparations which are found to be as effective as conventional treatment in improving osteoarthritis symptoms.
A placebo controlled, double blind, parallel group study was carried out including 247 patients with osteoarthritis of the knee (moderate to severe pain) where they were treated with ginger extracts as compared to control medicine (acetaminophen).
Analysis showed that the reduction in “knee on standing” pain was considerable greater in the ginger extract group as compared to placebo group indicating that the highly purified and standardized ginger extracts has significant role in reduction of osteoarthritis symptoms especially of knee.
However Niempoog et. al reported that 1g of ginger powder does not benefit in joint pain and function in osteoarthritis. Leach et. al also report in their review study that the current evidence regarding use of ginger in osteoarthritis is weak.
What does this mean?
Ginger alone or in combination with conventional treatment benefits in osteoarthritis by reducing pain and improving joint function.
2. It reduces inflammation and bone degradation
Inflammation is characterised by formation of inflammatory agent arachidonic acid which is metabolised by COX and LOX pathways to form prostaglandins and leukotrienes which are inflammatory mediators. Ginger acts by inhibiting the formation of these prostaglandins and leukotrienes.
The study reported that ginger powder consumption benefited in arthritis by bringing about reduction in pain, muscle soreness and reducing swelling. The time period when ginger was consumed ranged between 3 months to 2.5 years and no side effects were reported.
A clinical trial was conducted to assess the effect of ginger powder supplementation on inflammatory proteins in osteoarthritis. A dose of 1g ginger powder was given every day or placebo.
After 12 weeks of treatment, a significant reduction in inflammatory markers like Nitric oxide and C reactive protein was observed in the group receiving ginger powder. These results suggested that ginger powder could be an effective supplement for osteoarthritis.
6-shogaol, the active ingredient of ginger, reduces inflammation and cartilage and bone degradation in osteoarthritis. Dietary ginger can benefit in osteoarthritis. Ginger extract inhibits inflammation in synoviocytes- cells of synovial fluid that lubricates the joint.
Gingerol and shogaol have analgesic and anti-inflammatory properties. Ginger constituents inhibit formation of inflammatory mediators. Ginger extract benefits in chronic inflammation by influencing genes that regulate production of inflammatory mediators.
What does this mean?
Ginger constituents like gingerol and shogaol inhibit formation of inflammatory proteins in osteoarthritis; this brings about a reduction in pain, swelling and soreness. It also reduces degradation of bone and cartilage.
3. It inhibits pain
A review of 8 clinical trials shows that ginger’s anti-inflammatory effect helps in reduction of pain.
247 patients treated with ginger extract showed significant reduction in knee pain in the 6 week study. Mild GI effects were reported in ginger group.
Ginger extract has been found to be extremely efficacious in treating chronic pain and has an excellent safety profile in terms of kidney disease risk and bleeding risk associated with NSAIDs.
An important group of study was carried out to detect, how the pharmacological property of ginger extract is different from nonsteroidal anti-inflammatory drugs and more effective.
The discovery identified that ginger is effective in supressing prostaglandins synthesis through inhibition of enzymatic reactions of cyclooxygenase-1 and cyclooxygenase-2 which are key mediators for inflammation in osteoarthritis, muscle and ligament injury.
And therefore inhibition of these enzymes leads to inhibition of inflammation and pain related to inflammatory diseases. Surprisingly an important extension to this work was that, ginger is capable in supressing leukotriene biosynthesis by inhibiting 5-lipooxygenase activity also which is not found in nonsteroidal anti-inflammatory drugs (NASDs), thus proving this herbal medicine (ginger extracts) possess far better therapeutic profile and have fewer side effects than NSADs drugs.
This study helped to characterised the anti-inflammatory property of ginger which entered a new phase when it was successfully proved that the ginger extract derived from Zingiber officinale and Alpina galanga inhibits the induction of several genes (genes encoding cytokines, chemokines, cyclooxygenase-2) involved in inflammatory response in osteoarthritis.
And this discovery also helped to provide the evidence to show that ginger actually modulates the biochemical pathways which are activated in chronic inflammation thus proving effective in preventing the inflammation and pain associated with inflammatory diseases.
A study published in Journal of medicine and Food explained how ginger helps in reducing actually the pain and inflammation in osteoarthritis. It was reported that acetic acid induce writhing and footpad edema in mouse model was subsequently reduced when rat suffering from arthritic disorder was treated with red ginger extract (40% ethanolic extract of dried red ginger).
After bioassay studies, it was concluded that shogaol, gingerdiols and anthocyanidins (present in peel) which are phenolic compounds present in ginger were responsible to show anti-inflammatory properties by supressing prostaglandins (PG) and nitric oxide (NO) production.
Nitric oxide which is highly reactive, cytotoxic free radical (fatal to cell) has been shown associated with tissue injury in the disease of osteoarthritis.
Similarly prostaglandins also play important role in causing inflammation in osteoarthritis patients and hence inhibiting its biosynthesis helps in reducing the inflammation and pain associated with this diseases.
Thus indicating that the red ginger extract has potent suppressive effect on acute and chronic joint inflammation such as in osteoarthritis.
Modern scientific research is therefore focussing on how Ayurveda and herbal medicine could be used in treatment of various ailments so that we can minimize the use of chemical drugs and antibiotics.
A double-blind, parallel study was carried out in support of this, where Ayurvedic formulations containing extracts of Zingiber officinale and glucosamine sulphate (2g daily) and celcoxib (200mg daily) were administrated with 440 patients suffering from symptomatic knee osteoarthritis for a period of 6 months.
Research indicated that Ayurvedic formulations were successful in reducing significantly knee pain and improves the condition of knee problem associated with osteoarthritis as similar to chemical drugs used (glucosamine and celcobix), thus indicating this Ayurvedic medicines has a good potential to be used as alternative to other drugs.
What does this mean?
Ginger extract exerts anti-inflammatory effect and reduces pain. It also has a good safety profile in comparison to other painkillers and it also reduces dependence on opioid painkillers.
4. It has gastroprotective property
Ginger extract has gastroprotective action- it can protect from gastric ulcers caused by use of NSAIDs. Animal study reported that ginger exerts gastroprotective effect against ulcers caused by aspirin and other painkillers.
A study was conducted in which osteoarthritis patients were treated with either 340mg ginger extract and 100mg diclofenac daily. Ginger group experienced in dyspepsia related pain but no reduction in dyspepsia; also a slight increase in inflammation in gastric lining was observed.
Interestingly the group receiving diclofenac group experienced a reduction in inflammation in gastric mucosa but increase in dyspepsia pain and symptoms.
What does this mean?
Ginger helps in remedying gastric problems and can protect against formation of ulcers caused by use of non steroidal anti-inflammatory drugs.
How to include ginger in diet for osteoarthritis?
Ginger is used as a popular cooking spice to add flavour and zest to variety of dishes. It can be used in fresh, dried, powdered or oil form. It is also found in variety of foods and drinks such as ginger bread, ginger snaps, ginger sticks and ginger ale. Along with this, it can be used in number of other ways to give that spicy peppery flavour and aroma to food and drinks.
Ginger tea is one of the popular drink served mainly in winters to get rid of cold and cough. It is prepared by simply putting a fresh piece of ginger (peeled) to boiling water.
Add honey and milk to make that famous chai called “adrak wali chai” which goes well with any snacks served in evening time. If you don’t want to have tea with milk, you can just add honey and little lemon juice to it to make that perfect cool weather tonic.
Vegetable sauté – Ginger and garlic are mainly used along with every vegetable sauté. Just add few pieces of these spice to oil, sauté them along with vegetables, add salt and chillies and have it in lunch and dinner time.
Pickled Ginger – Pickled ginger is primarily eaten as side dish with rice, chapattis, parathas, sandwiches and salads.
Soups – Ginger is a fantastic ingredient to be added in number of soups and goes very well with vegetable, chicken and other meat soups.
Staple for stir fry – Almost every stir fry can be compliments with grated ginger to spice it.
Bake it– Ginger can be baked along with bread to make famous ginger bread and even it becomes a useful ingredients in cakes too. But it is mainly used when fish is baked along with garlic, oil, bread crumbs and other spices which make a delicious fish dish.
Homemade Ginger ale is made by boiling ginger to make syrup and then it is mixed with soda and lemon juice. Home-made ginger ale has soothing effect on digestive disturbances which contains enzymes and probiotics.
Thus ginger is become an important spice in Asian cuisines which is because the sweet peppery spicy taste of ginger compliment best with every Asian dish and hence can be used in various ways, and therefore it will find its place in every Asian kitchen.
Dosage of Ginger for Osteoarthritis
1g of ginger is the recommended dosage for any ailment or as preventive measure but doses of 1-3g are recommended for nausea. For arthritis a dose of 250mg 4 times a day is recommended.
Capsules , liquid extract, tincture, oils or syrup of ginger are available. You can also prepare ginger tea by steeping ½ to 1 tsp grated ginger in water for 10-15 minutes.
Dosage should never exceed 4g a day.
Side effects with ginger are rare. Mild heartburn or stomach upset is possible when taking ginger supplements.
Ginger supplements should be taken with caution if suffering from gallstones, have a bleeding disorder, pregnant or breastfeeding women, people with heart conditions or diabetes.
Ginger supplements could have possible drug interactions with blood thinning medications, diabetes medicines and high blood pressure medicines.
Therefore recommended to consume this spice in food or as dietary supplement only after consulting your doctor, especially when you taking other medicines.
Ginger is an excellent herb when it comes to pain relief and reduction in inflammation. Additionally its gastroprotective properties can counteract the gastric side effects caused by painkillers prescribed for arthritis treatment. You can include ginger in diet for arthritis treatment