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A Standardized Extract of Ginger May Reduce Knee Pain in Elderly
By Darin Ingels, ND

Healthnotes Newswire — Daily use of a highly concentrated extract of ginger by elderly people may reduce the pain associated with osteoarthritis of the knee, according to a new report in Arthritis and Rheumatism.1 Ginger has been traditionally used in herbal medicine for nausea, heartburn, muscle aches, and more recently as a treatment for motion sickness. While the exact mechanism by which ginger relieves pain remains unclear, animal and test tube studies indicate that ginger may inhibit key enzymes that lead to inflammation.2 3

This six-week controlled trial examined the effects of taking either a daily supplement of a standardized ginger extract (510 mg per day from Zingiber officinale and Alpinia galanga) or placebo in 247 elderly men and women with knee pain. In addition to their treatment, all participants were allowed to use up to 4,000 mg per day of acetaminophen, as needed, to control pain. The primary assessment was the degree of pain on standing, measured by the visual analog scale (VAS), a numerical pain scale between 0 and 100, where 0 is pain-free and 100 indicates severe pain and impairment.

The researchers found that knee pain was reduced in 63% of people taking the ginger extract, compared with 50% of those receiving the placebo, a statistically significant difference. People taking ginger reported a 24.5-point decrease in the VAS pain scale, compared with a 16.4-point decline in those taking the placebo. Pain after walking and stiffness in the knee were also reduced in both ginger and placebo groups; however, the effects were greater in those taking the ginger extract. Side effects, including belching, heartburn, and nausea were reported in 59% of those receiving ginger, compared with 37% of the placebo group. None of these effects were described as being serious. Use of acetaminophen was equal in both groups and did not alter the results.

Although the effect of ginger extract on knee pain was only modest, evidence suggests that other nutritional supplements may be even more effective for individuals with osteoarthritis. Studies have shown that 1,500 mg of glucosamine sulfate per day significantly reduced both degeneration in the knee and pain,4 and was as effective as, or more effective than, ibuprofen (Advil®).5 6 Other reports have demonstrated that 1,200 mg of S-adenosylmethionine (SAMe) per day decreased pain in the knee and worked as well as naproxen (Aleve®).7 8 Despite causing minor stomach and intestinal side effects in some cases, ginger is considered safe, and including ginger extract as part of a comprehensive treatment program may be helpful in controlling the pain of osteoarthritis and in living a more active life.

References
1. Altman RD, Marcussen KC. Effects of a ginger extract on knee pain in patients with osteoarthritis. Arthritis Rheum 2001;44:2531–8.
2. Mustafa T, Srivastava KC, Jensen KB. Drug development: report 9. Pharmacology of ginger, Zingiber officinale. J Drug Dev 1993;6:25–89.
3. Tjendraputra E, Tran VH, Liu-Brennan D, et al. Effect of ginger constituents and synthetic analogues on cyclooxygenase-2 enzyme in intact cells. Bioorg Chem 2001;29:156–63.
4. Reginster JY, Deroisy R, Rovati LC, et al. Long-term effects of glucosamine sulphate on osteoarthritis progression: a randomised, placebo-controlled clinical trial. Lancet 2001;357:247–8.
5. Qiu GX, Gao SN, Giacovelli G, et al. Efficacy and safety of glucosamine sulfate versus ibuprofen in patients with knee osteoarthritis. Arzneimittelforschung 1998;48:469–74.
6. Muller-Fassbender H, Bach GL, Haase W, et al. Glucosamine sulfate compared to ibuprofen in osteoarthritis of the knee. Osteoarthritis Cartilage 1994;2:61–9.
7. Konig B. A long-term (two years) clinical trial with S-adenosylmethionine for the treatment of osteoarthritis. Am J Med 1987;83:89–94.
8. Caruso I, Pietrogrande V. Italian double-blind multicenter study comparing S-adenosylmethionine, naproxen, and placebo in the treatment of degenerative joint disease. Am J Med 1987;83:66–71.

Darin Ingels, ND, MT (ASCP), received his bachelor’s degree from Purdue University and his Doctorate of Naturopathic Medicine from Bastyr University in Kenmore, WA. Dr. Ingels is the author of Garlic and Cholesterol: Everything You Need to Know (Prima, 1999) and Natural Treatments for High Cholesterol (Prima, 2000). He currently is in private practice in Westport, CT, where he specializes in environmental medicine and allergies. Dr. Ingels is a regular contributor to Healthnotes and Healthnotes Newswire.




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