Topical Ginger for Osteoarthritis1
Tessa Therkleson RN, PhD. New Zealand
Ginger is a traditional remedy used on the skin and joints (including for 100s of years in China and Europe) to stimulate blood circulation and relieve muscular and joint pain and tension2. It has been used extensively for chronic inflammatory conditions such as arthritis. It's active components, gingerols and shogaols diminish production of enzymes COX-1, COX-2 and 5-lipooxygenase that produce the pro-inflammatory prostoglandins and leukotrienes3,4. Ginger inhibits COX-2 when applied to human epithelial tissue5 and gingerol enriched extract can permeate human epidermis tissue6.
This study shows the potential7 for significant beneficial effects from the use of a ginger compress, or standardized ginger patch, applied to the back for people with osteoarthritis.
In 2011, twenty participants with osteoarthritis symptoms for over 12 months were selected8 and randomly assigned to one of two groups for 7 consecutive days of ginger treatment, applied by a registered nurse:
- Group 1 received a manually prepared ginger compress to the back
- Group 2 a standardised ginger patch to the back
- Participants had the option to continue self-treatment using the ginger patch for a further 20 weeks
A Health Assessment Questionnaire9 was completed weekly for 3 weeks then 4 weekly for 20 weeks, with 14 simple questions;
- 4 independent questions on Pain, Fatigue, Mobility and Overall Impact
- Mobility had 10 specific questions
- A question on Health Satisfaction recorded on a categorical scale
Additionally, changes in pain experience, medication and activity were recorded on the Questionnaire.
Outcomes for Pain, Fatigue, Mobility and Overall Impact
- Responses within the 2nd & 3rd quartiles (shown in blue & red boxes) are separated by the median (yellow line) with standard error bars indicating the full range responses.
- Group 1 participants had 7 daily treatments of ginger compresses, followed by 20 weeks of self treatment using ginger patches (Group 1a)
- Group 2 participants had all treatments using ginger patches
- Medication for pain relief decreased during the study. 70% of participants took conventional analgesia and after 4 weeks, 78% (55%) of these were no longer requiring medication. Ginger therapy was well tolerated and no adverse effects were reported
Figure 1 shows the mean questionnaire scores for all participants by treatment Groups 1 & 2 using the Pain, Fatigue, Mobility and Overall Effect combined and recorded over the duration of the study, with error bars showing the maximum and minimum scores.
Figure 2 shows mean questionnaire scores by the 4 key questions (Pain, Fatigue, Mobility & Overall Impact) with the percentage improvements;
- 7 days after the treatment was completed (48%, 49%, 31% and 40%, for each of these respectively)
- After 12 & 24 weeks of self treatment with ginger patches
Shows a positive shift from 7 days before treatment, when 80% were dissatisfied to 7 days after treatment 70% were satisfied. Then, after 20 weeks of self treatment 83% were satisfied (Fig 3).
- Therkleson, T., Topical ginger treatment with a compress or patch for osteoarthritis. Journal of Holistic Nursing, 2014. 32(3): p. 173-182.
- Therkleson, T., Ginger compress therapy for adults with osteoarthritis. Journal Advanced Nursing, 2010. 66(10): p. 2225 - 2233.
- Chopra, A., M. Saluja, & G. Tillu, Ayurveda-modern medicine interface: A critical appraisal of studies of Ayurvedic medicines to treat osteoarthritis and rheumatoid arthritis. Journal Ayurveda and Integrative Medicine, 2010. 1(3): p. 190-198.
- Terry, R., et al., The Use of Ginger (Zingiber officinale) for the Treatment of Pain: A Systematic Review of Clinical Trials. Pain Medicine, 2011. 12(1): p. 1808-1818.
- Breeman van, R., Y. Tao, & L. Wenkui, Cyclooxygenase - 2 inhibitors in ginger (zingiber officinale). Fitoterapia, 2011. 82(1): p. 38-43.
- Minghetti, P., et al., Evaluation of the topical anti-inflammatory activity of ginger dry extracts from solutions and plasters. Planta medica, 2007. 73(15): p. 1525-30.
- Up to 16% of participants may have experienced no change in overall health satisfaction.
- Wolfe, F., et al., The Short Arthritis Assessment Scale: a brief assessment questionnaire for rapid evaluation of arthritis severity in research and clinical practice. Journal of Rheumatology, 2004. 31(12): p. 2472-9.
- Wolfe, F., K. Michaud, & T. Pincus, Development and validation of the Health Assessment Questionnaire II: a revised version of the Health Assessment Questionnaire. Arthritis & Rheumatism, 2004. 50(10): p. 3296-3305.
Mahle Stiftung, Stuttgart, Germany
Practical and professional;
New Zealand Anthroposophic Nurses Association & New Zealand Anthroposophic doctors
Deborah Bednarek, Jocelyn Freeman, Cassandra Mossman, Ann Oliver, Shona Stronach, Sarah Therkleson, Michelle Vette
Statistical & design;
Edith Cowan University Nursing School, Perth, Western Australia