Clinical trials on pain lowering effect of ginger: A narrative review

Abstract

Ginger has a pain-reducing effect and it can modulate pain through various mechanisms: inhibition of prostaglandins via the COX and LOX-pathways, antioxidant activity, inibition of the transcription factor nf-kB, or acting as agonist of vanilloid nociceptor. This narrative review summarizes the last 10-year of randomized controlled trials (RCTs), in which ginger was traditionally used as a pain reliever for dysmenorrhea, delayed onset muscle soreness (DOMS), osteoarthritis (AO), chronic low back pain (CLBP), and migraine. Regarding dysmenorrhea, six eligible studies suggest a promising effect of oral ginger. As concerned with DOMS, the four eligible RCTs suggested a reduction of inflammation after oral and topical ginger administration. Regarding knee AO, nine RCTs agree in stating that oral and topical use of ginger seems to be effective against pain, while other did not find significant differences. One RCT considered the use of ginger in migraine and suggested its beneficial activity. Finally, one RCT evaluated the effects of Swedish massage with aromatic ginger oil on CLBP demonstrated a reduction in pain. The use of ginger for its pain lowering effect is safe and promising, even though more studies are needed to create a consensus about the dosage of ginger useful for long-term therapy. K E Y W O R D S chronic low back pain, dysmenorrhea, ginger, knee osteoarthritis, myalgia, pain 1 | INTRODUCTION Zingiber officinale Roscoe (Zingiberaceae family), commonly known as ginger is a climbing perennial plant, indigenous to southeastern Asia. Ginger extract is a mixture of many biologically active constituents (Grzanna, Lindmark, & Frondoza, 2005). These compounds are numerous and vary depending on the place of origin and whether the rhizomes are fresh or dry (Ali, Blunden, Tanira, & Nemmar, 2008). More than 400 chemical substances have been isolated and identified in ginger rhizomes extracts, and new ones are still being discov

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“…Curcumin has a significant effect in reducing the production of recognized algogenic substances, such as COX-2 molecules ( Kang et al, 2004 ), prostaglandin E2 ( Clutterbuck et al, 2013 ) and histamine ( Nugroho et al, 2009 ) and can decrease pain sensitivity both by interacting with nociceptor response ( Yeon et al, 2010 ; Leamy et al, 2011 ), and by modulating pro-inflammatory cytokines production, such as TNF-α, IL-6, and IL-8 ( Fernández-Lázaro et al, 2020 ). Likewise, ginger can exhibit pain-reducing effects by interacting with COX-2 pathways, by inhibiting inflammatory cytokines transcripts ( via NF-κB), and by acting as an agonist of vanilloid nociceptors ( Rondanelli et al, 2020 ).…”

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