Comparing the effects of ginger (Zingiber officinale) extract and ibuprofen on patients with osteoarthritis

Ginger (Zingiber officinale) extract supplementation has been shown to improve the severity of symptoms and decrease the nonsteroidal antiinflammatory drug (NSAID) requirements in patients with osteoarthritis (OA). To assess the effects of ginger extract as an alternative to NSAIDs and as a supplement drug in the symptomatic treatment of OA. Between April and October 2002, 120 outpatients with OA of moderate to severe pain, requiring only the use of NSAIDs, were enrolled into a double-blind, randomized, placebo-controlled clinical trial. These patients were randomized into three groups of 40, including the placebo (PL), ginger extract (GE), and ibuprofen (IBP) groups. After a washout period of one week (week 0), patients received either 30 mg ginger extract in two 500 mg capsules, placebo, or three 400 mg ibuprofen tablets daily for one month. Acetaminophen tablet was prescribed as a rescue analgesic during the study. The clinical assessments included a visual analog scale (VAS) for pain, gelling pain, joint swelling measurement, and joint motion slope measurement. Joint motion slope was measured by goniometry (normal = 130°, limited = 120°, and very limited = 110°). The improvement of symptoms (defined as reduction in the mean change) was superior in the ginger extract and ibuprofen groups than the placebo group. VAS scores and gelling or regressive pain after rising the scores were significantly higher in the PL group than both the GE and IBP groups, a month after the treatment (P < 0.0001). However, there was no significant difference in VAS and gelling pain scores between the ginger extract and the ibuprofen groups. Ginger extract and ibuprofen were significantly more effective than the placebo in the symptomatic treatment of OA, while there was no significant difference between the ginger extract and ibuprofen groups in a test for multiple comparison.