The Benefits of Ginger for Osteoarthritis

If ginger is so effective against migraines and also helps with the pain of menstrual cramps, what about osteoarthritis? I explore this in my video Ginger for Osteoarthritis.

An all too common disorder, osteoarthritis produces chronic pain and disability. The first major study, published in 2000, showed no benefit of ginger extract over placebo, but that study only lasted three weeks. The next study, in 2001, lasted six weeks and, by the end, was able to show significantly better results compared to placebo. However, because the placebo did so well, reducing pain from the 60s down to the 40s on a scale of 1 to 100, ginger reducing pain further down into the 30s was not especially clinically significant, so an editorial in the official journal of the American College of Rheumatology concluded that “ginger should not be recommended at present for treatment of arthritis because of the limited efficacy.”

Since that time, there have been a few other trials that showed more impressive results, such that ginger is now considered “able to reduce pain and disability” in osteoarthritis. How does it compare to other treatments? Since osteoarthritis is a chronic disease, it’s especially important to weigh the risks versus the benefits of treatment. The commonly used anti-inflammatory drugs can carry serious cardiovascular and gastrointestinal risks. For example, nearly half of the osteoarthritis patients on drugs like ibuprofen were found to have major injuries to the lining of their small intestines. That risk can be reduced by taking additional medication to counteract the side effects of the first drug.

Ibuprofen-type drugs reduce our stomach lining’s ability to protect itself from stomach acid, so blocking acid production with a second drug can lower the risk. However, ginger can actually improve stomach lining protection. Indeed, at the kinds of doses used to treat osteoarthritis—about a quarter- to a half-teaspoon a day—ginger can be considered not just neutral on the stomach, but beneficial. So, ginger can be as pain-relieving as ibuprofen but without the risk of stomach ulcers.

What about topical ginger treatment, as in externally applying a ginger-soaked cloth or patch to the affected joint? In a controlled study, compress versus patch, both showed remarkable and lasting pain relief for osteoarthritis sufferers. What was missing from the study, though, was a control group: There was no placebo patch. I don’t care if ginger has been applied externally to painful joints for a thousand years. The placebo effect has been shown to be remarkably effective in osteoarthritis in providing pain relief. So, until there’s a controlled study on topical ginger, I’m not going to believe it.

There wasn’t such a study until… 24 men stuck ginger slices on their scrotum.

Men with inflamed testicles applied six to ten paper-thin slices of ginger “over the affected testes,” and, evidently, the ginger group healed nearly three times faster than the control group. Unfortunately, the original source is in Chinese, so I can’t get further details, as is the only other controlled study on topical ginger I could find, whose title apparently translates to “Evaluation of point plaster therapy with ginger powder in preventing nausea and vomiting occurred after platinum-based interventional chemotherapy.” We know ginger powder taken orally can be a miracle against chemo-induced vomiting, but what about stuffing it in your belly button?

The external application of ginger powder to the so-called point of Shenque, which is the navel, was compared to the control group, who got potato powder in their belly buttons instead. The ginger group evidently had significantly less nausea and vomiting. Unfortunately, only the abstract is in English, so I can’t tell how effectively the researchers blinded the patients to the treatment. Presumably, it would be easy to tell whether or not you were in the ginger or placebo group simply by the smell, but perhaps the researchers controlled for that? Until we know more, I would suggest those who want to try ginger use it in the stomach, rather than on the stomach.


What other dietary interventions can help with arthritis? See, for example:

What else can ginger do? Check out:

If the placebo effect is really that powerful, should doctors prescribe them? They already do. See my video The Lie That Heals: Should Doctors Give Placebos? for more on this.

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live presentations:

The Benefits of Wakame Seaweed Salad on Blood Pressure

I used to think of seaweed as just a beneficial whole-food source of minerals like iodine, for which it is the most concentrated dietary source. Indeed, just a daily half-teaspoon of mild seaweeds, like arame or dulse, or two sheets of nori should net you all the iodine you need for the day. But, the intake of seaweeds is advised not only as a whole-food source of iodine, but also, evidently, “for the prevention of lifestyle-related diseases, including cancer, cardiovascular and cerebrovascular disease….” Based on what?

As I discuss in my video Wakame Seaweed Salad May Lower Blood Pressure, the reasoning is that the Japanese live long and eat seaweed, so there is speculation that seaweed might have “influence on life expectancy,” based on suggestive reports. But when we see long lists of the supposed benefits a particular food is purported to have, such as “compounds found in [seaweed] have various biological activities including anticoagulant, anti-viral, antioxidant, anti-allergic, anti-cancer, anti-inflammatory, anti-obesity, and neuroprotective properties,” we need to know if they are based on clinical data, meaning studies with actual people, or so-called preclinical data, that is, from test tubes and lab animals. I mean, what are we supposed to do with a study talking about the effects of “seaweed-restructured pork diets” on rats? Those researchers tried to use seaweed, as well as other ingredients, to “improv[e] the ‘image’ of meat product.” Researchers also tried to add grape seeds to meat, they tried flaxseeds, they tried walnuts, they tried purple rice, and they even tried “thong-weed.”

When you look at epidemiological studies, where you compare the diets and disease rates within a population, you see that Japanese pre-schoolers who eat seaweed tend to have lower blood pressures, suggesting “seaweed might have beneficial effects on blood pressure among children.” That could make sense given all the minerals and fiber in seaweed, but cause and effect can’t be proven with this kind of study. Perhaps other components of the diet that went along with seaweed eating that made the difference.

It’s even harder to do these kinds of studies on adults, since so many people are on high blood pressure medications. University of Tokyo researchers took an innovative approach by comparing the diets of people on different intensities of medication: low-dose of a single blood pressure drug, high-dose of a single drug, and multiple drugs. And, although they all had artificially normalized blood pressure “as a result of effective medication,” those who ate the most fruits and sea vegetables tended to be the ones on the lower dose of a single drug, supporting a dietary role for seaweed. An interesting finding, but why not just put it to the test?

A double-blind, crossover trial found that seaweed fiber lowered blood pressure, apparently by pulling sodium out of the system. Real seaweed couldn’t be used in the study, because the subjects wouldn’t be able to be fooled with a placebo, but why not just put whole powdered seaweed into pills? That was finally attempted ten years later. Compared to doing nothing, subjects receiving a daily dose of dried wakame powder in capsules had beautiful drops in blood pressure. The researchers, however, desalinized the seaweed, taking out about two-thirds of the sodium naturally found in it. So, we still don’t know if eating seaweed salad is actually going to help with blood pressure. What we need is a randomized, controlled trial with plain, straight seaweed. No one had ever done that research, until…they did!

Six grams of wakame, with all of its natural sodium, led to a significant drop in blood pressure, especially in those who started out with high pressure. The subjects experienced only minor side effects and ones that could be expected with increasing fiber intake. A nice thing about whole-food, plant-based interventions is that we sometimes get good side effects, such as the resolution of gastritis (stomach inflammation) some subject had been having, as well as the disappearance of chronic headaches. 


What other foods might help with high blood pressure? See:

For more on preventing and treating hypertension, one of our leading killers, see:

Want more on seaweed and iodine? Check out:

My video Salt of the Earth: Sodium and Plant-Based Diets further addresses the sodium question.

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

How to Achieve Food Synergy

There are thousands of phytochemicals that will never make it onto the side of a cereal box but may play a role in reducing the risk of chronic diseases—and those are just the ones we know about. Whole plant foods have consistently been found to be protective, so it’s reasonable for scientists to try to find the “magic bullet” active ingredient that can be sold in a pill, but “[p]ills or tablets simply cannot mimic this balanced natural combination of phytochemicals present in fruits and vegetables.” When isolated out, the compound may lose its activity or behave differently. The antioxidant and anticancer activities of plant foods are thought to derive from the “additive and synergistic effects of phytochemicals in fruits and vegetables,” meaning the whole may be greater than the sum of its parts. This helps explain why a pill can’t replace the complex combination of phytochemicals present in whole plant foods.

As T. Colin Campbell has pointed out, more than a hundred trials “overwhelmingly show no long-term benefit for vitamin supplements, along with worrisome findings that certain vitamins may even increase disease occurrence for diabetes, heart disease, and cancer.” Supplementation with fish oil, for example, appears useless or, even worse, “posing increased risk for diabetes,” yet the science doesn’t seem to matter. People continue to buy them. “The public desire for quick fixes through pills…is overwhelming, especially when money can be made.”

Each plant has thousands of different phytochemicals, as well as entirely different phytonutrient profiles. So, there may be synergistic effects when eating different foods together, too. Eating beta-carotene in carrot form is more beneficial than in pill form. because of all the other compounds in the carrot that may synergize with the beta-carotene. Well, when we dip that carrot in hummus, we suddenly have the thousands of carrot compounds mixing with the thousands of chickpea compounds. So what happens if we mix different fruits with different vegetables or different beans?

As you can see in my video Food Synergy, combining foods across different categories increased the likelihood of synergy. For example, a study showed the antioxidant powers of raspberries and adzuki beans. If there were a strictly additive effect, the expected combined antioxidant power would simply be that of the raspberries plus that of the adzuki beans. However, the observed combined antioxidant power was actually greater than the sum of one plus the other.

What about cancer-fighting effects? The study was repeated, but, this time, different combinations of food were dripped on breast cancer cells growing in a petri dish. For some foods, the same synergistic effects were found. Grapes, for example, can suppress the growth of breast cancer cells about 30 percent, but onions worked even better, cutting breast cancer cell growth in half. One would assume that if we added half the grapes with half the onion, we’d get a result somewhere in the middle between the two. Instead, the researchers found that cancer cell growth was suppressed by up to 70 percent with that combination. The whole plus the whole was greater than the sum of the whole parts. Given these findings, did the researchers recommend people eat a variety of foods? Perhaps adding some raisins along with chopped red onions to our next salad? Where’s the money in that? No, the reason the researchers were investigating the different types of interactions was “to identify mixtures that hold synergistic interactions that can ultimately lead to the development of functional foods”—maybe something like grape-flavored Funyuns.


Why should we care about the antioxidant power of foods? See

If you’re not familiar with this concept of reductionism, be sure to check out some of these other videos: Industry Response to Plants Not Pills, Why Is Nutrition So Commercialized?, and Reductionism and the Deficiency Mentality.

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations: