Zingiberaceae extracts for pain: a systematic review and meta-analysis

Area of Science:

• Phytomedicine
• Pain Management
• Evidence-Based Medicine

Background:

• The Zingiberaceae family, encompassing turmeric, ginger, Javanese ginger, and galangal, possesses a long history of medicinal use.
• Preclinical research suggests that extracts from Zingiberaceae exhibit analgesic properties.
• This study systematically reviews and meta-analyzes the clinical effectiveness of Zingiberaceae extracts as hypoalgesic agents.

Purpose of the Study:

• To systematically review and meta-analyze randomized controlled trials on the clinical efficacy of Zingiberaceae extracts for pain relief.
• To assess the hypoalgesic potential of Zingiberaceae extracts in humans.
• To compare the safety profile of Zingiberaceae extracts with conventional pain medications.

Main Methods:

• A comprehensive literature search was conducted across electronic databases using keywords such as "Zingiberaceae" and "pain" or "visual analogue score (VAS)".
• The search identified 18 studies, from which 8 randomized, double-blinded, placebo-controlled trials measuring pain via VAS were selected for meta-analysis.
• The meta-analysis focused on quantifying the effect size of Zingiberaceae extracts on subjective pain reduction.

Main Results:

• Zingiberaceae extracts demonstrated significant efficacy in alleviating subjective chronic pain, with a standardized mean difference (SMD) of -0.67 (95% CI: -1.13 to -0.21; P=0.004).
• A clear linear dose-effect relationship was observed across the included studies (R²=0.71).
• All reviewed studies reported a good safety profile for Zingiberaceae extracts, comparable in effectiveness to non-steroidal anti-inflammatory drugs (NSAIDs) without associated renal risks.

Conclusions:

• Zingiberaceae extracts are clinically effective hypoalgesic agents, offering a potentially better safety profile than NSAIDs.
• While generally safe, both NSAIDs and Zingiberaceae extracts may increase bleeding risk, an area needing further comparative research.
• Additional clinical studies are recommended to determine optimal extract types and rigorously evaluate safety, particularly bleeding risk.