title: Zingiberaceae extracts for pain: a systematic review and meta-analysis.
abstract: BACKGROUND
  Members of the family Zingiberaceae including turmeric, ginger, Javanese ginger, and galangal have been used for centuries in traditional medicine. Preclinical studies of Zingiberaceae extracts have shown analgesic properties. This study aims to systematically review and meta-analyze whether extracts from Zingiberaceae are clinically effective hypoalgesic agents.
  
  
  METHODS
  Literature was screened from electronic databases using the key words Zingiberaceae AND pain OR visual analogue score (VAS) to identify randomized trials. From this search, 18 studies were identified, and of these, 8 randomized, double-blinded, placebo-controlled trials were found that measured pain by VAS for inclusion in the meta-analysis.
  
  
  RESULTS
  Findings indicated significant efficacy of Zingiberaceae extracts in reducing subjective chronic pain (SMD - 0.67; 95 % CI - 1.13 to - 0.21; P = 0.004). A linear dose-effect relationship was apparent between studies (R(2) = 0.71). All studies included in the systematic review reported a good safety profile for extracts, without the renal risks associated with non-steroidal anti-inflammatory drugs, and with similar effectiveness.
  
  
  CONCLUSIONS
  Our findings indicated that Zingiberaceae extracts are clinically effective hypoalgesic agents and the available data show a better safety profile than non-steroidal anti-inflammatory drugs. However, both non-steroidal anti-inflammatory drugs and Zingiberaceae have been associated with a heightened bleeding risk, and there have been no comparator trials of this risk. Further clinical studies are recommended to identify the most effective type of Zingiberaceae extract and rigorously compare safety, including bleeding risk.
authors.affiliation: Global Neuroscience Initiative Foundation, Los Angeles, California, USA. slakhan@gnif.org.
authors.forename: Shaheen E
authors.initials: SE
authors.lastname: Lakhan
authors.affiliation: Global Neuroscience Initiative Foundation, Los Angeles, California, USA. fishcray@hotmail.com.|Department of Musculoskeletal Biology, Institute of Ageing and Chronic Disease, The University of Liverpool, Liverpool, UK. fishcray@hotmail.com.
authors.forename: Christopher T
authors.initials: CT
authors.lastname: Ford
authors.affiliation: Neurological Institute, Cleveland Clinic, Cleveland, Ohio, USA. tepperd@ccf.org.
authors.forename: Deborah
authors.initials: D
authors.lastname: Tepper
mesh_terms: D000700:Analgesics / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D059350:Chronic Pain / Q000178:diet therapy* / Q000503:physiopathology; D006801:Humans; D010936:Plant Extracts / Q000008:administration & dosage / Q000627:therapeutic use*; D016896:Treatment Outcome; D030521:Zingiberaceae
chemical_list: D000700:Analgesics; D010936:Plant Extracts