OBJECTIVES: To compare the effectiveness, safety and acceptability of topical ginger oil extract with VCO and methylsalicylate in reducing pain in adult patients with osteoarthritis at the outpatient department of DLSUMC.

STUDY DESIGN: Randomized Controlled Trial

METHOD: The study included 165 patients ≥ 40 years old complaining of knee pain, screened based on the following criteria: < 30 minutes morning stiffness and crepitus on motion. Those who passed the screening were asked to sign an informed consent and were randomly allocated in the three groups: VCO + ginger extract, VCO, and methylsalicylate. Patients were followed up for 4 consecutive weeks where the assessment was based on the following tools: universal pain assessment tool, range of motion and a questionnaire. The universal pain assessment tool and range of motion were assessed weekly while the questionnaire (1 and 2) were answered on the initial and 4th week of follow up, respectively. The amount of medication that has been applied for the week was also measured weekly. All results were recorded in the patients' record sheet and were then analyzed.

RESULTS: Universal pain assessment tool and range of motion were compared to baseline values at the end of 1 month treatment of 165 patients. There was decrease in pain in VCO + ginger extract (mean difference 2.35) as compared to VCO (mean difference 1.67) and methylsalicylate (mean difference 1.9)(p 0.0066). Analysis of the secondary efficacy variable showed that VCO + ginger extract group (mean difference 18.84) had better improvement in range of motion compared to VCO group (mean difference 18.38), but methylsalicylate (mean difference 27.06) was superior to both VCO groups. Analysis of acceptability variables showed that VCO + ginger extract were more acceptable as compared to VCO, but methylsalicylate was superior to both the VCO and VCO + ginger extract group. However, acceptability as to cost and preparation was not done in this study because the treatment was provided by the researcher and so, the researcher has no means of identifying if the cost and preparation were acceptable to the patient. All treatment groups were found safe to use, no adverse effects reported to all groups.

CONCLUSION: Comparison of the efficacy, safety and acceptability as to ease of application. VCO + ginger extract was superior to VCO group, but methylsalicylate was superior to both VCO + ginger and VCO in terms of efficacy and acceptability.

RECOMMENDATIONS: Based on the efficacy, safety and acceptability, in the absence of methylsalicylate, VCO + ginger extract can be used as an alternative treatment for osteoarthritis.