• Ginsenosides (Rg3, Rh4, Rc) inhibit osteoclast differentiation via the karyopherin α2-NF-κB axis, reducing bone resorption in osteoporosis.
• Ginseng polysaccharides exert anti-inflammatory effects through the MAPK/NF-κB pathway, with processing methods influencing their immunomodulatory activity.
• Ginseng peptides improve mitochondrial function via the NAD+/SIRT1/PGC-1α axis, counteracting sarcopenia.
• Ginseng's multi-component, multi-target approach offers a promising strategy for treating musculoskeletal degenerative diseases, though bioavailability and clinical validation remain challenges.