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Boswellia serrata Extract Improves Pain, Stiffness, Function in Knee Arthritis

Person holding knee outside

Men and women with osteoarthritis of the knee experienced relief from pain and stiffness and improvements in musculoskeletal function and cartilage structure after being given an extract of Boswellia serrata gum resin for 180 days.

The randomized, double-blind trial included 37 healthy participants with mild to moderate knee osteoarthritis who received 100 milligrams per day Boswellia serrata extract and 36 individuals with the same condition who were given a placebo. Participants rated their pain, physical function and stiffness at the beginning of the study and at 30, 60, 120 and 180 days. Walking and stair climbing tests were conducted at these time points to evaluate joint function. The participants underwent magnetic resonance imaging (MRI) of the knee at the beginning and end of the study to measure joint space width and cartilage thickness and volume. Blood biomarkers, including C-reactive protein (CRP), a marker of inflammation, and markers of cartilage degradation were also measured at the beginning of the study and its conclusion.

Pain, physical function and stiffness scores, six-minute walk distance and stair climb test time significantly improved among participants who received Boswellia serrata compared with the beginning of the study and compared with the placebo group. MRI assessments at the end of the trial revealed significant improvements in knee joint space and cartilage volume and thickness compared with measurements obtained at the beginning of the study in the Boswellia serrata-treated group, while these measurements decreased among those who received the placebo.

C-reactive protein and MMP-3 (another marker of inflammation) significantly declined among participants who received Boswellia serrata compared to the beginning of the study and compared to the placebo. Other serum and urine markers also improved in the Boswellia serrata-treated group.

The authors concluded that Boswellia serrata extract “is safe, and it mitigates joint pain and improves musculoskeletal function and cartilage morphology in knee osteoarthritis.”

The Journal of the American Nutrition Association reported the findings on December 19, 2024.1



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Apply What You’ve Learned: Boswellia serrata

  • Boswellia serrata is a tree native to India, North Africa and the Middle East.2 Its gummy resin is also known as frankincense and has been used in perfumes and incense as well as traditional medicines.
  • Boswellia serrata helps support a healthy inflammatory response.3 This explains the extract’s benefits in people with arthritis.
  • In addition to arthritis, study findings suggest benefits for Boswellia serrata in diabetes, periodontal disease, exercise-induced pain and other conditions.4-6
  • Boswellia serrata’s ability to help maintain inflammation at a healthy level may also contribute to the management of asthma.7

References

  1. Kumar B et al. J Am Nutr Assoc. 2024 Dec 19:1-12.
  2. Siddiqui MZ. Indian J Pharm Sci. 2011 May;73(3):255-61.
  3. Abdel-Tawab M et al. Clin Pharmacokinet. 2011 Jun;50(6):349-69.
  4. Karimi M et al. Front Clin Diabetes Healthc. 2024 Oct 10:5:1466408.
  5. Vang D et al. Curr Issues Mol Biol. 2024 Mar 30;46(4):2991–3004.
  6. Rudrappa GH et al. Medicine (Baltimore). 2022 Sep 2;101(35):e30144.
  7. Yugandhar P et al. Phytother Res. 2018 Jan;32(1):140-150.

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