Originating from the tree of the same name, the boswellia herb has been a key part of Ayurvedic medicine for thousands of years
Arthritis is the leading cause for disability among American adults, according to the Arthritis Foundation.1 As of 2018, approximately 54 million adults have been diagnosed with some form of arthritis.
Osteoarthritis is the most common type of arthritis and affects approximately 31 million Americans.1 Significant chronic joint pain and stiffness are two of the main symptoms with all forms of arthritis and can affect mobility. If this pain is left unaddressed, it can eventually affect patients’ activities of daily living, such as bathing, dressing, shaving, or brushing out their hair.
Standard pharmaceutical treatment for treating arthritis usually relies on nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil or Motrin) or naproxen (Aleve) to relive pain and reduce joint inflammation. Unfortunately, these medications come with significant risks if taken over the long term, including stomach ulcers and bleeding, liver and kidney damage, and increased risk for heart attacks.
Because of the poor risk profile associated with NSAIDs, research into alternative treatments has increased over several years. Boswellia, sometimes known as Indian frankincense, has shown some promising results in treating pain associated with both osteoarthritis and rheumatoid arthritis.
How the Boswellia herb works
Boswellia extract comes from the Boswellia tree (Boswellia serrata) and has been used for thousands of years as a key part of Ayurvedic medicine to treat pain and chronic inflammatory conditions.2 It is available as a resin, pill, or cream. For oral dosing the Arthritis Foundation suggests 300-400 mg three times per day.
There are four specific acids within the boswellia extract that prevent the body from forming leukotrienes, which are the molecules that can cause inflammation and pain.3 Specifically, β-boswellic acid (the most abundant), 3-acteyl-β-boswellic acid, 11-keto-β-boswellic acid, and 3-acetyl-11-keto-β-boswellic acid inhibit the formation of the 5-lipoxygenase (5-LO) enzyme.3
A 2003 study in the journal Phytomedicine assessed the safety, efficacy, and tolerability of a boswellia herb extract in treating osteoarthritis of the knee.4 For this study, 15 patients with osteoarthritis were given boswellia extract, while another 15 were given placebo. At the end of eight weeks, the two groups traded treatments so that all 30 patients received the boswellia extract.
At the end of the 16-week study, patients taking boswellia reported decreased knee pain, and increased knee flexibility and walking distance. They also reported less frequent swelling of the knee joint.4 Boswellia was also well tolerated, with only mild GI symptoms reported.
Rheumatoid arthritis research
A 2014 article also published in Phytomedicine examined the effect of a boswellia extract using lab rats specially bred to develop rheumatoid arthritis.5 The rats were given a daily boswellia herb extract for 21 days. At the end of the study, all rats showed significantly reduced levels of inflammation, as well as rheumatoid arthritis markers.
The researchers theorized that the boswellia herb extract may have a protective effect against rheumatoid arthritis as a result of its anti-inflammatory properties.5
While it is true that your patients with arthritis can be frustrated by chronic pain in their joints, it is equally true that keeping active helps protect their joints and slows deterioration. Fortunately, boswellia extract may help support joints while having a better side-effect profile than traditional NSAIDs.
- Arthritis Foundation. Arthritis by the Numbers / Book of Trusted Facts & Figures. 2018.
- Arthritis Foundation. Indian frankincense. arthritis.org/living-with-arthritis/treatments/natural/supplements-herbs/guide/indian-frankincense.php. Accessed April 24, 2019.
- Singh S, Khajuriaa A, Tanejaa SC, et al. Boswellic acids: A leukotriene inhibitor also effective through topical application in inflammatory disorders. Phytomedicine. 2008;15(6-7):400-407.
- Kimmatkar N, Thawanib V, Hingoranic L, Khiyanid R. Efficacy and tolerability of Boswellia serrata extract in treatment of osteoarthritis of knee – A randomized double blind placebo controlled trial. Phytomedicine. 2003;10(1):3-7.
- Umar S, Khalid U, Abu H, et al. Boswellia serrata extract attenuates inflammatory mediators and oxidative stress in collagen induced arthritis. Phytomedicine. 2014;6(15):847-856.