Pilot Trial Finds Boswellia Serrata Supplementation Associated with Reduced Arthritis Pain

September 10, 2019

Results of a double-blind, placebo-controlled trial reported in the May 2019 issue of Phytotherapy Research reveal a benefit for treatment with an extract of Boswellia serrata in men and women with osteoarthritis of the knee.

Gum resin derived from Boswellia serrata, commonly known as frankincense, has been used in Ayurvedic medicine for centuries and has more recently been the subject of scientific investigation that has added evidence to its anti-inflammatory and pain-relieving effects.

The trial included 42 participants between the ages of 35 and 75 years with newly diagnosed knee osteoarthritis. Subjects were given a placebo or tablets that contained Boswellia serrata extract to be consumed twice daily for 120 days.

Pain, stiffness and physical function were assessed at the beginning of the study and on days 30, 60, 90 and 120. Six-minute walking tests were conducted before the treatment period and at other visits. X-ray images obtained before and after the treatment period provided further information concerning treatment efficacy.

The safety of Boswellia serrata extract was evaluated using data collected during physical examinations conducted during each visit. Blood samples were analyzed for serum high-sensitivity C-reactive protein (hs-CRP), a marker of inflammation.

In comparison with the placebo, treatment with Boswellia serrata was associated with improvement in pain, stiffness and physical function by the end of the trial. Knee joint gap and bone spurs revealed by x-ray imaging also improved among those treated with Boswellia serrata. By the final visit, walking test scores had significantly improved in association with Boswellia serrata compared to the placebo.  

Boswellia serrata-treated individuals experienced a larger reduction in hs-CRP levels by the end of the study compared to the placebo group, indicating a greater decrease in inflammation. Treated patients also experienced more improvement in self-reported quality of life between the beginning and end of the trial. No serious adverse events occurred.

“This is the first study with Boswellia serrata extract conducted for a period of 120 days, longer than any other previous clinical trial on patients with osteoarthritis of the knee,” authors Muhammed Majeed and colleagues announce. They recommend further studies be conducted that include a larger number of subjects.


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Apply What You’ve Learned: Arthritis

  • The spaces between our bones are occupied by cartilage. Unlike many areas of the body, cartilage does not obtain its nourishment from a network of blood vessels, but from surrounding synovial fluid. Movement assists in the delivery of nutrients to cartilage cells. Therefore, exercise is one of the best ways to maintain the health of our joints. Exercise also improves joint support by enhancing muscle strength.
  • Glucosamine sulfate, chondroitin sulfate, curcumin, omega-3 fatty acids, vitamin D, S-adenosylmethionine and methylsulfonylmethane (MSM) are natural options that may help support joint health.1-7
  • Osteoarthritis is not an inevitable part of growing older. Avoidance of aggravating factors such as obesity, pro-inflammatory foods, high-impact sports and excessive oxidative stress caused by free radicals can help contribute to the maintenance of healthy joints.
  • For joint pain that does not go away, please consult your physician.


  1. Tsuji T et al Aging Clin Exp Res. 2016 Apr;28(2):197-205.
  2. Bishnoi M et al. Glycoconj J. 2016 Oct;33(5):693-705.
  3. Henrotin Y et al. Osteoarthritis Cartilage. 2010 Feb;18(2):141-9.
  4. Gruenwald J et al. Adv Ther. 2009 Sep;26(9):858-71.
  5. Zheng S et al. Am J Med. 2017 Oct;130(10):1211-1218.
  6. Hosea Blewett HJ et al. Crit Rev Food Sci Nutr. 2008 May;48(5):458-63.
  7. Butawan M et al. Nutrients. 2017 Mar 16;9(3).

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