Boswellia for Osteoarthritis Pain

Boswellia serrata extract may be as effective as a selective COX-2 inhibitor for osteoarthritis pain relief, according to the results of a new study.

Researchers in India from Government Medical College, Government Ayurved College, Indira Gandhi Government Medical College, and Pharmanza compared the efficacy, safety and tolerability of Boswellia serrata extract (BSE) in knee osteoarthritis (OA) with valdecoxib, a selective COX-2 inhibitor.

In the randomized, prospective, open-label, comparative study, the efficacy, safety and tolerability of BSE was compared with valdecoxib in 66 patients of OA of knee for six months. The patients were assessed by WOMAC scale at baseline and thereafter at monthly intervals until one month after drug discontinuation. Antero-posterior radiographs of affected knee joint were taken at baseline and after six months.

The study found that in the BSE group, the pain, stiffness and difficulty in performing daily activities showed statistically significant improvement with two months of therapy that lasted one month after stopping the intervention. In the valdecoxib group, the statistically significant improvement in all parameters was reported after one month of therapy but the effect persisted only as long as drug therapy continued.

Three patients from the BSE group and two from the valdecoxib group complained of acidity. One patient from the BSE group complained of diarrhea and abdominal cramps.

Researchers concluded that BSE showed a slower onset of action but the effect persisted even after stopping therapy, while the action of valdecoxib became evident faster but waned rapidly after stopping the treatment.

Previous studies have found that unlike non-steroidal anti-inflammatory drugs (NSAIDs), long-term use of boswellia has not been shown to cause gastrointestinal irritation or ulceration, although side effects have not been systematically studied in humans. Boswellia has traditionally been used for a number of topical applications, including the treatment of acne, bacterial and fungal infections, boils, wound healing, scars and varicose veins. It is used cosmetically as a facial toner and to smooth wrinkles. Chinese herbalists use boswellia in powder form and in teas for rheumatism, menstrual pain and as an external wash for sores and bruises.

Historically, boswellia has been used to improve emotional well-being and as part of religious rituals. It has been reported that boswellia can enhance spirituality, mental perception, meditation, prayer and consciousness when burned (burning is said to produce a psychoactive substance, trans-hydrocannabinole). Boswellia has been noted in animal and in vitro studies to possess anti-inflammatory properties.