The Benefits of Boswellia Serrata Extract Supplementation in Individuals with Knee Osteoarthritis

by | Jan 27, 2025 | 2024, Arthritis, Boswellia, Botanicals, Joint Health, Recent Articles

Written by Harold Oster, MD. Results suggest that supplementation with Boswellia serrata extract may diminish pain, improve function, and reduce inflammation in adults with knee osteoarthritis.

kneeOsteoarthritis affects more than two hundred million people worldwide. It destroys cartilage and bone, leading to pain, stiffness, and loss of function. Nearly 30% of individuals older than forty-five have evidence of knee osteoarthritis1. Frankincense, the resin of trees from the Boswellia genus, has been used in traditional medicine for thousands of years. Terpene compounds found in Boswellia serrata, notably 11-keto-b-acetyl-beta-boswellic acid (AKBA), have anti-inflammatory and antioxidant properties2 and may benefit patients with arthritis3.

Brijesh Kumar et al. investigated the effects of an oral extract of Boswellia serrata on signs and symptoms of knee osteoarthritis. The authors recruited eighty individuals with mild to moderate knee osteoarthritis and randomized them to consume one capsule of 100 mg Boswellia serrata resin extract or a placebo daily for 180 days. The study product consisted of at least 20% AKBA. The participants were questioned regarding demographics, medical history, diet, and pain medications. At baseline and on days 30, 60, 120, and 180, the participants were evaluated with the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), the Visual Analog Scale (VAS), and Lequesne’s Functional Index (LFI). WOMAC is a self-administered measure that assesses pain, stiffness, and function in patients with knee osteoarthritis4. The VAS test asks patients to rate their pain level on a numerical, visual scale5. LFI measures the severity of joint pain and the patient’s level of function6. Participants were also administered the Six Minute Walk Test (SMWT)7, in which the distance an individual can walk in six minutes is measured, and the Stair Climb test, where the time it takes for an individual to ascend and descend nine steps is measured8. Routine labs were drawn to evaluate for adverse effects, and blood was tested for C-reactive protein (CRP)9, an inflammatory marker, and the following tests for cartilage degradation: Matrix metalloproteinase-310, fibulin-311, and C-terminal telopeptide of type 2 collagen12. Knee MRI scans were performed to evaluate for signs of osteoarthritis progression13.

The authors noted the following:

  • Based on exclusion criteria, 73 participants completed the study.
  • The average age of the participants was 48 years.
  • WOMAC scores for pain, stiffness, and function improved more in the Boswellia group than in the placebo group.
  • VAS and LFI scores improved more in the participants who consumed the Boswellia serrata extract than in those who took the placebo.
  • The SMWT and SCT improved more in the participants who consumed the Boswellia serrata extract than in those who took the placebo.
  • At the end of the study, the Boswellia group had lower levels of CRP and markers of cartilage degradation than those in the placebo group.
  • At the end of the study, the MRI scans showed improvement in the Boswellia group and worsening in the placebo group.
  • None of the participants consumed pain medication during the study.
  • No significant adverse effects were noted in either group.

Results suggest that supplementation with Boswellia serrata extract may diminish pain, improve function, reduce inflammation, and improve signs of joint damage on MRI scans in adults with knee osteoarthritis. A limitation of the study is its small sample size.

Source: Kumar, Brijesh, Abhijeet Balbhim Ghaytidak, Abhinav Kumar Pandey, Raghu Ram Somepalli, Praveen Sarda, Siba Prasad Raychaudhuri, and Meher Prasanna Rokkam. “A Standardized Boswellia serrata Extract Improves Knee Joint Function and Cartilage Morphology in Human Volunteers with Mild to Moderate Osteoarthritis in a Randomized Placebo-Controlled Study.” Journal of the American Nutrition Association (2024): 1-12.

© 2024  American Nutrition Association

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Posted January 27, 2025.

Harold Oster, MD graduated from medical school in Miami, Florida in 1992 and moved to Minnesota in 2004. After more than 25 years of practicing Internal Medicine, he recently retired. Dr. Oster is especially interested in nutrition, weight management, and disease prevention. Visit his website at haroldoster.com.

References:

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