Boswellia serrata possesses anti-inflammatory and analgesic properties that could offer relief in osteoarthritis.
Boswellia serrata is a tree that grows in dry mountainous regions of India, North Africa and Middle East and it is commonly known as Indian Frankincense. There are three other popular forms of boswellia: boswellia carteri, boswellia frereana and boswellia sacra. The resin obtained from Bosweliia frereana is the most expensive brand available in the market. Prior to being used for medicinal purposes, Boswellia serrata was used as incense, fumigant and for other aromatic purposes. Even today incense sticks and powder are prepared from it.
Salai or oleo-gum resin is obtained from incicions made on the bark of the Boswellia tree, which is then solidified and chopped to form small pieces with aromatic scent. The resin is graded based on color, shape, flavour and size. The gum resin contains 30-60% resin, 5-10% essential oils and the rest are polysaccharides. The essential oils impart the fragrance and these are also extracted for commercial purposes.
The resinous part contains monoterpenes, diterpenes, triterpenes, pentacyclic triterpenic acids (boswellic acids) and tetracyclic triterpenic acids. These boswellic acids present in the resinous part are responsible for its anti-inflammatory action and contribute to he plant’s medicinal value.
Boswellia serrata is traditionally used to treat diarrhea, dysentery, ringworm, boils, fevers (antipyretic), skin and blood diseases, cardiovascular diseases, mouth sores, bad throat, bronchitis, asthma, cough, vaginal discharges, hair-loss, jaundice, hemorrhoids, syphilitic diseases, irregular menses and stimulation of liver.
How does Boswellia serrata help in osteoarthritis?
Osteoarthritis is the most common form of arthritis. It is estimated that 78 million adults above the age of 18 will be affected by arthritis and two thirds of those would be women.
Osteoarthritis involves degradation of the cartilage- the tissue that ensures better flexibility of bone joints. This leads to friction and wear and tear of the joints leading to inflammation and pain.
Osteoarthritis can affect joints like that of thumbs, fingers, neck, lower back, knee and hips. Treatment involves exercise and pain relief medications such as NSAIDs and opioids.
Current research suggests that Boswellia serrata possesses anti-inflammatory and analgesic properties that could offer relief in osteoarthritis.
Reduces osteoarthritis symptoms
Bioavailable forms of Boswellia serrata extracts- such as Aflapin have been found to reduce osteoarthritis symptoms as early as 5 days.
In a 90-day placebo controlled clinical study by Vishal et al., the anti-arthritic efficacy of Aflapin was evaluated in OA subjects. Aflapin demonstrated a significant improvement in the quality of life in OA subjects. Aflapin was found to significantly improve joint function and relieve pain (including VAS, LFI, WOMAC pain, WOMAC function and WOMAC stiffness scores) in as early as 5 days of treatment.
Boswellia serrata inhibits the activity of LOX enzyme, which is involved in inflammation unlike other agents which act on COX enzyme (inflammatory enzyme). Research shows that its anti-inflammatory effect is more persistent than that of a conventional medicine that inhibits COX enzyme.
Boswellic acids present in the resinous part are the compounds are responsible for its anti-inflammatory action. Most herbs and anti-inflammatory drugs reduce inflammation by inhibiting the activity of enzyme COX. Boswellia serrata extract is found to inhibit the activity of inflammatory cells. It also regulates immune responses in order to reduce inflammation. Inhibition of other enzymes have also been reported which contribute to its anti-inflammatory effect and research suggests that boswellia serrata could be an alternative to NSAIDs (non steroidal anti-inflammatory drugs). Boswellia is slow acting but its therapeutic effects are persistent even after stopping the therapy COX inhibitors.
Reduces pain fast
FlexiQule ( a standardized Boswellia extract) in combination with standard treatment in symptomatic knee osteoarthritis is found to reduce pain and stiffness within 4 weeks. Belcaro et. al studied the therapeutic efficacy of FlexiQule in hand ‘stress’ arthritis. Within 2 weeks of supplementation there was a marked reduction in pain. No patient that received Boswellia supplement needed to take medications while the control group had to consume NSAIDs and steroids to reduce pain. Indian researchers have studied the analgesic or pain relieving property of Shallaki, a standardized extract of Boswellia in humans. 250mg of Shallaki is found to reduce pain and increase pain-bearing threshold in mechanical pain model in humans.
Prevents wearing off of bone tissue
Apart from controlling inflammation, Boswellia serrata has chondroprotective property- it protects bone and cartilage from degrading which is the major feature of osteoarthritis. Sumantran et. al describe the effect of a herbal formulation containing Boswellia serrata on cartilage of knee osteoarthritis patients. This formulation demonstrated anti-inflammatory effect and protected cartilage from degradation.
Boswellia serrata present in this formulation is said to be responsible for this chondroprotective( protecting bone tissue) and anti-inflammatory effect. Aflapin, a boswellia serrata formulation has been found to have bone protective properties. Its inhibitory potential against MMP-3 (an enzyme that degrades cartilage) is also found to be 14.83% better than other boswellia formulations. A herbal formulation containing Boswellia serrata and leucine (amino acid that build protein) is found to have chondroprotective action. It not only protects bone tissue but also aid in repair and regeneration.
Topical application of Boswellia serrata benefits in arthritis
Topical application of Boswellia serrata also helps in controlling inflammation and protecting bone tissue from damage. Singh et. al have reported that Boswellia serrata exerts anti-inflammatory effect even via topical application. It aids in reducing swelling and arthritis in animal models.
- It works in combination with other herbs and medicines to treat osteoarthritis
- Boswellia has therapeutic efficacy equivalent to that of glucosamine and works synergistically with it.
- 500mg of a combined formulation of turmeric and boswellia serrata administered twice a day is alo found to be more effective than 100mg celecoxib twice a day in osteoarthritis (Celecoxib is a medicine prescribed in treating arthritis and it inhibits the activity of inflammatory enzyme-COX).
The active ingredients of Boswellia serrata have unique anti-inflammatory action. Also the herb protects bone tissue making it even more effective in osteoarthritis.
There is compelling evidence in case of Boswellia serrata’s utility in osteoarthritis and it is definitely one herbal supplement that must be considered as part of treatment in arthritis.