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Bsw7.5
Boswellia Research
Likely helps
85 peer-reviewed studies
What the evidence says
Likely helps
Boswellia appears to help in 6 of 6 studies with measurable effects — the evidence leans clearly favourable.
Most evidence is from high-quality meta-analyses and randomised trials published 2003–2026 with a typical study size of 98 participants.
Based on 85 studies · 12 meta-analyses · 54 RCTs · 19,595 total participants
Confidence
High confidence
What the studies found
6helped· 79 more without graded effect data
By outcome
Joint pain & arthritisReduced joint pain and stiffness within 2-4 weeks · 2-4 weeks
Likely helps73 studies
Therapeutic & clinical
Mostly mechanism / observational10 studies
Safety profile
Likely helps8 studies
Cognitive function
Mostly mechanism / observational4 studies
InflammationSignificant reduction in joint pain and stiffness · 4-8 weeks
Mostly mechanism / observational3 studies
Digestive healthReduces IBD symptoms and intestinal inflammation · 4-8 weeks
Too few graded studies2 studies
Recovery
Too few graded studies1 study
Cholesterol & lipids
Too few graded studies1 study
By the numbers
Pulled from 28 studies with measurable effects
Likely real effects
100%
across studies
People studied
20k
typical study: 98 people
Strongest designs
66
12 pooled, 54 randomised
Showed benefit
100%
6/6 studies
How long studies ran
1–4 weeks
3
1–3 months
2
3+ months
1
Populations Studied
Patients with knee osteoarthritis3
Patients with osteoarthritis3
IBD patients2
Knee osteoarthritis patients2
Active research area
43 studies in the last 5 years · Latest meta-analysis: 2026
200320142026
1Pain and stiffness in knee osteoarthritisMeta-Analysisn=4,599 · very large study2025
In plain English: However, further large-scale, well-designed randomized controlled trials (RCTs) are needed to confirm these findings, particularly those that include more standardized dosages and formulations, as well as to evaluate their long-term efficacy.
Zhang Y et al. · Nutrients (2025)
Bayesian rankings indicated Boswellia had the highest probability of being most effective for pain and stiffness, with krill oil and curcumin showing potential for function improvement.
Conclusions: Nutritional supplements, particularly Boswellia, appear to be effective and well-tolerated for improving KOA symptoms and function.
These results suggest that certain supplements may be useful as part of non-pharmacological KOA management.
In plain English: Well-planned, well-conducted and well-published trials are warranted to improve the evidence for Ayurvedic interventions.
Kessler CS et al. · Rheumatology international (2015)
Huge benefit
← WorseNo effectBetter →
Likely real
For the compound preparation, Rumalaya, large and apparently unbiased effects beyond placebo were found for pain (standardized mean difference [SMD] -3.73; 95 % confidence interval [CI] -4.97, -2.50; P < 0.01) and global improvement (risk ratio 12.20; 95 % CI 5.83, 25.54; P < 0.01).
There is also some evidence that effects of the herbal compound preparation Shunti-Guduchi are comparable to those of glucosamine for pain (SMD 0.08; 95 % CI -0.20, 0.36; P = 0.56) and function (SMD 0.15; 95 % CI -0.12, 0.36; P = 0.41).
No severe adverse events were observed in all trials.
3Physical function (WOMAC)Meta-Analysisn=5,980 · very large study2014
In plain English: Evidence for the proprietary ASU product Piasclidine® in the treatment of osteoarthritis symptoms seems moderate to high for short term use, but studies over a longer term and against an apparently active control are less convincing.
Cameron M et al. · The Cochrane database of systematic reviews (2014)
Noticeable benefit
← WorseNo effectBetter →
Seventeen studies of confirmatory design (sample and effect sizes pre-specified) were mostly at moderate risk of bias.
Physical function was 33 points on the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) 0 to 100 point subscale (0 is no loss of function) with placebo, enriched Boswellia serrata improved function by 8 points (95% CI 2 to 14); NNTB 4.
Moderate-quality evidence (one study, 96 participants) indicated that adverse events were probably reduced with enriched Boswellia serrata (18/48 events versus 30/48 events with placebo; relative risk (RR) 0.60, 95% CI 0.39 to 0.92).
4Pain in osteoarthritisMeta-Analysisn=1,741 · large study2017
In plain English: Z. officinale showed improvement of pain over placebo.
Del Grossi Moura M et al. · Phytotherapy research : PTR (2017)
Z. officinale showed improvement of pain over placebo.
The evidence was insufficient to support the effective and safe use of these herbal medicines, because the quality of evidence of studies was low.
This study guides managers of the Brazilian public health system and prescribers in decision-making regarding the use of these herbal medicines for OA.
Wu YR et al. · Chinese journal of integrative medicine (2024)
They also have comprehensive effects on regulating flora.
Frankincense and its principal chemical constituents have demonstrated promising chemoprophylactic and therapeutic abilities against tumors.
This review provides a systematic summary of the mechanism of action underlying the antitumor effects of frankincense and its major constituents, thus laying the foundations for developing effective tumor-combating targets.
10Knee osteoarthritis symptomsMeta-Analysisn=13 · very small study2024
In plain English: the subsequent subgroup analysis demonstrated the significant beneficial effect of Boswellia extracts in the treatment of knee OA with respect to a placebo (lower WOMAC score in the treatment groups).
Dalmonte T et al. · Phytotherapy research : PTR (2024)
More than 40% of patients use complementary and alternative medicine including supplements containing phytoextracts with anti-inflammatory properties as those from the Boswellia genus.
This was also confirmed in the meta-regression applied to the WOMAC scores.
This is an important finding as people exposed to NSAID-related adverse effects could benefit from the use of Boswellia extracts.
In plain English: Currently the scientific evidence is insufficiently robust to establish definitive clinical practice guidelines, but processes could be established to track the impact of these ingredients.
Crawford C et al. · Pain medicine (Malden, Mass.) (2019)
Currently the scientific evidence is insufficiently robust to establish definitive clinical practice guidelines, but processes could be established to track the impact of these ingredients.
Until then, providers have the evidence needed to make informed decisions about the safe use of these dietary ingredients, and future research can address existing gaps.
12Disease activity in inflammatory bowel diseaseReview2016
In plain English: In summary, attention to dietary factors such as curcumin, green tea and vitamins, including vitamins D and B12, appears to be beneficial and, if necessary, supplementation may be appropriate.
Rossi RE et al. · European journal of gastroenterology & hepatology (2016)
Zinc and iron should be supplemented in selected cases.
Probiotics (VSL#3) may reduce disease activity in IBD patients with pouchitis.
Complementary and alternative medicines are used by IBD patients and some studies have shown promising results.
In plain English: The overall analysis including all trials showed that supplements provided moderate and clinically meaningful treatment effects on pain and function in patients with hand, hip or knee osteoarthritis at short term, although the quality of evidence was very low.
Liu X et al. · British journal of sports medicine (2018)
Another six (undenatured type II collagen, avocado soybean unsaponifiables, methylsulfonylmethane, diacerein, glucosamine and chondroitin) revealed statistically significant improvements on pain, but were of unclear clinical importance.
Chondroitin demonstrated statistically significant, but not clinically important structural improvement (effect size -0.30, -0.42 to -0.17).
The overall analysis including all trials showed that supplements provided moderate and clinically meaningful treatment effects on pain and function in patients with hand, hip or knee osteoarthritis at short term, although the quality of evidence was very low.
In plain English: The major limitation in reviewing the evidence is the paucity of randomized controlled trials in the area: widening the evidence base, particularly for those compounds for which there is promising evidence, should be a priority for both researchers and funders.
De Silva V et al. · Rheumatology (Oxford, England) (2011)
For other substances with promising evidence, the evidence base was either insufficiently large or the evidence base was inconsistent.
Most of the CAM compounds studied were free of major adverse effects.
The major limitation in reviewing the evidence is the paucity of randomized controlled trials in the area: widening the evidence base, particularly for those compounds for which there is promising evidence, should be a priority for both researchers and funders.
15Treatment of inflammatory bowel diseasesSystematic Review2015
In plain English: Complementary and alternative therapies might be effective for the treatment of inflammatory bowel diseases; however, given the low number of trials and the heterogeneous methodological quality of trials, further in-depth research is necessary.
Langhorst J et al. · Journal of Crohn's & colitis (2015)
Complementary and alternative therapies might be effective for the treatment of inflammatory bowel diseases; however, given the low number of trials and the heterogeneous methodological quality of trials, further in-depth research is necessary.
In plain English: Their potential value lies in modest symptom support that may facilitate rehabilitation participation in selected patients, not in stand-alone treatment of KOA or sarcopenia.
Park D, Koh HS, Choi YH, Moon JW, Park I. · Nutrients (2026)
Across glucosamine/chondroitin, collagen peptides, omega-3 fatty acids, curcumin, and Boswellia, symptomatic benefits were modest, heterogeneous, and formulation-dependent, with no consistent evidence of structural disease modification.
Direct evidence that nutraceuticals improve exercise adherence or long-term physical activity remains limited; however, selected exercise-integrated or function-oriented studies show participation-relevant signals in gait speed, activity volume, and performance-based outcomes.
Conclusions Nutraceuticals should be interpreted as optional, time-limited adjuncts within exercise-centered KOA management.
17Pain reduction (VAS) and joint function (WOMAC)Meta-Analysisn=1,633 · large study2026
In plain English: BS extract, particularly in modified formulations, improves joint function in patients with mild to moderate KOA, while only the modified formulation of CL demonstrates notable pain-reducing efficacy.
Inprasit C et al. · Complementary therapies in medicine (2026)
Huge benefit
← WorseNo effectBetter →
The modified formulations of CL showed a significant reduction in VAS compared to placebo (SMD: -2.82; 95 %CI: -5.30 to -0.33), while the modified formulations of BS demonstrated significant improvement in WOMAC pain, stiffness, and knee function compared to other intervention groups.
BS extract, particularly in modified formulations, improves joint function in patients with mild to moderate KOA, while only the modified formulation of CL demonstrates notable pain-reducing efficacy.
The potential benefits of combined CL and BS preparations warrant further investigation.
Basch E, Boon H, Davies-Heerema T, Foppo I, Hashmi S, Hasskarl J · J Herb Pharmacother (2004)
19Review2026
In plain English: By comparing the advantages and limitations of conventional preparations with modern drug delivery systems, this review outlines the most effective strategies to enhance the bioavailability of BAs and highlights future research directions for their translational development.
Rutkowska M, Olszewska MA. · International journal of molecular sciences (2026)
Results indicate that emerging formulation technologies significantly increase the oral absorption, systemic exposure, and biological effectiveness of BAs.
Available in vivo and cellular studies are critically evaluated, with a focus on disease-specific outcomes.
However, despite promising preclinical data, challenges remain regarding the standardization of Boswellia extracts, the stability of novel formulations, their safety, and limited clinical evaluation.
20Knee osteoarthritis and cartilage degenerationRCTn=62 · small study2025
In plain English: Taken together, the combination of Boswellia and celery could be a safe and promising herbal nutraceutical option for managing osteoarthritis and cartilage health effectively.
Vaidya N et al. · Pharmaceutical research (2025)
Taken together, the combination of Boswellia and celery could be a safe and promising herbal nutraceutical option for managing osteoarthritis and cartilage health effectively.