Roughly 50% of IBD patients experience extra-intestinal manifestations, most commonly arthritis. And as conventional therapies for rheumatoid arthritis are linked to adverse effects, researchers are now turning to traditional forms of medicine to seek a safer alternative for joint pain and inflammation.
Boswellia is one of the more promising solutions and has been successfully tested for osteoarthritis and joint pain in a number of trials. And although research on Boswellia for rheumatoid arthritis (RA) is still underway, a small number of studies suggest the extract may be a promising remedy for joint pain associated with IBD.
What is Boswellia Serrata?
Boswellia resin is the woodsy, sweet-smelling herbal extract from the Boswellia serrata tree, native to the dry highlands of India, Northern Africa, and the Middle East. It is also known as Indian frankincense.
Boswellia resin has long been classified as a medicinal anti-inflammatory and is still used today in Ayurveda and Traditional Chinese Medicine (TCM) to treat inflammatory conditions. Practitioners of TCM administer Boswellia for blood stagnation, and to Crohn’s disease patients suffering inflammation in a restricted area, localized abdominal pain, and extraintestinal manifestations.
Boswellia through the ages
For much of history, Boswelia resin was equal to gold and ivory in value. Considered a gift for gods and kings, the resin was used in royal cosmetics and incense in temple rituals. Throughout the rise and fall of numerous civilizations, Boswellia resin maintained its sacred and religious significance.
Boswellia first appears as a medicinal remedy in the Ebers papyrus (1500 BC), one of the oldest and best-preserved medical records from Ancient Egypt. In the 2nd century CE, Celsus described Boswellia as a treatment for wounds and hemlock. A few centuries later, the Babylonian Talmud told of its administration to prisoners sentenced to death to numb their senses ‘so they should not feel sorry’. And in the 10th century, Iranian physician Aviccea “Ibn Sina ” recorded its use for fever, gastric ailments, and tumors.
By the 11th century CE, Boswellia was widely known for its medicinal properties, especially for inflammation. It had by now entered the Ayurvedic canon. Two of the fundamental Ayurvedic texts describe Boswellia as an antirheumatic (meaning anti-arthritis) remedy. It was otherwise used to treat diarrhea, dysentery, ringworm, boils, blood diseases, heart diseases, bronchitis, jaundice, syphilitic disease, and a host of other ailments.
The Anti-Inflammatory Mechanisms of Boswellia Serrata
Today, modern clinical research on the pharmacological properties of Boswellia has confirmed its antiarthritic, anti-inflammatory, pro-apoptotic, and pain-relieving activities, making the extract a highly promising potential treatment for IBD-related arthritis.
Boswellia contains two active compounds, incensole acetate, and incesole. The two compounds inhibit NF-κB activity and IκBα degradation, which play a large role in immune and inflammatory responses. In recent trials, Boswellia has been shown to suppress interleukin-1 β, TNF-α & interferon-γ, enhance the production of IL-10 and inhibit pro-inflammatory cytokines that play a role in inflammation and tissue damage during the progression of rheumatoid arthritis.
Health Benefits of Boswellia
A study published in 2000 tested a range of herbal extracts for RA, including Boswellia serrata, curcumin, ginger, and ashwagandha. The trial, which included 182 participants, showed ‘significant improvements in RA markets, including swollen joints, rheumatoid factor improvement, and improvement in the American College of Rheumatology joint assessment score.
An animal model study in 2019 suggested Boswellia as a useful complementary therapy to support RA treatment. CFA-induced arthritic rats were treated with Boswellia, which had an antiarthritic effect on their joints, bones, and cartilage, and all rats showed significantly reduced inflammatory levels, as well as reduced markers of rheumatoid arthritis.
The Arthritis Foundation now recommends Boswellic acid as a treatment for rheumatoid arthritis and osteoarthritis, and researchers believe the combination of Boswellia and curcumin to be a highly promising natural RA therapy, which may spare many patients the adverse effects of conventional therapies.
Boswellia & Curcumin for Arthritis
Curcumin, the bioactive compound found in turmeric, is well known for its potent anti-inflammatory effects. Curcumin reduces inflammation by suppressing NF-κB activity, which, when dysregulated, can cause chronic inflammation. Curcumin additionally targets numerous inflammatory cytokines and has been found to help manage inflammatory conditions including osteoarthritis.
A recent trial tested a combined formula of curcumin and Boswellic acid for the treatment of osteoarthritis. After twelve weeks, the OA patients showed a reduction in pain-related symptoms. The results showed that combining curcumin with Boswellia increases efficacy due to the synergistic effects of the two remedies.
This would suggest that using high-bioavailable curcumin with Boswellia will increase the anti-inflammatory properties and help manage chronic joint pain.