Boswellia Serrata and Bromelain Extracts Useful in Mitigating Osteoarthritis Symptoms

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Researchers find Boswellia serrata and bromelain extracts as safe and effective tools for reducing pain and inflammation in arthritis patients

A study published by the Journal of Alternative and Complementary Medicine identified Boswellia serrata and bromelain, two natural extracts used medicinally since ancient times, as possible nonpharmacological supplements for improving the quality of life for patients with osteoarthritis.

What Is Osteoarthritis?

Osteoarthritis is a common degenerative joint disease that mostly affects older adults and is usually caused by age or obesity. Osteoarthritis causes stiffness and pain in weight-bearing joints like the hips, knees or spine, but can also affect the fingers, hands and feet.[i]

It's estimated that over 27% of adults over the age of 60 suffer from osteoarthritis, and that number is likely to increase as the population ages and obesity levels rise.[ii] Conventional therapies consist of anti-inflammatory drugs, corticosteroids and opioids, but long-term use of these drugs is associated with cardiovascular and gastrointestinal complications.

Thus, researchers are eager to discover natural therapies that provide relief without presenting such dangerous side effects. In this study, researchers tested extracts of Boswellia serrata and bromelain, two natural substances reported to have anti-inflammatory effects, for their safety and efficacy against osteoarthritis symptoms.

Historical and Medicinal Uses of Boswellia Serrata and Bromelain

Boswellia serrata, also known as Indian Frankincense, has been used for medicinal, cosmetic, and religious purposes since ancient times.[iii] In India, Boswellia serrata is tapped from the trunk of the Boswelia tree and used medicinally to treat arthritis, ringworm, diarrhea, asthma and a variety of other illnesses.[iv] It is considered a potent anti-inflammatory agent and has been studied for its promising effects in patients with osteoarthritis and various cardiovascular diseases.[v],[vi]

Bromelain, a protein-digesting enzyme, is an extract found in pineapple stem. In South America, bromelain extract is commonly used to treat irritation and swelling, especially in digestive disorders.[vii] Bromelain may also relieve irritation from burns, reduce nasal swelling, improve inflammatory conditions such as asthma and stop bruising, but few studies have been done on the efficacy of bromelain for osteoarthritis.[viii]

Because the stem of a pineapple is usually considered a waste product, bromelain extract is relatively inexpensive to obtain and could be a powerful potential treatment for osteoarthritis symptoms.

Dosage and Research Methods

Forty-nine patients were enrolled in the study, suffering from several kinds of osteoarthritis, including knee, hip, hand, and spine osteoarthritis. Patients took two tablets daily, each containing 750 milligrams (mg) of Boswellia serrata extract and 80 mg of bromelain.[ix] Additionally, patients continued any pre-existing medications and experienced no drug interactions.

The participants were tested on their autonomy in various activities including bathing and dressing, eating, cooking, sitting or standing, walking and moving about the house. To test the efficacy of the treatment, the patients' questionnaires were analyzed using the Wilcoxon signed-rank test, a nonparametric analysis frequently used to test clustered data for pre- and post-treatment results.[x],[xi]

Results and Clinical Efficacy of Boswellia Serrata and Bromelain for Osteoarthritis Symptoms

The study revealed three principal findings related to the synergistic relationship of Boswellia serrata and bromelain in the mitigation of osteoarthritis symptoms:

  • Tolerance for Boswellia serrata and bromelain was very good. During the study, which lasted three to four months, no patient experienced any drug interactions to their medications or experienced any adverse effects.[xii]
  • Bromelain extract may stop the formation of pannus. Pannus, an abnormal tissue growth that forms in later stages of arthritis, forms when pro-inflammatory molecules called cytokines cause new tissue to form around joints. That tissue, or pannus, releases enzymes and acids that damage cartilage and bone.[xiii]

Pannus formation is very painful and can reduce mobility, and is found in both osteoarthritis and rheumatoid arthritis patients.[xiv] Thus, bromelain extract may act as a preventative measure against arthritic disease progression.[xv]

  • Boswellia serrata inhibits pro-inflammatory processes. The main ingredients in Boswellia serrata are pentacyclic triterpenic acids, a kind of plant compound known to reduce non-enzymatic glycation related to various forms of arthritis.[xvi]

Thus, Boswellia serrata and bromelain are considered synergistic tools that fight the onset and progression of osteoarthritis. Researchers also noted that because the ingredients in this study were in a gastro-resistant and prolonged release formation, the tablets used may be more powerful than the individual extracts. Researchers concluded:

"The results of this pilot study strongly support the potential of using the combination of the two ingredients to potentiate their therapeutic efficacy in the treatment of [osteoarthritis], not limited only to the knee but also to other sites and in generalized [osteoarthritis]."[xvii]

For further research into the benefits of Boswellia serrata and bromelain extracts, as well as other natural substances that target osteoarthritis, please reference the Database.


[iii] J Ethnopharmacol. 2018 Oct 28;225:279-286.

[iv] Indian J Pharm Sci. 2011 May-Jun; 73(3): 255-261.

[v] Oxid Med Cell Longev. 2018; 2018: 2504305.

[vi] Phytomedicine. 2003 Jan;10(1):3-7.

[viii] Biotechnol Res Int. 2012; 2012: 976203.

[x] Biometrics. 2006 Mar;62(1):185-92.

[xi] Biometrics. 2006 Mar;62(1):185-92.

[xiii] Clin Exp Rheumatol. 2008 Jul-Aug;26(4):554-60

[xiv] Clin Exp Rheumatol. 2008 Jul-Aug;26(4):554-60.

[xvi] Biomedicine (Taipei). 2015 Sep; 5(3): 13

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