Can Turmeric and Indian Frankincense Relieve Acute Musculoskeletal Pain?
Boswellia tree resin extract, also known as Indian frankincense, and turmeric have been used in traditional ayurvedic medicine for thousands of years. Both botanical medicines are touted for rejuvenating joints and for their many other anti-inflammatory-based health benefits. They can each be taken orally or applied topically. Curcumin, one of the active compounds in turmeric, has been shown to ameliorate obesity, metabolic syndrome, diabetes, depression, and fatty liver disease.1
Frankincense
In recent years, turmeric and Boswellia supplements have become popular for the relief of chronic pain and discomfort, largely owing to their reliable anti-inflammatory effects. The implications for acute applications, however, are less well studied,1 and this clinical trial aimed to shed light on their use for acute situations, namely injury-induced musculoskeletal pain.
Turmeric Has Unique Properties
Turmeric (and its active compound, curcumin) is widely known for its anti-inflammatory effects. Fewer studies focus on Boswellia, as it is less available and less popular than turmeric. Research, however, has found that long-term use of Boswellia for patients with osteoarthritis is safe and effective.2 Recent research shows a potential synergistic effect between turmeric and Boswellia for treating the inflammation and pain of osteoarthritis.3
The Study
The study reviewed here was placebo-controlled, randomized, and double-blinded, and researchers conducted it at multiple centers in India. The design, intervention, and randomization used sound procedures. The study uses several pain scales to obtain a variety of data points, leading to a more rigorous conclusion. However, it must be noted that the data collected are subjective. Researchers did not collect any objective measures, such as functional changes (improved activity level or range of motion of the affected joint). There was no comparison to an over-the-counter analgesic, such as a nonsteroidal anti-inflammatory drug (NSAID) or to any prescription medications.
The study used a product called Rhuleave-K™, created by Arjuna Natural Private Ltd and manufactured in India. Extraction of the turmeric rhizomes and Boswellia serrata gum resin used a proprietary technology. It is unknown whether this technology is utilized by other companies.
Prior randomized control trials have shown the efficacy of other curcumin and Boswellia formulations for pain relief with fewer adverse gastrointestinal effects than NSAIDs.4 The dosage was chosen for this particular study’s healthy participants, but there was no mention of dosage adjustments for special populations such as the elderly or those with liver or renal impairment. Turmeric is generally considered safe at the dose of 500 mg, twice daily.5 However, mention of special populations may provide a better clinical application.
No Reported Side Effects
The study did not report any side effects that the participants may have suffered. A literature search finds that excessive intake of curcumin can have several adverse effects, including on the liver, kidney, cardiac system, and blood, and immune system.6 Although these adverse effects are rare and mostly seen in cases of excessive intake, they must be considered. Investigators also did not discuss the bioavailability and absorption, which could be considered outside the context of this study.
As an intervention for acute musculoskeletal pain in urgent settings, a turmeric and Boswellia supplement looks promising. The implications are great, with the possibility of avoiding opioids or NSAIDs, which have a more dangerous safety profile, in high-risk populations. More research is needed to determine the efficacy outside of healthy populations and examine adverse effects before making clinical conclusions.
About The Author
Poorvi Shah, DO, is a physician who is board-certified in family medicine and specializes in osteopathy and integrative medicine. She graduated from Michigan State University’s College of Osteopathic Medicine and completed a family medicine residency. She later completed a fellowship in integrative medicine at the Andrew Weil Center for Integrative Medicine. Shah practices integrative medicine and osteopathy in the greater Washington, DC, area.
References
1. Mantzorou M, Pavlidou E, Vasios G, Tsagalioti E, Giaginis C. Effects of curcumin consumption on human chronic diseases: a narrative review of the most recent clinical data. Phytother Res. 2018;32(6):957-975.
2. Yu G, Xiang W, Zhang T, Zeng L, Yang K, Li J. Effectiveness of Boswellia and Boswellia extract for osteoarthritis patients: a systematic review and meta-analysis. BMC Complement Med Ther. 2022;20:225.
3. Sethi V, Garg M, Herve M, Mobasheri A. Potential complementary and/or synergistic effects of curcumin and boswellic acids for management of osteoarthritis. Ther Adv in Musculoskelet Dis. 2022;14:1-22.
4. Bannuru R, Osani M, Al-Eid F, Wang C. Efficacy of curcumin and boswellia for knee osteoarthritis: systemic review and meta-analysis. Semin Arthritis Rheum. 2018;48(3):416-429.
5. Soleimani V, Sahebkar A, Hosseinzadeh H. Turmeric (Curcuma longa) and its major constituent (curcumin) as nontoxic and safe substances: review. Phytother Res. 2018;32(6):985-995.
6. Liu S, Liu J, He L, et al. A comprehensive review on the benefits and problems of curcumin with respect to human health. Molecules. 2022;27(14):4400.