Boswellia with MSM Beats Glucosamine in Treating Knee Osteoarthritis
The efficacy of glucosamine and chondroitin – especially the two in combination – for arthritis is questionable at best.
This position is backed up by clinical research evidence. Several studies, including the large 2006-2010 National Institutes of Health’s Glucosamine/Chondroitin Arthritis Intervention Trial (GAIT), has proven out glucosamine’s lackluster effects.
The GAIT study included 1,583 patients with mild to severe knee pain. The study found that glucosamine-chondroitin supplements didn’t have a significant effect on osteoarthritis symptoms. While some reported slightly less pain, the results were confounded by being teased from a sub-group.
The GAIT researchers followed up with another study of 572 people that continued to take the supplements (or a placebo) for two years. The research found there was no difference in cartilage loss or joint spaces in the knees of those taking the glucosamine-chondroitin supplements.
Other studies have confirmed these findings, in both humans and arthritic horses. Multiple reviews of the multitude of studies on glucosamine-chrondoitin have found little evidence that the combination is more effective than placebo. That means, of course, that it doesn’t do too much.
Of those glucosamine-chondroitin studies that have found some effectiveness, researchers have observed significant bias among the studies, many funded by the supplement manufacturers.
One of the problems in the case of chondroitin, in my opinion, is the notion that if we eat cartilage, it will somehow make it to the joints and shore up our joint cartilage. In reality, the body forms its own cartilage, using building blocks provided by the diet. As I state in my book, there is some evidence that glucosamine sulfate might have a slight positive effect upon joint pain – likely a result of adding sulfur atoms to the diet.
Methylsulfonylmethane (MSM) and arthritis
This point about the effect of sulfur leads us right to the potential benefits of Methylsulfonylmethane (MSM): A naturally-derived compound centered around sulfone. This is considered by some as a metabolically active form of sulfur.
Several clinical studies have shown that MSM reduces pain and increases mobility among osteoarthritis patients. In a 2011 study from Israel’s Assaf Harofeh Medical Center, 49 people with osteoarthritis took 3.375 grams of MSM or a placebo for 12 weeks. The researchers found the MSM group had significantly less pain and better mobility. The researchers stated:
“Patients with osteoarthritis of the knee taking MSM for 12 weeks showed an improvement in pain and physical function.”
Another study gave 100 patients 6 grams per day of MSM or a placebo for 26 weeks (six months). The researchers found that hip and/or knee pain was significantly less among the MSM group.
Boswellia proves significant osteoarthritis benefit
Boswellia serrata is an Ayurvedic herb used for thousands of years for the treatment of various inflammatory conditions. This is now supported by a number of scientific studies.
The research evidence has also been clear about Boswellia serrata and its main extracted constituents, boswellic acids. A 2015 study from Italy’s Ch-Pe University tested 32 patients who took a Boswellia extract with another 34 patients as controls.
After 12 weeks of taking the Boswellia extract, pain and walking distances were significantly improved compared to the control group.
Boswellia has also been found in other studies to have significant anti-inflammatory effects.
Boswellia and MSM outperform glucosamine sulfate
This background leads us to the 2016 study hinted at above. Researchers from the General Hospital and Medical School of Italy’s University of Bari conducted a randomized clinical trial of 120 people with osteoarthritis of the knee.
The researchers gave half the people 5 grams of MSM plus 7.2 milligrams of boswellic acids (Boswellia extract) per day. The other half was given 1,500 milligrams of glucosamine sulfate each day. The patients were examined before the study, after 60 days and after 6 months.
They were tested using the Visual Analog Pain Scale (VAS) and the Lequesne Index (LI) for joint function and mobility.
After 60 days, pain scores and joint function scores were significantly improved in the MSM-Boswellia group compared to the glucosamine group.
After 6 months, the effect was even greater. The researchers found the MSM-Boswellia combined treatment decreased pain and increased mobility even more in the longer term.
The combination of MSM and Boswellia extract also significantly decreased the needs for any other pain relief drugs such as NSAIDs.
The researchers stated:
“These results are consistent with the anti-inflammatory and chondroprotective effects previously occurred in experimental studies. This new combination of integration (MSM and Boswellia) has presented good results and satisfactory in comparison with glucosamine sulfate, until now the cornerstone of the treatment of arthritis in according to guidelines.”
Learn more about the causes and clinically proven solutions for all types of arthritis:
Notarnicola A, Maccagnano G, Moretti L, Pesce V, Tafuri S, Fiore A, Moretti B. Methylsulfonylmethane and boswellic acids versus glucosamine sulfate in the treatment of knee arthritis: Randomized trial. Int J Immunopathol Pharmacol. 2016 Mar;29(1):140-6. doi: 10.1177/0394632015622215.
Belcaro G, Dugall M, Luzzi R, Ledda A, Pellegrini L, Hu S, Ippolito E. Management of osteoarthritis (OA) with the pharma-standard supplement FlexiQule (Boswellia): a 12-week registry. Minerva Gastroenterol Dietol. 2015 Oct 22.
Kessler CS, Pinders L, Michalsen A, Cramer H. Ayurvedic interventions for osteoarthritis: a systematic review and meta-analysis. Rheumatol Int. 2015 Feb;35(2):211-32. doi: 10.1007/s00296-014-3095-y.
Debbi EM, Agar G, Fichman G, Ziv YB, Kardosh R, Halperin N, Elbaz A, Beer Y, Debi R. Efficacy of methylsulfonylmethane supplementation on osteoarthritis of the knee: a randomized controlled study. BMC Complement Altern Med. 2011 Jun 27;11:50. doi: 10.1186/1472-6882-11-50.
Sawitzke AD, Shi H, Finco MF, Dunlop DD, Harris CL, Singer NG, Bradley JD, Silver D, Jackson CG, Lane NE, Oddis CV, Wolfe F, Lisse J, Furst DE, Bingham CO, Reda DJ, Moskowitz RW, Williams HJ, Clegg DO. Clinical efficacy of glucosamine, chondroitin sulphate, their combination, celecoxib or placebo taken to treat osteoarthritis of the knee: 2-year results from GAIT. Ann Rheum Dis. 2010 Aug;69(8):1459-64. doi: 10.1136/ard.2009.120469.
Sawitzke AD, Shi H, Finco MF, Dunlop DD, Bingham CO 3rd, Harris CL, Singer NG, Bradley JD, Silver D, Jackson CG, Lane NE, Oddis CV, Wolfe F, Lisse J, Furst DE, Reda DJ, Moskowitz RW, Williams HJ, Clegg DO. The effect of glucosamine and/or chondroitin sulfate on the progression of knee osteoarthritis: a report from the glucosamine/chondroitin arthritis intervention trial. Arthritis Rheum. 2008 Oct;58(10):3183-91. doi: 10.1002/art.23973.
Eriksen P, Bartels EM, Altman RD, Bliddal H, Juhl C, Christensen R. Risk of bias and brand explain the observed inconsistency in trials on glucosamine for symptomatic relief of osteoarthritis: a meta-analysis of placebo-controlled trials. Arthritis Care Res (Hoboken). 2014 Dec;66(12):1844-55. doi: 10.1002/acr.22376.
Case Adams is a California Naturopath and a Board Certified Alternative Medicine Practitioner with a PhD in Natural Health Sciences. He has authored 26 books on natural healing strategies. “My journey into writing about alternative medicine began about 9:30 one evening after I finished with a patient at the clinic I practiced at over a decade ago. I had just spent the last two hours explaining how diet, sleep and other lifestyle choices create health problems and how changes in these, along with certain herbal medicines and other natural strategies can radically yet safely turn our health around. As I drove home that night, I realized this knowledge should be available to more people. So I began writing about health with a mission to reach those who desperately need this information. The strategies in my books and articles are backed by scientific evidence along with wisdom handed down through traditional medicines for thousands of years.”