The question: Can standardised Ayurvedic formulations ease knee osteoarthritis as well as glucosamine, or as well as celecoxib, a prescription anti-inflammatory painkiller (an NSAID)?
Who was studied: 440 people with painful knee osteoarthritis, in a multicentre trial with four groups.
What they took: One of two standardised Ayurvedic formulations, coded SGCG and SGC, made from extracts of guduchi (Tinospora cordifolia), ginger, amla and boswellia; or glucosamine sulphate, 2 g a day; or celecoxib, 200 mg a day. Treatment lasted 24 weeks, and neither patients nor doctors knew who had which.
What happened: For knee pain while bearing weight, and for WOMAC pain and function scores (a standard osteoarthritis questionnaire), the differences between the groups stayed inside the range the trial had set in advance to count as equivalent. Twenty-six people had a rise in SGPT, a liver enzyme, without symptoms and with otherwise normal liver tests. Seven of them, all on the Ayurvedic formulations, were withdrawn, and their SGPT returned to normal after they stopped. In all, 28% of participants left the trial early.[1]
How strong is this: A large, double-blind, multicentre trial against two real treatments is a strong design. The high dropout and the liver-enzyme rises mean the result has to be read with care.

The limits

Equivalent is not better. The trial showed the formulations did about as well as glucosamine and celecoxib, within set limits; it did not show they beat them.
More than a quarter of the participants (28%) withdrew, which can tilt the comparison between groups.
Twenty-six people had raised SGPT, and seven on the Ayurvedic formulations were withdrawn for it. Liver safety needs more study.
The registry gives the first enrolment as 12 January 2006, before the registration date of 8 July 2008. A trial registered after it starts is harder to check for outcomes chosen in advance.
These were two specific standardised products. A churna or tablet from a shop, even one with the same herbs, was not tested.

Who paid for it

Not given in the abstract we read. We have not confirmed who paid for the trial.

Questions people ask

What exactly was tested?

Two standardised formulations made from extracts of guduchi, ginger, amla and boswellia, against glucosamine and celecoxib. The registry entry lists the same main outcomes as the paper: pain on walking, and WOMAC pain and difficulty scores, measured at intervals up to week 24.[1][2]

Does this mean Ayurveda works for knee osteoarthritis?

It means these two products did about as well as two common treatments over six months, in one trial. Other Ayurvedic medicines, and other ways of treating, need their own evidence.[1]

Condition

Osteoarthritis and knee pain: what Ayurveda offers

One boswellia extract and two Indian formulations eased knee pain in trials. The evidence is uneven, and one trial found raised liver enzymes.

Evidence

Does boswellia (shallaki) help osteoarthritis pain?

A Cochrane review found one enriched boswellia extract eased osteoarthritis pain over 90 days. A review of Ayurvedic trials was less sure.

Evidence

Does whole-system Ayurveda help knee pain?

In a trial of 151 people in Germany, 12 weeks of Ayurvedic care eased knee osteoarthritis more than conventional care. Patients knew which they had.

Sources

Updated 4 November 2026

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Can Ayurvedic medicines match celecoxib for knee pain?