Systematic reviewPending review

The question: Does an extract of boswellia (shallaki, Boswellia serrata) ease pain and improve movement in osteoarthritis?
Who was studied: A 2014 Cochrane review of 49 randomised trials of herbal medicines for osteoarthritis, with 5,980 people in all. The main boswellia result comes from two of those trials, with 85 people.
What they took: 100 mg a day of one enriched Boswellia serrata extract, against placebo, for 90 days. Enriched here means one specific proprietary extract.
What happened: On a 0 to 100 pain scale, people on placebo averaged 40 points. The enriched extract lowered pain by 17 points more than placebo (95% CI 8 to 26). Physical function improved by 8 points on a 0 to 100 scale (95% CI 2 to 14). The reviewers rated this evidence high quality.[1]
How strong is this: Cochrane reviews are carefully done, and this one rated the boswellia comparison high quality. Even so, the finding rests on two small trials of a single proprietary extract.

The limits

Only two trials and 85 people support the main result.
The 8-point gain in function is below the 10-point change the reviewers treated as the smallest that matters to patients. They say some people may still gain that much.
Other shallaki products, including plain resin powder and Ayurvedic tablets, were not part of this comparison.
Quality of life and changes in the joint on X-ray were not measured.
A second review, of Ayurvedic treatments only, did not find a boswellia effect that held up. See the questions below.

Who paid for it

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

Questions people ask

Do other reviews agree?

Not fully. A 2015 review of Ayurvedic treatments for osteoarthritis, covering 33 controlled studies with 2,952 people, found no effect for boswellia, or for a combination containing boswellia, that held up once possible bias in the studies was taken into account.[2]

Will the shallaki tablet I buy work the same way?

Not necessarily. The good result was for one enriched extract. Other boswellia or shallaki products were not tested in that comparison, so the result does not carry over to them.[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

Can Ayurvedic medicines match celecoxib for knee pain?

In a six-month trial of 440 people, two Ayurvedic formulations matched glucosamine and celecoxib for knee pain. Some had raised liver enzymes.

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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Does boswellia (shallaki) help osteoarthritis pain?