ADVERTORIAL
Managing pain and inflammation with a specialised boswellia extract and synergistic herbs
by Laura Dwyer | BHSc ( Naturopathy )
Managing pain in clinical practice
Various types of pain exist , encompassing neuropathic , nociceptive , musculoskeletal , inflammatory , psychogenic , and mechanical categories . Arthritis and musculoskeletal diseases are significant contributors to pain and disability , with the number of cases in Australia projected to affect over 30 % of the population by 2032 . 1 Insufficient management of these pain types frequently leads to the onset of chronic pain and inflammation , posing challenges for treatment with pharmaceutical medications . Furthermore , evidence indicates that certain nonsteroidal anti-inflammatory drugs may block the synthesis of the cartilage matrix , exacerbating degeneration and leading to detrimental health effects over time . 2 , 3 Therefore , herbal medicines could present an alternative option , given they frequently lack severe side effects , can be used longterm , and may contribute to symptom alleviation and impede the progression of disease . 4
AprèsFlex ®: a phytochemically enhanced boswellia extract Modern research encompassing boswellia has primarily focused on the boswellic acids found in the resin , particularly 3-0-acetyl-11-keto-β-boswellic acid ( AKBA ), which possesses the most significant inhibitory activity on arachidonate 5-lipoxygenase ( 5-LOX ). 5 AprèsFlex ®, a standardised boswellia extract containing a minimum of 20 % AKBA , has been shown to possess greater absorption and provide 50 % more bioavailable systemic concentrations of AKBA after a single dose compared to another AKBAenriched extract . 5 In preclinical studies , AprèsFlex ® has demonstrated the ability to diminish joint inflammation and prevent cartilage breakdown by inhibiting matrix metalloproteinase-3 ( MMP-3 ), tumour necrosis factor-α ( TNF-α ), and adhesion molecules . 5-7
Synergist herbs Other commonly co-prescribed analgesic compounds such as devil ' s claw , white willow , ginger and curcumin ( Cucrucmin C3 Complex ®) influence various inflammatory mediators that are implicated in a broad range of pain-related inflammatory conditions , such as NF-κB , TNF-α , cyclooxygenase , lipoxygenase and cartilage degrading enzymes , prostaglandins and interleukins . 8-31 Together , these synergistic herbs have the potential to reduce systemic and local inflammation and improve clinical outcomes significantly .
Clinical indications Musculoskeletal conditions Boswellia and these synergistic herbs have undergone extensive clinical studies for a diverse range of musculoskeletal conditions , including osteoarthritis ( OA ) and joint pain , rheumatoid arthritis ( RA ), lower back pain , and post-exercise pain . 32-65 AprèsFlex ® specifically has demonstrated notable efficacy in alleviating joint pain within five days , concurrently diminishing joint stiffness and enhancing physical function in clinical trials involving OA patients . 6 , 7 A soon-tobe-published six-month clinical trial also observed that AprèsFlex ® increases joint space and cartilage thickness , suggesting this extract offers cartilage protection , halts disease progression , and exerts a diseasemodifying effect . 66
Nervous system conditions Given that inflammation and platelet aggregation have been implicated in the pathogenesis of migraine and headaches , 67 ginger , curcumin and boswellia are proposed to be effictive in their management . Various trials have demonstrated reduced pain intensity and duration of migraine attacks after administration of ginger , 68-74 or curcumin , 75 , 76 while boswellia was found to improve nocturnal pain in patients with chronic cluster headaches . 77
Reproductive conditions Pain reduction is often a commonly sought treatment for dysmenorrhoea and endometriosis , which is thought to be due to the underlying inflammatory process . Boswellia , curcumin and ginger have all been found to relieve dysmenorrhoea and attenuate pain , potentially by reducing prostaglandin synthesis . 78-85 Boswellia and curcumin have shown potential in animal models to inhibit the adhesion of endometrial lesions , suggesting positive effects , 86-89 while a preliminary study discovered that devil ’ s claw reduces dysmenorrhoea and dyspareunia in women with endometriosis . 90
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Gastrointestinal conditions In inflammatory bowel diseases ( IBDs ), the excessive formation of leukotrienes and the production of pro-inflammatory cytokines play a major role in the immune and inflammatory pain process , resulting in tissue damage to the intestinal mucosa . 91 Owing to their anti-inflammatory and immunomodulatory effects , curcumin and boswellia supplementation have improved ulcerative colitis symptoms , achieved clinical remission and prevented relapse in multiple studies . 92-99 Boswellia has additionally proved to be as effective as mesalazine in treating Crohn ’ s disease 100 and induced remission in patients with collagenous colitis . 101
Clinical summary Boswellia and these synergistic herbs have shown considerable clinical efficacy , either alone or in combination , for a variety of pain and inflammation-related conditions . With their high safety profile and capacity to alter the course of the condition , these herbs hold promise for offering symptomatic relief while also impacting the disease progression .
Full reference list available on request .
Disclaimer : The views and opinions expressed in these advertorials are those of the authors and do not necessarily reflect the opinions of ATMS or its Directors .
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