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MSM and Boswellia for Joints and Arthritis: Better than Glucosamine?

MSM and Boswellia for Joints

Glucosamine and chondroitin are by far the most widely used supplements for joint problems such as osteoarthritis. And while there are many studies that demonstrate their efficacy, there are lesser-known supplements that are possibly more effective. In this post we look at two such supplements: MSM and boswellia. How do they stack up against established joint supplements?

Article summary:

  • Glucosamine and chondroitin are the most popular supplements for joint issues such as osteoarthritis
  • Lesser-known supplements such as MSM and boswellia also show promise for treating these conditions
  • Trials of MSM show it improved symptoms of osteoarthritis
  • Similarly, trials of boswellia have shown improved symptoms of both osteoarthritis and rheumatoid arthritis
  • A trial comparing glucosamine with MSM and boswellia found both to be similarly effective
  • The effects of these supplements may be a result of their anti-inflammatory properties

Glucosamine and chondroitin

glucosamine Both glucosamine and chondroitin are key structural components of cartilage – the connective tissue found in joints.

The theory goes that supplementing glucosamine and chondroitin will stimulate the body to produce more cartilage. This should help heal and protect joints and maintain optimal health and function.

Increased cartilage production is likely to be of particular benefit to individuals with osteoarthritis – a condition caused by the breakdown of cartilage in the joints.

And there’s a fair amount of clinical evidence backing glucosamine and chondroitin. However, it’s not always consistent.

Many studies suggest glucosamine and chondroitin are more effective than placebo for controlling joint pain and reducing joint space narrowing1,2,3,4. However, other studies have cast doubt on these effects1,2,3.

As such, the Osteoarthritis Research Society International recommends patients with osteoarthritis discontinue glucosamine use if they don’t notice improved symptoms after 6 months1.

Methylsulfonylmethane (MSM)

Glucosamine and chondroitin are by far the most popular supplements for osteoarthritis and joint issues. But this doesn’t necessarily mean they’re the most effective.

MSM is an organosulfur compound found in small quantities in some foods. Though not as extensively studied as glucosamine, the evidence supporting MSM for reduced joint pain and inflammation is growing.

For example, this randomized, double-blind trial from 2004 tested the effects of glucosamine, MSM, and a combination of both against placebo. The authors note:

“[Glucosamine], MSM and their combination produced an analgesic and anti-inflammatory effect in osteoarthritis. Combination therapy showed better efficacy in reducing pain and swelling and in improving the functional ability of joints than the individual agents. All the treatments were well tolerated. The onset of analgesic and anti-inflammatory activity was found to be more rapid with the combination than with [glucosamine]. It can be concluded that the combination of MSM with [glucosamine] provides better and more rapid improvement in patients with osteoarthritis.”

Randomised, Double-Blind, Parallel, Placebo-Controlled Study of Oral Glucosamine, Methylsulfonylmethane and their Combination in Osteoarthritis. PMID: 17516722

Essentially, this trial suggests the efficacy of MSM is comparable to glucosamine and that combining both therapies is more effective than either one alone.

Further studies since then confirm the efficacy of MSM for treating osteoarthritis and reducing joint pain and inflammation1,2,3.


Another potentially effective supplement for arthritic joint issues is boswellia.

Also referred to as frankincense, gum from the boswellia serrata tree has been shown to possess anti-inflammatory and pain-reducing effects. Like MSM, there is evidence that this translates to reduced symptoms of osteoarthritis:

“All patients receiving drug treatment reported decrease in knee pain, increased knee flexion and increased walking distance. The frequency of swelling in the knee joint was decreased. […] BSE is recommended in the patients of osteoarthritis of the knee with possible therapeutic use in other arthritis.”

Efficacy and tolerability of Boswellia serrata extract in treatment of osteoarthritis of knee–a randomized double blind placebo controlled trial. PMID: 12622457

What’s more, boswellia may alleviate a similar condition: rheumatoid arthritis.

Whereas osteoarthritis can be characterized as general wear and tear of the joints, rheumatoid arthritis is an autoimmune disorder where the body’s immune system attacks healthy joint tissue. The exact cause is not fully understood, though rheumatoid arthritis is always accompanied by inflammation.

As mentioned, boswellia has powerful anti-inflammatory effects. And studies in rats suggest this may make it an effective treatment for rheumatoid arthritis:

“Oral administration of [boswellia] resulted in significantly reduced levels of inflammatory mediators (IL-1β, IL-6, TNF-α, IFN-γ and PGE2), and increased level of IL-10. The protective effects of [boswellia] against [rheumatoid arthritis] were also evident from the decrease in arthritis scoring and bone histology.”

Boswellia serrata extract attenuates inflammatory mediators and oxidative stress in collagen induced arthritis. PMID: 24667331

MSM and boswellia vs glucosamine

So how do MSM and boswellia stack up against established joint supplement glucosamine?

A 2016 study looked to answer this question. 120 subjects with arthritis of the knee were randomly assigned either glucosamine sulfate or MSM and boswellia. Each group was treated for 60 days.

“Both treatments permitted a significant reduction in the need of anti-inflammatory drugs with a tendency to better results for MSM and [boswellia] at 6 months. It is interesting to note that the benefits are persistent 4 months after the suspension. […] The point that this new combination of integration (MSM and [boswellia]) has presented results comparable with [glucosamine] could confirm validity in the treatment of [osteoarthritis].”

Methylsulfonylmethane and boswellic acids versus glucosamine sulfate in the treatment of knee arthritis: Randomized trial. PMCID: PMC5806735

Researchers measured the effectiveness of each intervention using three criteria: joint function, level of pain, and dependence on anti-inflammatory drugs.

Both groups showed improvements on all three measures. However, patients treated with boswellia and MSM saw greater reduction in reliance on anti-inflammatory drugs. These improvements persisted even after the trial was over. This research provides further support for glucosamine, boswellia and MSM for the management of joint issues such as osteoarthritis.

Side effects?

Generally speaking, both MSM and boswellia are well tolerated and side effects are rare.

As with pretty much any supplement, they may cause minor stomach issues such as nausea and diarrhea in some individuals. Some people taking MSM report headache, fatigue or itchiness.

If you are unsure, consult a doctor before use – especially if you are concerned about potential reactions with other medications.

MSM and boswellia for joints

Although glucosamine is by far the best known supplement for joints, there are many others that improve flexibility and reduce pain.

And so far, studies suggest both MSM and boswellia may be equally as effective as glucosamine – possibly even more so. Both have been shown to reduce inflammation, improve function and reduce pain. When pitted against glucosamine, MSM and boswellia were shown to improve knee arthritis to a similar degree. What’s more, individuals taking MSM and boswellia were less reliant on anti-inflammatory drugs.

Another study discussed here saw symptoms of osteoarthritis improve more rapidly when glucosamine was combined with MSM than glucosamine alone. This suggests a synergistic effect when the two supplements are taken in conjunction.

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