Boswellia

It targets the leukotriene pathway (5-LOX). The most active boswellic acid (AKBA) directly inhibits 5-lipoxygenase, lowering leukotrienes that drive inflammatory and neuropathic pain. This mechanism is well documented in pharmacology studies and modern simulations. JPET

It also appears to down-modulate cartilage-degrading enzymes. In an osteoarthritis RCT, an AKBA-enriched extract reduced synovial MMP-3, aligning with less joint breakdown and less pain—mechanisms relevant to TMJ arthralgia/osteoarthritis subtypes. BioMed Central

Anti-inflammatory + analgesic effects translate to joint pain relief in RCTs (OA). Multiple randomized trials and meta-analyses in osteoarthritis show clinically meaningful reductions in pain, stiffness, and improved function with standardized Boswellia extracts; these effects are often seen within 4–8 weeks. TMJ is a synovial joint, so these data are commonly extrapolated for TMJ pain management. BioMed Central

1) Choose a standardized extract

• Look for Boswellia serrata extract standardized to ≥30–65% boswellic acids, or an AKBA-enriched extract (e.g., 5-Loxin®, Aflapin®) or a phytosome (Casperome®) for better bioavailability. BioMed Central

2) Typical oral dosing used in trials

• Standardized extract: 300–500 mg, 2–3×/day with food. (Common clinical ranges from reviews and trial summaries.) BioMed Central
• AKBA-enriched extracts: 100–250 mg once daily (evidence from RCTs in OA; 250 mg often performs better). BioMed Central
• Duration: plan at least 4–8 weeks before judging benefit; many analyses recommend ≥4 weeks minimum. BioMed Central
• Absorption tip: fat-containing meals may help; phytosome (Casperome®) formulations improve boswellic-acid exposure (faster and higher AKBA levels). ScienceDirect

3) Where it fits in a TMD plan

• Myogenous (muscle-dominant) TMD: can be tried for pain modulation alongside conservative therapy (exercise, splint if indicated). The 2024 TMD RCT used Casperome® 1 tab nightly for 40 days as part of a combo product and saw symptom improvements. De Gruyter Brill
• TMJ arthralgia/degenerative (OA-like) TMD: the OA data are the best match; consider AKBA-enriched or phytosome forms. BioMed Central
• Topical use: human TMJ data are not yet available; a 2025 paper describes a Boswellia-based topical gel with analgesic/anti-inflammatory signals in preclinical testing. You may try a commercial Boswellia cream massaged over the masseter/TMJ region, but consider this experimental for TMJ pending clinical trials. SpringerLink

4) Pairing with other supplements/therapies

• The TMD RCT combined Boswellia (Casperome®) with magnesium, tryptophan, vitamins B2/D, and it also worked add-on to splints—useful if you’re already wearing one. De Gruyter Brill

TMD-specific (human):

• Randomized clinical trial (2024): Nutraceutical containing Boswellia (Casperome®) improved TMD pain and comorbid symptoms vs. control, and as add-on to splints. (Adjunctive, combo product; short term.) De Gruyter Brill

TMD-adjacent/preclinical:

• Topical gel concept for myogenous TMD (2025): Boswellia-based phytochemical gel showed anti-inflammatory/analgesic activity in vitro and in vivo (zebrafish model). SpringerLink
• Orofacial/TMJ animal models (2018): Boswellia extracts reduced TMJ/orofacial inflammatory pain behaviors. koreascience.kr

Osteoarthritis (best human analog for TMJ OA):

• Systematic review & meta-analysis (2020; 7 RCTs, n=545): Boswellia reduced pain and stiffness and improved function vs. control; ≥4 weeks recommended. BioMed Central
• Double-blind RCT (5-Loxin®, 90 days): 100 or 250 mg/day improved pain and function; 250 mg showed faster onset (as early as 7 days) and lowered MMP-3 in synovial fluid. BioMed Central

Mechanistic/Pharmacology:

• AKBA inhibits 5-LOX and leukotriene production; detailed in classic and modern mechanistic papers. JPET
• NCCIH (2025 update) summarizes that Boswellia may help OA pain; overall evidence quality varies and larger trials are still needed. NCCIH