Clinical data indicating that Boswellia serrata can reduce joint stiffness and pain through 5-lipoxygenase (5-LOX) inhibition provide strong support for this product. Unlike many conventional anti-inflammatory drugs, Boswellia specifically inhibits the creation of pro-inflammatory leukotrienes. Additionally, clinical studies have shown that Boswellia extracts improve physical function and reduce joint swelling in patients diagnosed with osteoarthritis in randomized controlled trials—some utility was noted within 7 to 10 days of beginning supplementation. Lastly, because it inhibits matrix metalloproteinases, it appears to protect against loss of cartilage integrity. Methylsulfonylmethane, or MSM, has been shown to improve comfort for patients with knee osteoarthritis. Clinical studies indicate a significant reduction in systemic pain and physical disability associated with knee osteoarthritis, as MSM contains a high level of organic sulfur that supports the structural stability of joints and connective tissues. The probability that MSM works primarily to suppress the production of IL-6 and TNF-alpha (pro-inflammatory cytokines) and reduce systemic oxidative stress (high oxidative stress can create an inflammatory response) appears to be the primary reason why it has been reported to increase joint comfort and reduce how stiff one's knees are when arising from sleep each morning. There is certainly enough existing research data on Turmeric (Curcumin) to support the conclusion that it modulates joint inflammation at multiple levels by suppressing the NF-kB signaling cascade—this signaling pathway acts as the master regulator of the inflammatory response. Based on existing clinical research, curcumin has been reported to be comparable to certain non-steroidal anti-inflammatory drugs in reducing joint pain and increasing flexibility among patients with arthritis, while offering a greater safety profile with fewer gastrointestinal tract adverse effects. The consequence of decreasing the extent of inflammation in the synovial fluid allows curcumin to increase joint range of motion and flexibility, as well as allow for more fluid movement during daily physical activity.