A combination of Boswellia and curcumin showed superior efficacy and tolerability compared with nonsteroidal diclofenac for treating active osteoarthritis. Boswellia typically is given as an extract standardized to contain 30-40% boswellic acids (300-500 mg two or three times/day). Boswellia has been well tolerated in most studies, although some people may experience stomach discomfort, including nausea, acid reflux, or diarrhea.[1–10,42,48,56,62,103,104]
White willow bark, for instance, may have pain-relieving properties similar to aspirin. Salicin, a compound found in white willow bark, is converted in the body to salicylic acid, just as aspirin is. Salicylic acid is believed to be the active compound that relieves pain and inflammation. Another herb sometimes used in the treatment of back pain is devil's claw. Devil's claw contains harpagosides, which are chemical compounds found to possess anti-inflammatory properties.
Traditional wisdom says that NSAID pain relievers only damage your gut lining if you take them every day for a long time, but recent research disagrees. High-level athletes with stress-related intestinal damage tried taking ibuprofen to improve muscle soreness and recovery. Ibuprofen ended up damaging their gut lining even further after just a couple weeks; it increased inflammation and made their original pain issues worse. In fact, a single dose of aspirin can significantly increase your intestinal permeability.