Modulation of Affective and Sensory Qualities of Acute Nociceptive Pain by Curcuma longa and Boswellia serrata Extract Formulation: A Randomized, Double-Blind, Placebo-Controlled Design in Subjects With Exercise-Induced Acute Musculoskeletal Pain.

Introduction Excessive repetitive physical activity most often leads to acute musculoskeletal pain. The management of acute pain is one of the primary concerns. The nociceptive pain has both sensory and affective qualities, patterns, and intensity. In this article, we focus on the effect of a turmeric-Boswellia formulation on that aspect at different locations of the body. Methods This multicentric study with a randomized, double-blind, placebo-controlled design enrolled 232 subjects in a male-to-female ratio of 1:1. The test dosage was 1,000 mg of turmeric-Boswellia extract (TBE) and a similar placebo in a parallel design allocation of 1:1 ratio. Healthy subjects with acute musculoskeletal pain of exercise-related origin with a numerical pain rating score of ≥ 5 were included in the study. The study duration was six hours, and the efficacy was analyzed using the short form of the McGill Pain Questionnaire, having subscales visual analog scale (VAS) and present pain index (PPI). Results There was a significant reduction in pain in the McGill total score (p < 0.001) of the TBE group, with a 98% change from the baseline compared to the placebo. The sensory and affective domains showed a significant reduction of 98% (p < 0.001) and 97% (p < 0.001) in pain in the TBE group from the baseline compared to placebo. The VAS had a 97% (p < 0.001), and PPI had 96% (p < 0.001) pain relief in the TBE group from the baseline compared to placebo. In the sensory domain, the most common pain descriptor reported by the participant was "tender," and in the affective domain, it was "tiring-exhaustive." The descriptor frequency of "tender" reduced from 65% in baseline to 1%, and "tiring-exhaustive" reduced from 61% to 3% at the end of six hours for the TBE group, while the placebo showed negligible change. The mean pain intensity of all pain descriptors in the TBE group showed more than 95% change from baseline. Conclusion It can be concluded that the turmeric-Boswellia formulation was very effective for exercise-induced musculoskeletal pain irrespective of location and had a significant reduction in pain intensity for sensory as well as affective pain sensations.