Co-analgesic therapy for arthroscopic supraspinatus tendon repair pain using a dietary supplement containing Boswellia serrata and Curcuma longa: a prospective randomized placebo-controlled study

Musculoskelet Surg. 2015 Sep;99 Suppl 1:S43-52. doi: 10.1007/s12306-015-0364-1. Epub 2015 May 10.


Background: The cuff tendon that is most prone to full-thickness rotator cuff tears is the supraspinatus (SSP). Arthroscopic SSP repair ensures good to satisfactory mid- to long-term clinical outcomes. However, the intense postoperative pain reduces rehabilitation compliance and is cause of patient dissatisfaction. Many natural compounds act by inhibiting inflammatory pathways in a similar way to anti-inflammatory drugs

Materials and methods: This was a prospective randomized trial designed to assess the analgesic effect of a dietary supplement (DS) containing Boswellia serrata and Curcuma longa in a population of subjects with full-thickness SSP tendon tear treated by arthroscopy. Three weeks before surgery, patients were randomized to receive Tendisulfur(®) (group T) or a placebo (group P) for 2 months. The primary outcome measure was subjective VAS pain. Secondary outcomes measures were Constant-Murley score simple shoulder test, and patient global assessment (PGA) scores. Patients were assessed immediately at baseline and subsequently at 1, 2, 4, 6, 8, 12, and 24 weeks.

Results: Stratification of pain scores and subscores demonstrated significantly lower overall pain scores in group T versus group P at 1 week (p = 0.0477), and lower but not significantly different scores on week 2 (p = 0.0988); at subsequent time points, differences were not significant (p > 0.05). PGA scores were good in all subjects.

Conclusions: In conclusion, this study provides objective data on the effect of a DS containing natural substances, added to standard analgesics, on postoperative RC pain. DS alleviated short and partially mid-term pain, while long-term pain was unchanged. This limitation can probably be addressed by a dosage increase over the first 4 weeks and by extending treatment by 1 or 2 months.

Keywords: Arthroscopy; Co-analgesia; Dietary supplements; Supraspinatus pain.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Anti-Inflammatory Agents, Non-Steroidal / administration & dosage
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use*
  • Arginine / administration & dosage
  • Arginine / therapeutic use
  • Arthroscopy*
  • Boswellia / chemistry*
  • Collagen Type I / administration & dosage
  • Collagen Type I / therapeutic use
  • Collagen Type II / administration & dosage
  • Collagen Type II / therapeutic use
  • Curcuma / chemistry*
  • Dietary Supplements*
  • Dimethyl Sulfoxide / administration & dosage
  • Dimethyl Sulfoxide / therapeutic use
  • Drug Combinations
  • Female
  • Glycosaminoglycans / administration & dosage
  • Glycosaminoglycans / therapeutic use
  • Humans
  • Lysine / administration & dosage
  • Lysine / therapeutic use
  • Male
  • Middle Aged
  • Pain Measurement / methods
  • Pain, Postoperative / prevention & control*
  • Phytotherapy / methods
  • Plant Extracts / administration & dosage
  • Plant Extracts / therapeutic use*
  • Preoperative Care / methods
  • Prospective Studies
  • Rotator Cuff Injuries / surgery*
  • Rupture / surgery
  • Sulfones / administration & dosage
  • Sulfones / therapeutic use


  • Anti-Inflammatory Agents, Non-Steroidal
  • Collagen Type I
  • Collagen Type II
  • Drug Combinations
  • Glycosaminoglycans
  • Plant Extracts
  • Sulfones
  • Arginine
  • dimethyl sulfone
  • Lysine
  • Dimethyl Sulfoxide