A registered double-blind RCT is enrolling 72 adults over age 60 with chronic knee osteoarthritis (pain ≥4 on Wong-Baker Faces scale, duration >3 months, Kellgren-Lawrence grade ≤4) to compare Ashwagandha churna against Boswellia extract over 45 days. Both arms also receive Til Taila Abhyanga — sesame oil massage. Primary outcome is numeric pain rating scale measured every 15 days; secondary outcomes include KOOS, WHO-5 Wellbeing Index, sleep quality, and functional mobility tests (Five Times Sit-to-Stand, Timed Up and Go).
This is a protocol paper only — no efficacy data yet exist. The trial addresses a genuine clinical gap: NSAIDs and analgesics carry substantial gastrointestinal, cardiovascular, and renal risks in elderly polypharmacy patients, making tolerable alternatives genuinely valuable. Ashwagandha (Withania somnifera) has demonstrated anti-inflammatory activity via NF-κB suppression and withanolide-mediated COX inhibition in preclinical and limited clinical work, while Boswellia serrata's AKBA compound has more robust human trial evidence for OA — making it a credible active comparator rather than a placebo. However, the 72-participant sample is modest, the 45-day window may be insufficient to capture disease-modifying effects, and blinding integrity for differently textured plant powders is untested here. Crucially, as a medRxiv preprint not yet peer-reviewed, the methodology itself may undergo revision. If results favor either arm with clinically meaningful effect sizes, this could meaningfully inform integrative geriatric pain management.
