Balsam, referring in general to resinous substances derived from trees such as Balsam of Peru (Myroxylon balsamum), Balsam of Tolu, or Canada Balsam, has been used in traditional medicine systems for a variety of ailments, including arthritis. Historical records and ethnobotanical sources indicate that indigenous peoples and traditional healers have applied balsamic resins topically to affected joints, aiming to relieve pain and inflammation. The rationale for these uses is rooted in the presumed anti-inflammatory and analgesic properties of the aromatic resins and essential oils found in balsam. However, while traditional use is well documented, there is very limited modern clinical research or scientific evidence directly supporting the efficacy of unspecified balsam for arthritis. Most of the available data come from in vitro studies or animal models, which suggest some anti-inflammatory activity in certain constituents of balsam (such as cinnamic acid derivatives), but these findings have not been substantiated in human trials specifically for arthritis. Furthermore, balsam preparations can cause allergic reactions and dermatitis, which limits their clinical usefulness. In summary, the use of balsam for arthritis is primarily justified by traditional practices, with minimal scientific validation at present. The evidence rating reflects the predominance of historical rather than modern clinical support.