Bromelain and Joint Pain

Bromelain belongs to a group of natural protein digesting enzymes obtained from the core or stem of pineapple. Included in both Post Edge and Joint Edge Rx, bromelain is a safe and natural anti-inflammatory and analgesic for patients or athletes suffering from arthritis and joint pain.

If that’s not enough, this “superfood” has also shined in clinical studies to improve absorption/digestion, gut health and overall immunity.

Why Use Bromelain?

Bromelain’s action as an anti-inflammatory is mediated via the following factors: reducing plasma fibrinogen levels, decreasing bradykinin levels (which results in reduced vascular permeability and hence reducing edema and pain) and decreasing levels of PGE2 and thromboxane.

Bromelain was first reported to be of value as an analgesic and anti-inflammatory for use in both rheumatoid arthritis and osteoarthritic patients in 1964.

Bromelain Studies

Over ten studies have been identified that have assessed bromelain in osteoarthritis of the knee, most of which indicated that the use of bromelain had positive clinical effects (as measured by assessment of reduction in soft tissue swelling, pain and/or joint stiffness) and no adverse events associated with the medication were reported in any of these case reports.

In a blinded study from Germany, researchers divided 90 patients with painful osteoarthritis of the hip into two groups: one half receiving bromelain for six weeks, while the other half received the anti-inflammatory drug diclofenac.

They found that the bromelain preparation was as effective as diclofenac in standard scales of pain, stiffness and physical function, and better tolerated than the drug comparator. So next time you want to order a pizza, don’t forget to add pineapple as a topping!

References

  1. Maurer HR. Bromelain: biochemistry, pharmacology and medical use. Cell Mol Life Sci. 2003 Aug;58(9):1234-45.
  2. Brien S, Lewith G, Walker A, Hicks SM, Middleton D. Bromelain as a treatment for osteoarthritis: a review of clinical studies. Evid Based Complement Alternat Med. 2004 Dec;1(3):251-7.
  3. Klein G, Kullich W, Schnitker J, Schwann H. Efficacy and tolerance of an oral enzyme combination in painful osteoarthritis of the hip. A double-blind, randomised study comparing oral enzymes with non-steroidal anti-inflammatory drugs. Clin Exp Rheumatol. 2006 Jan-Feb;24(1):25-30.
  4. Akhtar NM, Naseer R, Farooqi AZ, Aziz W, Nazir M. Oral enzyme combination versus diclofenac in the treatment of osteoarthritis of the knee—a double-blind prospective randomized study. Clin Rheumatol. 2004 Oct;23(5):410-5.
  5. Cohen A, Goldman J. Bromelain therapy in rheumatoid arthritis. Penn Med J. 1964;67:27–30.
  6. Leipner J, Iten F, Saller R. Therapy with proteolytic enzymes in rheumatic disorders. Biodrugs. 2001;15:779–789.
  7. Singer F, Oberleitner H. Drug therapy of activated arthrosis. On the effectiveness of an enzyme mixture versus diclofenac. Wien Med Wochenschr. 1996;146:55–58.
  8. Klein G, Kullich W. Short-term treatment of painful osteoarthritis of the knee with oral enzymes: a randomised, double-blind study versus Diclofenac. Clin Drug Invest. 2000;19:15–23.
  9. Singer F, Singer C, Oberleitner H. Phlyoenzym versus diclofenac in the treatment of activated osteoarthritis of the knee. Int J Immunother. 2001;17:135–141.
  10. Tilwe GH, Beria S, Turakhia NH, Daftary GV, Schiess W. Efficacy and tolerability of oral enzyme therapy as compared to diclofenac in active osteoarthritis of the knee joint: an open randomized controlled clinical trial. Journal of the Association of Physicians of India. JAPI. 2001;49:621.
  11. Walker AF, Bundy R, Hicks SM, Middleton RW. Bromelain reduces mild acute knee pain and improves well being in a dose dependant fashion in an open study of otherwise healthy adults. Phytomedicine. 2002;9:681–686.

About Dr. Jarrell NeSmith, DO

Board Certified Sports Medicine Physician