For INFLAMMATORY ARTHRITIS, bromelain eases pain, swelling, and joint tenderness through a variety of mechanisms. Beyond short-term pain relief, it also enhances tissue repair as inflammation recedes. Patients report an improved range of motion, reduced stiffness, and less pain, allowing them to increase activity and feel better over time. Bromelain was first used therapeutically in 1957 and has been widely used for decades since then. Several hundred research studies have documented its effectiveness for inflammatory arthritis, including rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, juvenile idiopathic arthritis, and systemic lupus. Bromelain also eases chronic inflammation of tendons, ligaments, fascia, as well as promoting healing after injuries, bone fractures, and surgeries.

What is bromelain?

Bromelain is derived from the stem of the pineapple plant and is the name for a group of enzymes that break down proteins. The body contains 50,000 to 70,000 different enzymes that regulate every metabolic function. Without enzymes, metabolism would progress too slowly to sustain life. When taken with meals, bromelain will be used by the body to digest proteins, but when taken on an empty stomach, bromelain acts medicinally as a potent anti-inflammatory and assists with soft tissue repair to reduce pain and swelling.

How does bromelain work?

Bromelain is a highly effective anti-inflammatory in its own right. It can help to relieve joint and connective tissue pain, heat, and swelling, and reduce C-reactive protein, the inflammation marker.

Bromelain breaks down fibrin which forms a mesh that walls off inflammation. This action leads to improved tissue drainage, significantly reducing edema, swelling, and scar formation.

Bromelain frees up amino acids, the protein building blocks, so that they are better absorbed to ease inflamed joints. It also facilitates protein assimilation. Protein is essential for tissue repair, muscle formation, and for every metabolic enzyme in the body, and thus bromelain increases the amount of protein available to calm the inflammatory process.

Bromelain modulates several biochemical mediators in the body to ease joint inflammation: It inhibits the types of prostaglandins, thromboxanes and kinins that aggravate inflammation. Bromelain stimulates the production of plasmin which blocks the body’s inflammatory biochemicals and the creation of inflammation-causing mediators. In addition, bromelain inhibits the formation of various pro-inflammatory kinins, like bradykinin, which provoke pain and swelling. Studies show that bromelain can ease pain by inhibiting the conversion of kininogen to kinin.

Furthermore, bromelain reduces swelling by limiting the amount of fluid buildup at the inflamed area. It does this by decreasing bradykinin and pre-kallikrein levels, and this effect gets stronger as the dose of bromelain increases.

All of this leads to reduced pain by regulating these inflammatory pathways, such as inhibiting thromboxane synthesis and lowering kinin formation, even though bromelain is not a direct pain-reliever.

Since bromelain is a digestive aid, taking it alongside other botanicals like turmeric in a curcumin phytosome form can enhance the absorption and magnify the benefits of curcumin. Together these two remedies offer ongoing reduction of soft-tissue pain over weeks, months or even years. Bromelain together with turmeric appears to have a reparative effect on connective tissues, tendons, ligaments, and fascia.

Research shows bromelain’s efficacy for inflammatory arthritis

Bromelain is well-documented in hundreds of scientific papers for its wide-ranging therapeutic actions, primarily focused on reducing inflammation and associated pain.

In one important 12-week clinical trial comparing bromelain and physical therapy to just physical therapy with placebo, it was found that the bromelain group experienced a 54% improvement in their pain and difficulty walking, compared to 18% for the physical therapy-placebo group.

Research confirms that bromelain reduces swelling by limiting fluid buildup in inflamed joints, via its actions of decreasing bradykinin and pre-kallikrein levels, and the benefits mount with higher bromelain doses.

Studies also demonstrate that bromelain boosts plasmin production, which blocks the body’s inflammatory mediators and curbs the formation of pro-inflammatory prostaglandins, thromboxanes, and kinins (like bradykinin) which could otherwise provoke more pain and swelling.

Research shows that bromelain is an immunomodulator. It can help restore the balance between pro-inflammatory and anti-inflammatory cytokines. By helping to regulate inflammatory cytokines, bromelain can reduce the overall inflammatory surge that drives the destruction of cartilage and bone in the joints. This is part of its overall anti-arthritic and cartilage-protecting effect. In the context of progressive joint disease, studies have shown that bromelain can modulate the expression of TGF in patients affected by conditions like osteo-myelofibrosis and rheumatoid arthritis.

Clinical trials demonstrate that bromelain can reduce inflammatory markers linked with progressive joint destruction such as TGF, transforming growth factor. Bromelain can specifically contribute to reducing scarring and long-term tissue damage by preventing causative changes in the joint microenvironment. Bromelain can control the biochemical signals linked to progressive joint destruction, such as the cytokines called Transforming Growth Factor (TGF). This is a protein group produced by cells of the immune system that act as messengers to regulate and coordinate immune responses, cell growth, and inflammation. TGF is released in response to stimuli like infection or injury and can stimulate or slow down the immune system. While TGF is crucial for wound healing and tissue repair, abnormal TGF signaling is implicated in the pathogenesis of progressive joint diseases like rheumatoid arthritis and osteoarthritis.

As additional data, bromelain helps acute sport or other injuries: One notable study looked at boxers after their fights. Of those taking bromelain, 80% had complete resolution of bruising within 4 days, while in the placebo group only 15% healed in 4 days and the rest took 7 to 14 days to heal.

Our patients’ experiences with bromelain

In our clinic, the goals of treatment for inflammatory arthritis are to reduce joint inflammation and pain, maximize joint function, improve range of motion and each patient’s comfort with increased activity, and prevent future joint destruction and deformity. Inflammatory arthritis responds well to ample doses of bromelain, and the benefits can be enhanced with curcumin phytosome turmeric. Our patients who take bromelain at 1,000 to 1,500 mg daily for 1 to 6 months consistently report better range of motion, less pain, swelling and stiffness, and better energy as their pain level drops and sleep improves. Patients taking bromelain for rheumatoid or other inflammatory arthritis are sometimes able to reduce doses of steroids or other medications.

Recommendation: Bromelain 1,000 to 1,500 mg (2,400 GDU/gm) 1 to 2 times per day, taken between meals for anti-inflammatory benefits, or as directed by your healthcare practitioner.

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