Bromelain Improves All Parameters Associated with Osteoarthritis in Human Trials

By Kyle J. Norton

Osteoarthritis (OA), a type of musculoskeletal disorders associated with the wear and tear on a joint, found mostly in the aging population.

In other words, OA occurs when the protective cartilage on the ends of the bones wears down over time.
According to the statistics, osteoarthritis affects over 25 million people in the United States.

Because of its far higher prevalence due to aging and obesity, OA has become a significant economic burden to the US.

Believe it or not, approximately 1/3 of direct OA expenditures are allocated for medications, including pain medications accompanied by the 50% spent on hospitalization costs.

Most common symptoms of OA are the pain, tenderness, stiffness, and loss of flexibility of the joint, during or after movement. 

Some patients may also experience symptoms of grating sensation, bone spur and hard lumps developed around the affected joint.

Other risk factors, besides aging and obesity, are a genetic preposition, gender, joint injury that did not heal properly, bone deforms and occupation that requires repetitive use of the joint.

Dr. Keith T Palmer wrote, "Reasonably good evidence exists that physical work activities (especially kneeling, squatting, lifting, and climbing) can cause and/or aggravate knee OA. These exposures should be reduced where possible. Obese workers with such exposures are at additional risk of knee OA and should therefore particularly be encouraged to lose weight".

And, "This common chronic disease (OA) of older life causes significant disability and impaired quality of life, and its development often heralds a material reduction in a patient’s capacity to undertake daily activities, including their ability to work".

Bromelain, a proteolytic enzyme found in pineapples (Ananas comosus) has been used in traditional medicine as an inflammatory agent and to treat pains, strains, and muscle aches and pains and ease back pain and chronic joint pain, skin diseases, etc.

With an aim to find a potential compound for the treatment of osteoarthritis, researchers investigated the effectiveness of oral bromelain, trypsin, rutoside trihydrate enzymes and diclofenac sodium combination therapy over diclofenac sodium for the treatment of TMJ osteoarthritis.

30 patients selected to the study were randomly divided into three groups with 10 patients treated with diclofenac sodium (Group 1), 10 given oral enzymes (bromelain, trypsin, rutoside trihydrate) and diclofenac sodium combination (Group 2), and the other 10 treated with oral enzyme preparation (bromelain, trypsin, rutoside trihydrate) (Group 3).

According to the evaluation on day 1, day 4, day 7 and day 10, group 2 patients responded better than group 1 and 3, particularly in pain management.

There is no significant difference between group 1 and group 3.

Based on the finding, researchers wrote, "The trial showed significant improvement in reducing pain in patients treated with oral enzymes and diclofenac sodium combination therapy".

Also, in order to know more information about bromelain anti-OA, efficacy researchers examined the treatment with bromelain containing enzyme preparation for 3-4 weeks on patients with knee osteoarthritis (OA).

The randomized, single-blind, active-controlled pilot study included 40 knees OA patients were randomized to receive oral bromelain (500 mg/day) or diclofenac (100 mg/day).

In WOMAC and SF-36 scores, bromelain exerted an improvement of total WOMAC and pain subscales similar to those of diclofenac. However, 2 patients in the diclofenac discontinued the study due to adverse effects.

At week 16, bromelain treatment group demonstrated an improvement of total WOMAC scores (12.2 versus 25.5), pain subscales (2.4 versus 5.6), stiffness subscales (0.8 versus 2.0), and function subscales (9.1 versus 17.9), and physical component of SF-36 (73.3 versus 65.4) as compared to the baseline.

Additionally, levels of pro-inflammatory cytokines and oxidative stress markers also inhibited at week 16 compared to control.

Taken altogether, bromelain may be considered supplements for the prevention and treatment of OA, pending to the confirmation of the larger sample size and multicenter human study.

Intake of bromelain in the form of supplement should be taken with extreme care to prevent overdose acute liver toxicity.

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Author Biography
Kyle J. Norton (Scholar, Master of Nutrition, All right reserved)
Health article writer and researcher; Over 10.000 articles and research papers have been written and published online, including worldwide health, ezine articles, article base, health blogs, self-growth, best before it's news, the karate GB daily, etc.,.
Named TOP 50 MEDICAL ESSAYS FOR ARTISTS & AUTHORS TO READ by Disilgold.com Named 50 of the best health Tweeters Canada - Huffington Post
Nominated for shorty award over last 4 years
Some articles have been used as references in medical research, such as international journal Pharma and Bioscience, ISSN 0975-6299.

Sources
(1) Efficacy of Bromelain along with Trypsin, Rutoside Trihydrate Enzymes and Diclofenac Sodium Combination Therapy for the treatment of TMJ Osteoarthritis - A Randomised Clinical Trial by Jayachandran S1, Khobre P. (PubMed)
(2) Improved WOMAC score following 16-week treatment with bromelain for knee osteoarthritis by Kasemsuk T1, Saengpetch N2, Sibmooh N1, Unchern S. (PubMed)
(3) Occupational activities and osteoarthritis of the knee by Keith T Palmer. (PMC)