Pineapple Prescription instead of NSAIDs
Reference:Walker AF et al Bromelain reduces mild acute knee pain and improves well-being in a dose-dependent fashion in an open study of otherwise healthy adults Phytomedicine. 2002 Dec;9(8):681-6.
Aiyegbusi AI eta l A comparative study of the effects of bromelain and fresh pineapple juice on the early phase of healing in acute crush achilles tendon injury. J Med Food. 2011 Apr;14(4):348-52.
Fitzhugh DJ et al Bromelain treatment decreases neutrophil migration to sites of inflammation. Clin Immunol. 2008 Jul;128(1):66-74.
I think we are justified in recommending some patients with mild inflammatory conditions such as acute to sub-acute knee OA to eat more pineapples.
There is some clinical evidence to support the anti-inflammatory and analgesic properties of Bromelain (found in pineapple stem) to help reduce symptoms of OA and even RA.
One study found those with knee OA taking 400mg of Bromelain a day for one month had significant improvements in their pain and functional scores. In fact their overall psychological well-being also improved.
A study on rats found that Bromalain pills worked better than pineapple juice on healing acute tendon injuries.
Some MDs suggest Bromalain to be taken for everything from skin healing post surgery, to cancers and ulcerative colitis.
The science behind the anti-inflammatory process of Bromelain/pineapples is growing but there is still a lack of good RCTs on humans.
For now, casually tell your patients to increase their pineapple consumption (specially the stem/core of it). I have no idea what dose is good, how about a few slices every day?
As soon as I find good evidence for the dose of pineapples, I promise to write about it. For now, 500mg of the Bromelain pill is recommended.