Q: Can bromelain supplements help treat joint, tendon and muscle problems, as claimed?
A: Despite bromelain’s status as a “miracle” alternative therapy for ailments like arthritis and tendinitis, there’s not enough good research to evaluate its effectiveness. Bromelain, derived from pineapples, is a proteolytic enzyme, meaning that it breaks down proteins (hence, bromelain supplements are also used as a digestive aid). In animal and lab studies, the enzyme has been shown to have anti-inflammatory activity, help repair tendons and have other benefits on body tissues.
But studies in people have largely been disappointing. For example, a 2006 study published in the Quarterly Journal of Medicine found that bromelain (800 milligrams a day for 12 weeks) was no better than a placebo in treating symptoms of knee osteoarthritis. And a 2002 study from Indiana State University, in the Clinical Journal of Sports Medicine, found no benefit of bromelain (or ibuprofen or a placebo) in reducing delayed onset muscle soreness after participants exercised their biceps.
Studies that have suggested benefits have tended to be small and have design problems. Because many have no control group, a placebo effect cannot be ruled out. Several studies have combined bromelain with other ingredients (such as other enzymes) or therapies (such as diet and acupuncture), so even if a benefit is seen, it’s impossible to know what role, if any, the bromelain played.
The Natural Standard, which evaluates alternative and complementary therapies, considers the evidence for bromelain to be unclear or conflicting for inflammation, knee pain, knee osteoarthritis and muscle soreness.
Based on the limited research, we can’t recommend bromelain supplements. Bromelain is considered generally safe, but stomach upset and skin rash have been reported, and there is a possible risk of increased heart rate, blood clotting problems and other side effects.