Inflammation Management – An Update

A cascade of physiological, biomechanical and biochemical events complicate Acute and Repetitive Injuries. Musculoskeletal pain and range of motion is affected by biomechanical aberration, joint dysfunction, segmental hyper/hypo-mobility and the result of several pathways and stimuli. However, the inflammatory response may be treated anecdotally by ice, compression and elevation. Allopathic recommendations often include anti-inflammatory medication with significant side effects (consumed like candy), cortisone (with lidocaine or marcaine) injections and other more aggressive medicinal aids (nerve block, etc.) are commonly prescribed and administered for patients refractory to care.

Enzymes to the rescue

I recall numerous childhood athletic injuries for which my late doctor, L. C. Winnick, MD, would prescribe ice, elastic bandage and Ananase. Years later, I learned that ananacea, in Latin, translates to pineapple. The effective proteo-lytic enzyme found in the stem of the Hawaiian fruit is otherwise known as bromelain (an enzyme known to help modulate bradykinin activity, reduce excessive fibrin deposition, inhibit pro-inflammatory cytokines and help soft tissue damage). Other common, extremely beneficial enzymes, such as papain and trypsin when combined, are very effective for acute inflammation. However, the body must produce anti-enzymes  in order for them to be adequately processed and, as such, after prolonged exposure to high levels of enzymes, the body can no longer produce the required anti-enzymes and build-up occurs.

NOTE:  Extended use of these powerful and effective enzymes for acute inflammation is NOT recommended, as the effects can lead to long term complications.1

Natural COX-inhibitors

Prostaglandins, the hormone-like substances responsible for inflammation, are formed from arachadonic acid. The first step in their formation is catalyzed by the enzyme cyclo-oxygenase, or COX. Turmeric, ginger and boswellia extract help inhibit the production of COX. Excessive tissue oxidation can also lead to inflammation related pain. Rosemary extract and a lemon bioflavonoid complex, both powerful antioxidants, help mitigate this inflammatory factor. Bromelain derived from pineapple (ananas bracteur, ananas cosmosus) contains, among other components, various closely related proteases, demonstrating, in vitro and in vivo, anti-edematous, anti-inflammatory, anti-thrombotic and fibrinolytic activities.2

The 1-2 punch

Additional anti-inflammatory support is maximized when coupled with turmeric (inhibits production of leukotrienes), ginger (limits lipoxygenase production), citrus bioflavonoid, rosemary and boswellia. The powerful combination of proteolytic enzymes for acute tissue trauma and subsequent soft tissue de-flaming support, previously noted, has proven cost effective and efficacious as well. This 1-2 punch enhances the acute and chronic recovery process and affords the patient rapid, safe and natural relief of pain due to inflammation. Patients with chronic inflammation and those in the rehabilitation phase of care require a maintenance formula to prevent the post-acute injured tissue from becoming re-inflamed.1


Inflammation is becoming well recognized as the cause of many health problems/conditions and not solely the result. As cause and effect practitioners, we chiropractors pride ourselves on RESULTS. Whether your belief is right- or left-wing, pain management is an integral part of patient care and the most common reason for portal-of-entry in health care today.

This anti-inflammatory protocol is extremely effective in supporting the chiropractic adjustment, as muscles and joints that remain inflamed retard the natural healing process. As you know, patient history clearly demonstrates that patient’s recalcitrant to rapid pain relief will seek alternative pain management. Let the buck (patient) stop here, at your office!


1.  Seaman DC, David, Clinical Nutrition, 1st Edition, NutrAnalysis Inc.)
2.  Bucci, L R. Nutrition Applied to Injury Rehabilitation and Sports Medicine

For more product and seminar information, e-mail Dr. Mally at [email protected].

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