Enzymes Can Hasten Pain Relief

This section is compiled by Frank M. Painter, D.C.
Send all comments or additions to:    Frankp@chiro.org

From The February 2001 Issue of Nutrition Science News

By Anthony Cichoke, D.C.

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One of the more common reactions to pathological processes is inflammation. Just about every disease or injury involves some form of it, which often manifests as pain. Enzymes, particularly proteases that break down proteins, can effectively be used to ease inflammation. Enzymes are molecules involved in speeding up chemical reactions necessary for human bodily functions. Because enzymes occur naturally in the human body, using them to ease inflammation does not incur the side effects brought on by their synthetic counterparts. Enzymes work not by stopping or blocking inflammation, but by supporting and quickening the process; hence, they are not anti-inflammatory agents per se.

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Upon injury, a series of biochemical changes takes place in a predictable fashion. Capillary permeability increases, which allows excess bodily fluid to accumulate in the injured area, leading to swelling. The end result is a wall-like deposit of insoluble proteins, particularly fibrin. This insoluble fibrin formation leads to local circulatory interference that causes pain.

The therapeutic use of protease enzymes is most effective at this stage of inflammation because they hydrolyze the peptide bonds that join amino acids within a protein, thus dissolving the fibrin plugs. This fibrin reduction allows more oxygen to reach and revive tissue cells. Excess fluid is also reabsorbed, reducing inflammation.

Research indicates that certain mixtures of proteolytic enzymes exhibit anti-inflammatory effects. Examples include pancreatin, trypsin, and chymotrypsin from animal sources, and bromelain and papain from plant sources. A double-blind German study on an undisclosed number of dental patients found anti-inflammatory effects using a proprietary mixture of 100 mg pancreatin, 45 mg bromelain, 60 mg papain, 10 mg lipase, 10 mg amylase, 24 mg trypsin, and 1 mg chymotrypsin. The patients received the mixture prior to dental surgery and postoperatively for several days. By the third day after the operation, levels of C-reactive protein—a measure of inflammation—were threefold higher in the control group. [1 ]

A separate German review of a studies found proteolytic enzymes have analgesic effects based on the inhibition of inflammation as well as their direct influence on the network of pain receptor branches known as nociceptors. This latter point explains the therapeutic effects of such enzymes in cases where the inflammatory processes are not in the forefront, particularly degenerative rheumatic diseases. [2 ]

Enzyme preparations are generally well tolerated. Undesired side effects, which are generally controlled by decreasing dosage, include gastrointestinal tract disturbances, stool softening, flatulence, and/or a feeling of fullness.

Although more studies are needed to better ascertain the anti-inflammatory—and hence, pain relieving—effects of the various hydrolytic enzymes, it may be presumed that they can help in conditions with inflammation as one of the main calling cards.

Anthony Cichoke is the author of The Complete Book of Enzyme Therapy (Avery, 1999).

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