Evidence supporting the use of: Proteolytic enzyme (unspecified)
For the health condition: Sprains

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Synopsis

Source of validity: Scientific
Rating (out of 5): 2

Proteolytic enzymes, such as bromelain, trypsin, and chymotrypsin, have been used as adjunctive therapies for soft tissue injuries like sprains. The rationale is that these enzymes can help reduce inflammation and edema by breaking down inflammatory mediators and fibrin deposits at the injury site. Several clinical studies, primarily from the 1960s to the 1990s, have investigated oral or topical proteolytic enzyme preparations for acute sports injuries, including sprains. Some studies reported modest benefits in terms of reduced swelling, pain, and recovery time compared to placebo or NSAIDs, though methodological limitations and small sample sizes were common.

A 2004 systematic review (Klein & Kullich) found that enzyme preparations might reduce swelling and improve mobility in acute sports injuries, but concluded that the evidence was limited and not definitive. More recent reviews indicate a lack of large, high-quality randomized controlled trials. Thus, the scientific evidence supporting the use of unspecified proteolytic enzymes for sprains is weak to moderate at best, with some positive findings but a need for more rigorous research. Proteolytic enzymes are not considered standard therapy for sprains, but may be used as adjuncts in some countries. Overall, the evidence level is rated 2 out of 5.

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