Synopsis

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

Chymotrypsin is a proteolytic enzyme that has been used in some countries as an adjunct treatment for soft tissue injuries such as sprains. The rationale for its use is based on its anti-inflammatory properties and its ability to break down proteins in damaged tissue, which may help reduce swelling and facilitate the resolution of hematomas and edema. Several clinical studies, primarily from the mid to late 20th century, have explored the efficacy of chymotrypsin for these indications. Some small, randomized controlled trials and observational studies have reported faster reduction of swelling, pain, and bruising in patients with sprains and other musculoskeletal injuries who received chymotrypsin compared to placebo or standard care. However, the methodological quality of these studies is generally low, with issues such as small sample sizes, lack of blinding, and inconsistent outcome measures.

More recent systematic reviews and major clinical guidelines do not endorse the routine use of chymotrypsin for sprains, citing insufficient high-quality evidence and lack of robust safety data. While chymotrypsin is still occasionally included in combination enzyme therapies marketed for trauma and inflammation in some countries, its use is not widely accepted or standard practice in evidence-based medicine. In summary, there is some historical and limited scientific evidence suggesting chymotrypsin may provide benefit for sprains, but the overall quality and quantity of evidence is modest, and its clinical relevance remains uncertain.

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