Low Back Pain and Sciatica and Proteolytic Enzymes

Proteolytic enzymes (proteases) help you digest the proteins in food.

The primary use of proteolytic enzymes is as a digestive aid for people who have trouble digesting proteins. However, proteolytic enzymes may also be absorbed internally to some extent and may reduce pain and inflammation; it is this use that might help proteoltic enzymes beneficially treat low back pain and sciatica.

Several studies provide preliminary evidence that proteolytic enzymes might be helpful for various forms of chronic pain, including osteoarthritis.

Studies enrolling a total of more than 400 people compared proteolytic enzymes to the standard anti-inflammatory drug diclofenac for the treatment of osteoarthritis -related conditions of the shoulder, back, or knee.^42-43,53-54 The results generally showed equivalent benefits with the supplement as with the medication. However, none of these studies included a placebo group.

From a research perspective, the results of these studies can only be be speculated to extend to low back pain, and low back pain as associated specifically with osteoarthritis specifically.

Read more details about Proteolytic Enzymes.

Preliminary evidence suggests that proteolytic enzymes might be helpful for back pain, especially for that which is associated with rheumatoid diseases.⁴⁴

Safety Issues

In studies, proteolytic enzymes are believed to have proven to be quite safe, although they can occasionally cause digestive upset and allergic reactions.

One proteolytic enzyme, pancreatin, may interfere with folate absorption. ¹ In addition, the proteolytic enzyme papain might increase the blood-thinning effects of warfarin and possibly other anticoagulants. ² The proteolytic enzyme bromelain might also cause problems if combined with drugs that thin the blood. In addition, there are concerns that bromelain should not be mixed with sedative drugs. Finally, bromelain may increase blood concentrations of certain antibiotics. For more information, see the full Bromelain article.

Interactions You Should Know About

If you are taking:

• The proteolytic enzyme pancreatin: You may need extra folate.

• Warfarin (Coumadin), aspirin , or other drugs that "thin" the blood: You should not take the proteolytic enzymes papain or bromelain except under a doctor's supervision.

• Sedative drugs: Do not take bromelain, except under a physician's supervision.

1. Russell RM, Dutta SK, Oaks EV, Rosenberg IH, Giovetti AC. Impairment of folic acid absorption by oral pancreatic extracts. Dig Dis Sci. 25(5):369-73.
2. Shaw D, Leon C, Kolev S, Murray V. Traditional remedies and food supplements. A 5-year toxicological study (1991-1995). Drug Saf. 17(5):342-56.

44. Klein G, Kullich W. Reducing pain by oral enzyme therapy in rheumatic diseases [translated from German]. Wien Med Wochenschr. 1999;149:577-580.