What is Chymopapain?

Andrew Kirmayer

Chymopapain is a proteolytic enzyme that comes from the latex of a tropical tree known as carica papaya. It is used in injections for herniated disks in the spine. The procedure, called chemonucleolysis, was first used in 1965, and effectively dissolves part of the spinal disc using the enzyme or the derivative product chymodiactin. Administered in an operating room during slipped disk treatment, the substance is delivered via injection once a local or general anesthetic is given to the patient. The compound dissolves part of the affected disc to relieve pressure on the nerve, as well as lessen the associated pain.

Any papaya-based food can introduce compounds similar to chymopapain into the body.
Any papaya-based food can introduce compounds similar to chymopapain into the body.

This treatment must be approved by a physician and conducted at a hospital because side effects from chymopapain are common and can be severe. Reactions such as an upset stomach, headache, back pain, dizziness, and back spasms are most often reported. It is also possible to experience leg pain and tingling, as well as numb feet and toes following the procedure. The presence of other allergies and illnesses can exacerbate the reaction to chymopapain, and severe reactions can include rash, difficulty breathing, and anaphylactic shock. One percent of all people that have the enzyme injected suffer anaphylaxis as a result.

Chymopapain is commonly used to treat herniated discs.
Chymopapain is commonly used to treat herniated discs.

There are other ways chymopapain can be introduced into the body. Any kind of papaya-based food, such as pineapple or beverages that include exotic fruits, can include compounds that are similar in composition. Compounds such as papain and caracain are closely related, so exposure to them can trigger the same reactions as when chymopapain is injected directly into the body. Sensitivity to papain increases the likelihood of an allergic reaction if the proteolytic enzyme is used.

Chymopapain injections cause anaphylaxis in approximately 1 percent of all patients.
Chymopapain injections cause anaphylaxis in approximately 1 percent of all patients.

It is important to tell a doctor if there any known allergies to papain or any papaya-based food or substance. Drugs that include chymopapain should be used with caution in pregnant women. It is also not known whether the medication transfers to breast milk, and it is strongly advised to discuss this with a physician before breast feeding.

Numb feet and toes are a side effect of chymopapain.
Numb feet and toes are a side effect of chymopapain.

Chymopapain is synthesized in the carica papaya tree’s latex when it is damaged, and the enzyme fully matures a few minutes later. Other substances that are found in papaya latex include chitinase and glycyl endopeptidase. The enzyme used for slipped disc treatment is so similar to papain that they share 126 identical amino acids. It is strongly advised to disclose whether a papaya allergy is present when considering herniated disc treatment with chymopapain.

An anaphylactic response to chymopapain is a major medical emergency.
An anaphylactic response to chymopapain is a major medical emergency.
Back spasms are one possible side effect of chymopapain.
Back spasms are one possible side effect of chymopapain.
Side effects of chymopapain may include back pain.
Side effects of chymopapain may include back pain.
Treatment with chymopapain has been known to cause headaches and dizziness.
Treatment with chymopapain has been known to cause headaches and dizziness.

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Discussion Comments


I had the injections done in 1986 in Phoenix. The doctor who did it gave me three injections at the same time. I was told he was supposed to do one injection and wait a minimum six months to do another one (if needed). From what I have been told he did so much that it ran to other places.

In 1986, they finally realized that I needed a fusion because of things sliding back and forth. I have lived in excruciating pain since. I get injections which just mask the pain and get it where I can live with it while taking morphine twice a day. I would love to find a doctor who has researched the results of this procedure (chymopapain injections) being over used. I am getting to the point where I am probably going to have to get a motorized scooter together around.


I had the chymopapain injection in '99, and during the procedure, pain shot down my left leg and my whole leg began shaking uncontrollably, then great difficulty in breathing ensued and my entire body began shaking. A nurse bent down in front of me to try to talk me through controlling my breathing. Clearly more sedation was given as I don't remember any more beyond that. Afterward however, my physical difficulties snowballed. I would say categorically that the ligament problem in my legs is a direct result of chymopapain.

I'm 45 now, confined to home, dependent on a motor chair. I am profoundly disabled in a now deformed body while enduring muscle spasms that are not only excruciatingly painful, but they contort my body to such a degree people seem certain my bones will snap or the joints will dislocate. Then of course, there are the seizures/convulsions which we've termed the 'Hippyshakes' -- you've got to have a sense of humour.

But the twisted insult to this horrific injury is that, for the last eight years, doctors would try and have me believe that it's my own mind that's responsible, giving me the psychiatric diagnosis of conversion disorder. If I thought this to be true I would have claimed my physical abilities back a long time ago through working with professionals in that field but it's not conversion disorder.

Trying to access information seems impossible and chat forums have disappeared. I am but one of an innumerable amount of people living with the effects of these pharmaceutical concoctions that should never be injected into the human body.

To those companies and to some in the medical profession we are merely statistics 'cause profit is profit after all. Oh! For the day that courage, integrity, compassion and all else required, will lead to the 'Truth' being outed. By then, however, it will probably be too late for those of us because the damage done is irreversible and the progression unstoppable. How wonderful it would be though for those facing into this after us. This is not limited to chymopapain alone. Thanks for this forum. If nothing else, it has enabled this medical orphan to speak. Cheers and kind regards to you all.


I had a severe reaction to chymopapain injection in 1981. My doctor did not feel it necessary to do the new test to check for allergy as I was taking papaya tablets at the time that lessened outbreaks of cold sores. He was very wrong!

My blood pressure dropped to 0/40, we found out when my husband saw the chart. The doctor would not disclose any more information other than I had a reaction and was now OK and how lucky I was that he had seen it before and knew what to do. I was swollen from head to toe and getting epinephrine shots every few minutes for quite a while.

It is quite unnerving to be waking up to two nurses discussing the chances of a patient possibly not making it and find out you are the one they are talking about.

For several years after, I would have unexplained swelling in my abdomen and legs but was told it had nothing to do with the injection. I could swell three to four inches in my waist from morning to afternoon with my calves swelling so much I'd have to change to a larger pair of pants. I still wonder how much of the problems I have with ligaments in my legs could actually be directly related to the injection.


If you are allergic to latex, you are not supposed to eat any fruit with a pit in the middle of it which would include papaya.


The papaya tree has all kinds of uses. I've never heard of this one before, although it doesn't surprise me.

I know there's a component in the stem of the fruit that can act as a meat tenderizer, so it doesn't seem all that far fetched to me that the tree sap can be used to dissolve parts of the spine.

I've also heard that you can mix this latex with water and apply it to wasp stings to make them hurt less, but I've never tried that myself.

Of course, just like with chymopapain, you have to be very careful to make sure you don't have a papaya allergy, as it can make you very sick.

You might want to handle the fruit with gloves, in fact.


I have to say, it would be easy enough to test whether people have an allergy to this substance before setting them up in an operating theater and taking the risk that they are.

All you'd have to do is give them some papaya for dessert the night before the surgery. Or pineapple, since that apparently works as well.

One percent seems a very high risk for full anaphylaxis is all.

I mean, I'm sure not everyone would react to eating the chymopapain, so it wouldn't help in all cases. But still, it sounds like it could tip them off in some cases, so they would know better than to inject a person with it, in the spine.

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