Abstract
In terms of antinociceptive action, the main mode of action of magnesium involves its antagonist action at the N-methyl-d-aspartate (NMDA) receptor, which prevents central sensitization and attenuates preexisting pain hypersensitivity. Given the pivotal function of NMDA receptors in pain transduction, magnesium has been investigated in a variety of pain conditions. The oral and parenteral administration of magnesium via the intravenous, intrathecal, or epidural route may alleviate pain and perioperative anesthetic and analgesic requirements. These beneficial effects of magnesium therapy have also been reported in patients with neuropathic pain, such as malignancy-related neurologic symptoms, diabetic neuropathy, postherpetic neuralgia, and chemotherapy-induced peripheral neuropathy. In addition, magnesium treatment is reportedly able to alleviate fibromyalgia, dysmenorrhea, headaches, and acute migraine attacks. Although magnesium plays an evolving role in pain management, better understanding of the mechanism underlying its antinociceptive action and additional clinical studies is required to clarify its role as an adjuvant analgesic.
Highlights
The first use of magnesium in medicine dates back to the 17th century [1]
The present review describes the pharmacologic basis of pain relief provided by magnesium ions, and surveys preclinical and clinical trials that investigated its antinociceptive effects
Evidence of the role of magnesium in analgesic adjuvants against a variety of acute and chronic pain has accumulated over decades
Summary
The first use of magnesium in medicine dates back to the 17th century [1]. The major ingredient of magnesium sulfate, was used to treat conditions such as abdominal pain, constipation, and muscle strains. Magnesium is widely used for the prophylaxis and treatment of pain [2]. Since magnesium can regulate calcium entry into cells by antagonizing NMDA receptors [4], many studies have investigated its use as an adjuvant analgesic. Recent studies proposed the use of NMDA receptor antagonists in the management of postoperative pain and a variety of acute and chronic pain conditions. The present review describes the pharmacologic basis of pain relief provided by magnesium ions, and surveys preclinical and clinical trials that investigated its antinociceptive effects
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