Abstract
Neuropathic pain affects 7–10% of the population and is often ineffectively and incompletely treated. Although the gold standard for treatment of neuropathic pain includes tricyclic antidepressants (TCAs), serotonin-noradrenaline reuptake inhibitors, and anticonvulsants, patients suffering from neuropathic pain are increasingly turning to nonpharmacologic treatments, including nutritional supplements for analgesia. So-called “nutraceuticals” have garnered significant interest among patients seeking to self-treat their neuropathic pain with readily available supplements. The supplements most often used by patients include vitamins such as vitamin B and vitamin D, trace minerals zinc and magnesium, and herbal remedies such as curcumin and St. John’s Wort. However, evidence surrounding the efficacy and mechanisms of these supplements in neuropathic pain is limited, and the scientific literature consists primarily of preclinical animal models, case studies, and small randomized controlled trials (RCTs). Further exploration into large randomized controlled trials is needed to fully inform patients and physicians on the utility of these supplements in neuropathic pain. In this review, we explore the basis behind using several nutritional supplements commonly used by patients with neuropathic pain seen in rheumatology clinics.
Highlights
Neuropathic pain is defined as pain caused by a lesion or disease of the somatosensory nervous system and affects 7–10% of the general population [1,2,3]
In this review of the literature, we explore the role of nutritional supplements and other nonpharmaceutical therapies, including zinc, magnesium, vitamin
In a double-blinded randomized controlled trials (RCTs) of 45 patients suffering from neuropathic pain of various etiologies, oral magnesium supplementation did not significantly improve neuropathic pain compared with the placebo [19]
Summary
Neuropathic pain is defined as pain caused by a lesion or disease of the somatosensory nervous system and affects 7–10% of the general population [1,2,3]. The nutritional supplements proposed for the treatment of chronic neuropathic pain include St. John’s Wort (SJW), curcumin, zinc, magnesium, vitamin D, and vitamin B. Various elegant preclinical animal models, most often in mice, have been developed to study neuropathic pain and leveraged to study the effects of nutritional supplements in neuropathic pain These models induce neuropathic pain in mice, commonly via peripheral nerve injury models such as axotomy or chronic constriction injury, via drug-induced injury models using anti-cancer agents such as oxaliplatin, or via disease-induced models using streptozotocin to induce diabetic neuropathy [15,16]. B, vitamin D, curcumin, and SJW, in the treatment of neuropathic pain, including proposed mechanisms of action, efficacy, and evidence supporting their use. From the initial literature review until April 2021, PubMed, Embase, Google Scholar, and Scopus were searched for applicable studies
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