September 24, 2019

A 2019 post-hoc analysis of a trial originally reported in 2010 adds more evidence to an association between supplementation with palmitoylethanolamide (PEA) and improved comfort levels among individuals experiencing pain.

The trial included 636 patients with lower back pain (sciatica) who received 300 mg or 600 mg PEA, or a placebo for three weeks. Subjects were assigned by the authors of the current analysis to one of five categories of increasing neuropathic pain: pure lumbago (lower back pain), lumbago with pain projected to surrounding areas, lumbago with projecting pain to the leg, pure sciatica or radiculopathy, which is characterized by dysfunction of at least one nerve that is most often caused by compression of a nerve root. (Neuropathic pain is the result of damage or dysfunction to nerves, as opposed to pain caused by potentially harmful stimuli.)

Among subjects who received 300 mg PEA, 33% experienced at least a 50% improvement in pain and 38% had a 50% or greater improvement in function. For those who received the higher dose of PEA, 82% had at least a 50% improvement in pain and 88% experienced 50% or more improved function. In contrast, pain and function improved among 22% of the subjects who received a placebo.

“We found a significant correlation between the increasing probability of neuropathic pain and pain relief,” reported Georgo Cruccu and colleagues in CNS & Neurological Disorders—Drug Targets. “This result confirms the efficacy of PEA on neuropathic pain, which has been demonstrated by several studies in both experimental models and in humans.”

The authors remarked that the study may be the largest randomized controlled trial designed to assess the effect of PEA on pain and function to date. They note that the present analysis revealed that 600 mg PEA had greater efficacy on neuropathic pain than has been reported for first line drugs. Unlike these medications, PEA has the advantage of being safe. “According to our reassessment, PEA appears to be an ideal candidate for the treatment of mixed pains, such as low back pain with sciatica,” they conclude.

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