What is it about?

This review highlights the current knowledge about the effectiveness and safety of dietary supplements in the multimodal management of chronic pain. Through the analysis of literature and their it has been proposed a new mechanism of action a pain mechanism-based approach to their use.

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Why is it important?

Dietary supplements are even more utilized in chronic pain even though it is not often clear their real effectiveness and safety. At the same time there is a huge unmet need of new drugs for treating chronic pain as those presently available, even though effective, raise some concerns about their safety (opioids) or their side effects (anticonvulsants, antidepressants and NSAIDs). Hence, a more personalized approach, based on an expanded list of pain modulators exploiting novel mechanisms is required in order to design patient tailored interventions. In this perspective, there is the need to better summarize not only the effectiveness of dietary supplements but also to describe how they exactly exert their pain modulating activity. interestingly, dietary supplements can act on pain mechanism through modes of action that are not covered by “traditional” drugs. For this reason we propose the new approach in considering dietary supplements part of multimodal approach to treat chronic pain with a special focus on chronic postoperative pain and low back pain


The most important perspective is to start evaluating in clinical trials dietary supplements considering the type of pain and their mechanism of action. A better validation of their activity could help to have more data about their real activity and their potential synergistic effect with other drugs currently used in chronic pain. From a theoretical point of view it is possible to identify associations that make it possible to exercise potentially synergistic actions based on innovative mechanistic components and complementary to those of drugs pain relievers. It is not excluded that preparations with compounds listed in our review may exert a pain-relieving action autonomously. This is a situation that already sees a very broad spectrum of substances used today, many of which are clinically tested even if not always adequately and useful for regulatory purposes.

Nicoletta Marchesi
University of Pavia

Read the Original

This page is a summary of: Non‐drug pain relievers active on non‐opioid pain mechanisms, Pain Practice, September 2021, Wiley, DOI: 10.1111/papr.13073.
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