New Treatments for Chronic Pain Relief
The latest research shows that natural medicine could be the best place to look for new chronic pain treatments. Researchers recently discovered an intrinsic fatty acid, called PEA (Palmitoylethanolamide), that inhibits peripheral nerve inflammation—theorized as the first step in developing chronic pain.
Additionally, a little-known plant extract called honokiol improves GABA signaling in the brain, thus restoring a normalized perception of pain—an important step for chronic pain relief.
The newest approach to finding relief might include supplementing with PEA and honokiol. Life Extension®’s Michael A. Smith, MD, and Crystal Gossard, DCN, CNS, LDN, discuss chronic pain and readily available solutions that don’t involve opioids in this episode of Live Foreverish.
What is Chronic Pain?
Chronic Pain Definition
Did you know that chronic pain is not only long-term, day-in-and-day-out pain, but a diagnosis in its own right?
Chronic pain is defined as persistent or recurrent pain lasting longer than 3 months.1 While acute pain is the temporary pain that is the result of numerous possible occurrences or conditions, chronic pain is something that many people live with 24 hours a day, often for years. It is a condition that involves more than the site of the initial insult to the body and includes changes that occur in the spinal cord and the brain.
Chronic pain is now recognized as a diagnosis that is separate from any disease or condition that may have initiated it. As an article published recently in the journal Postgraduate Medicine noted, “Evidence supports the redefinition of chronic pain as a distinct disease entity, not simply a symptom of injury or illness.”2
According to a recent review, “If one views chronic pain as a single disease entity, then it is the most common and costly medical condition.”3
Chronic pain symptoms
In addition to persistent, significant pain, people suffering from chronic pain unsurprisingly endure other symptoms, including a significant amount of stress which, in turn, can aggravate their pain.4 Depression, anxiety, insomnia, physical disability and even cognitive changes can also be experienced by those suffering from chronic pain.
Current chronic pain treatment
Chronic pain is generally treated with prescription and nonprescription pain-relieving drugs. Nonprescription drugs include acetaminophen (Tylenol) and nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin, ibuprofen (Advil) and naproxen (Aleve). NSAIDs also include the prescription drugs celecoxib (Celebrex), diclofenac (Voltaren), indomethacin and others. While prescription opioid derivatives—including hydrocodone, fentanyl, codeine, morphine, and oxycontin—are considered good at relieving pain, some people become addicted in a matter of weeks of regular use and experience other significant side effects.
Local anesthetic injections that can be administered by a physician are sometimes an option. There are also pain-relieving patches, balms, lotions and ointments that can be applied topically.
Natural therapies for chronic pain include acupuncture, spinal adjustments, exercise, physical therapy, meditation, massage and specific plant compounds.5
PEA and Honokiol–Exciting New Options for Pain Relief
How does PEA work?
Palmitoylethanolamide, which (fortunately) is referred to by its acronym PEA, is a fatty acid produced in the human body that also occurs in small amounts in egg yolk, milk, soy and other foods.6 Available clinical data support the ability of PEA to relieve discomfort.7 The compound targets the mast cells activated peripherally during the initial insult to the body that is the first step in the development of chronic pain, thereby reducing the release of inflammatory mediators. PEA’s action against mast-cell driven localized inflammation is what makes it different from other compounds—natural and otherwise—that have an anti-inflammatory action.6
PEA also targets the nuclear receptor peroxisome proliferator-activated receptor-alpha (PPAR-alpha) to support a healthy level of inflammation. According to a recent review, “Synergistic interactions among several mechanisms often seem necessary so that PEA can produce its important therapeutic effects, both in the central and the peripheral nervous system.”6
Human studies have revealed benefits for the use of PEA for sciatic nerve pain, carpal tunnel syndrome, temporomandibular joint (TMJ) syndrome and migraine.8- 11 Doses used in these trials range from 300 milligrams to 1,200 milligrams.
What is honokiol?
Honokiol is a compound derived from the magnolia tree. Honokiol targets resistance to the inhibitory gamma-aminobutyric acid (GABA) in brain—a phenomenon that occurs as the final stage in the development of chronic pain syndrome. GABA slows down the rate at which neurons fire, which results in a calming effect.12
“The results of anatomical, biochemical, molecular and pharmacological studies support the notion that generalized activation of GABA receptor systems dampens the response to painful stimuli,” write S. J. Enaa and K. E. McCarson in Advances in Pharmacology. “The data leave little doubt that, under certain circumstances, stimulation of neuroanatomically discreet GABA receptor sites could be of benefit in the management of pain.”13
Targeting the beginning and the end of the development of chronic pain is one way to break the pain cycle. Unlike NSAIDs, PEA and honokiol are safe on the stomach, and unlike opioid drugs, they’re nonaddictive.
Although chronic pain has frustrated patients and physicians alike, there are treatment options that don’t involve the use of dangerous and addictive drugs. Do you or someone you care about suffer from chronic pain?
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- Nicholas M et al. Pain. 2019 Jan;160(1):28-37.
- Clauw DJ et al. Postgrad Med. 2019 Jan 31:1-14.
- Nicol AL et al. Anesth Analg. 2017 Nov;125(5):1682-1703.
- Crofford LJ. Trans Am Clin Climatol Assoc. 2015;126:167-83.
- Wylde V et al. Br J Surg. 2017 Sep;104(10):1293-1306.
- Petrosino S et al. Br J Pharmacol. 2017 Jun;174(11):1349-1365.
- Artukoglu BB et al. Pain Physician. 2017 Jul;20(5):353-362.
- Guida G et al. Dolor. 2010;25(1):35–42.
- Assini A et al. Eur J Neurol. 2010;17(S3):295.
- Marini I et al. J Orofac Pain. 2012 Spring;26(2):99-104.
- Chirchiglia D et al. Front Neurol. 2018 Aug 17;9:674.
- Ai J et al. Pharmacology. 2001 Jul;63(1):34-41.
- Enna SJ et al. Adv Pharmacol. 2006;54:1-27.