N‐Palmitoyl Ethanol Amide Pharmacological Treatment in Patients With Nonsurgical Lumbar Radiculopathy

Abstract

Palmitoyl ethanol amide (PEA) is an endogenous substance that plays a role in neuropathic pain. In this article, we evaluated both the safety and the efficacy of ultramicronized PEA (um-PEA) in the treatment of low back pain related to nonsurgical lumbar radiculopathy. In this prospective single-blind study, patients with low back pain related to nonsurgical lumbar radiculopathy received the fixed combination acetaminophen/codeine (500 mg + 30 mg/d) for 7 days, and then it was stopped and changed to um-PEA (1200 mg/d) for 30 days. Patients without an improvement in pain or disability started a second cycle of treatment with um-PEA (600 mg/d in tablets) for 30 days and then acetaminophen/codeine for 30 days. A total of 155 patients were included in the analysis. After the first cycle of treatment we recorded an improvement of pain in all patients with mild pain (visual analog scale score from 3-4 to 1) and in 75% of the patients with moderate pain (visual analog scale score from 5-6 to 2). After the second cycle, we recorded an improvement of pain and disability in all patients with moderate pain (P < .01), but in 26% of patients with severe pain we did not record any improvement in disability (P > .05). In conclusion we evaluated the role of um-PEA in patients with lumbar radiculopathy with a long-term follow-up (24 months) and put in evidence the effectiveness and the safety of this formulation in patients with mild and moderate pain.

Effects of Add-On Ultramicronized N-Palmitol Ethanol Amide in Patients Suffering of Migraine With Aura: A Pilot Study

“…Previous studies reported that treatment with PEA does not cause adverse events or drug interactions and it doesn't induce pharmacological tolerance ( 16 , 35 – 37 ). Our data demonstrate that um-PEA chronically administered for 90 days and occasionally added on to NSAIDs significantly reduces the score of pain intensity, the number of attacks/month, and the days of pain during each attack irrespective to age and gender, suggesting a synergic effect of these compounds.…”

<p>Add-on administration of ultramicronized palmitoylethanolamide in the treatment of new-onset burning mouth syndrome</p>

“…The ultramicronized form makes the substance more effective and safer. Ultramicronized PEA (umPEA) has been shown to effectively reduce central and peripheral neuroinflammatory disorders such as migraine, neuropathies, and radiculopathies 4–7. The case offers two considerations: the late onset of BMS and the efficacy of PEA on pain-burning.…”

“…It has a structure similar to endocannabinoids, which are produced by the body to repair the damage caused by various pathological situations, thanks to their antioxidant, immunosuppressive, anti-inflammatory and painkiller activity. It has proved effective in neuropathic disorders and in migraine as demonstrated by the studies of Chirchiglia et al in 2016, 2017, and 2018 4–7…”

ALIAmides Update: Palmitoylethanolamide and Its Formulations on Management of Peripheral Neuropathic Pain

“…Pain can radiate down the back along a leg or foot, and this is described as sciatica, which can usually be reproduced with certain activities and positions, such as sitting or walking, and it is often caused by the compression of the lower spinal nerve roots (L5 and S1) [215]. Overall, several findings would suggest that PEA and PEA-um administration might be effective in the management of pain sciatic associated with lumbosciatalgia [216,217] or lumbar radiculopathy [218], and of pain associated to carpal syndrome [211,219,220]. Moreover, according to the literature, patients complain of pain and swelling as the main factors negatively influencing their quality of life [221] during postoperative course, as well as in patients suffering from neuropathic pain that is associated with pathologies of various etiologies [222], such as post-herpetic neuralgia.…”