Latest article: Chronic neuropathic pain: Magnesium's role in treatment
Date
03 Feb 2025
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Magnesium plays a crucial role in pain management through its antagonistic action on N-methyl-D-asparate (NMDA) receptors to prevent central sensitisation and minimise pain hypersensitivity.1,2 It shows efficacy in common pain conditions, including neuropathic pain, fibromyalgia syndrome, dysmenorrhoea, headaches, and migraines,2,3 and its antinociceptive effects have been demonstrated in both animal models and human studies. Inadequate intake and low serum levels of magnesium are commonly found in many chronic pain states. 4,5
PATHOGENESIS OF CHRONIC NEUROPATHIC PAIN AND THE ROLE OF MAGNESIUM
Key mechanisms of chronic neuropathic pain that we clinicians can influence beyond standard treatment are neuroinflammation and central sensitisation.
Neuroinflammation
Neuroinflammation is characterised by the activation of peripheral and central glial cells, including microglia and astrocytes, in a process increasingly known as "glial activation".6
The role of microglia and astrocytes in neuroinflammation and “glial activation” is emerging as a powerful mechanism underlying neuropathic pain, characterised by astrocyte dysfunction and glutamate accumulation, which causes neuronal hyperactivity.6
Low serum magnesium levels are commonly found in chronic neuropathic pain and are associated with increased inflammation.7,8 Magnesium deficiency induces the expression of neuroinflammation-related genes in the brain9 and contributes to various neurological disorders, including Alzheimer's, Parkinson's, and multiple sclerosis.4,8
Central sensitisation
Repeated insults to the central nervous system (CNS) can significantly lower the body's pain tolerance. This phenomenon, known as central sensitisation, makes individuals more sensitive to pain. It can manifest as conditions like wind-up or long-term potentiation of pain, where even minor stimuli trigger intense pain responses.1
Key highlights
- Low serum magnesium levels and magnesium deficiency are commonly seen in chronic pain conditions, including neuropathic pain.
- Magnesium is an innovative and versatile tool for pain management, addressing both nociceptive and neuropathic pain. It acts through N-methyl-D-aspartate (NMDA) receptor antagonism and reductions in neuroinflammation.
- It is effective on its own or can be combined with other supplements for neuropathic pain, such as palmitoylethanolamide (PEA).
- Magnesium can augment the actions of commonly prescribed medications for chronic neuropathic pain.
- Integration into standard clinical or naturopathic practice—alone or in synergistic combinations—can significantly enhance patient outcomes.