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Chronic Pain and Central Sensitisation

 
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Chronic pain is persistent pain lasting more than 3-6 months.1 Chronic pain is complex and it is often reported that chronic pain sufferers concurrently experience psychological distress and symptoms such as poor mood and sleep.1 The body is equipped with a variety of mechanisms and systems to alleviate and resolve pain, including the endocannabinoid system. Compounds such as palmitoylethanolamide (PEA) and Crocus sativus (saffron), have the unique ability to influence the endocannabinoid system and in turn, manage chronic pain and its associated symptoms. Chronic pain sufferers are more likely to experience psychological issues such as depression, anxiety, and sleep disturbances.

The endocannabinoid system is involved in the modulation of pain and inflammation.2 Whilst PEA is not a cannabinoid itself, it is a naturally occurring endogenous fatty acid that is produced in response to inflammation or injury. In conditions such as chronic pain, it has been noted levels have been altered, highlighting the benefit of PEA supplementation.3 Ultimately, PEA provides analgesic, anti-inflammatory and neuroprotective benefits. Due to its fatty nature, PEA has poor absorption however, so it is imperative to select a high bioavailability form of PEA clinically.

Saffron is a notable adjunct therapy to PEA as chronic pain sufferers are more likely to experience psychological concerns such as depression, anxiety, and sleep disturbances. Saffron has been shown to provide anti-inflammatory, antinociceptive, immunomodulatory, analgesic, antidepressant, and anxiolytic effects.4

Finally, vitamin D may also be of use in chronic pain management. Studies have suggested its action on different biological mechanisms such as nociceptive sensitivity and nervous system modulation including serotonin and melatonin regulation.5

 

References

1.     Australian Institute of Health & Welfare, 2020, Chronic Pain in Australia https://www.aihw.gov.au/reports/chronic-disease/chronic-pain-in-australi...

2.     Bains S, Mukhdomi T. Medicinal cannabis for treatment of chronic pain. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan.​

3.     Clayton P, Hill M, Bogoda N et al. Palmitoylemthanolamide: A natural compound for health management. Int. J. Mol. Sci. 2021, 22, 5305.

4.     Orio L, Alen F, Balesta A et al. Antihedonic and antidepressant effect of affron® a standardised saffron (Crocus Sativus L.) extract. Molecules, 2020, 25, 3207.

5.     De Oliveria D, Hirotsu C, Tufik S et al. The interfaces between vitamin D, sleep and pain. J Endocrinol. 2017 Jul;234(1):R23-R36

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