Polyphenols Show Potential in Treating Fibromyalgia Pain
In a search for new treatment and prevention strategies for pain in patients with fibromyalgia, researchers explored bioavailable nutraceuticals and phytochemicals like polyphenols.
The use of plant-based polyphenols showed promising potential for the management of neuropathic pain and fibromyalgia (FM), according to data published in Nutrients.1
“FM is the second most frequent disease seen by rheumatologists, affecting more than 5% of the global population,” wrote authors of the study. “While it primarily affects young and middle-aged women, FM can affect individuals of any gender or age who chronically suffer from widespread pain in the fibromuscular tissue, tendons, ligaments, and other areas.”
There currently lacks evidence explaining a standard treatment regimen for patients with FM. Prior to the study, chronic pain in FM was commonly treated with a variety of pharmacological and non-pharmacological options. These medications and interventions are used to create neurovegetative hyperactivity that essentially modifies the patient’s threshold for pain.
Grapes have antioxidative benefits and are high in polyphenols. | image credit: Jirakit / stock.adobe.com
“The management of chronic pain in FM requires a varied medical plan that may include a combination of adjuvant medicines, psychological therapies, and behavioral strategies such as aerobic exercise to reduce distress and inflammation, as well as novel therapeutic strategies based on the use of nutraceuticals,” they continued.1
The researchers’ main goal was to define the conceptualization of pain as a disease in regard to FM. “Researchers think that FM amplifies painful sensations by affecting the way the brain and spinal cord elaborate painful and non-painful signals,” they wrote. Upon testing this hypothesis throughout a variety of literature, they then explored the idea of using novel nutraceutical therapies and natural molecules to treat FM pain.
READ MORE: Q&A: Innovative Technologies Revolutionizing Pain Medicine
The most notable product researchers explored was polyphenols because of their antioxidant and anti-inflammatory nature.1
“Polyphenols are a class of compounds found in many plant foods that includes flavonoids, phenolic acids, lignans, and stilbenes. There are more than 8,000 different types of polyphenols that have been identified so far,” according to the Colorado State University Kendall Reagan Nutrition Center.2 “Most polyphenols work as antioxidants in the body, meaning they can combat environmental harm such as UV damage and pollution.”
Before exploring the potential benefits of these products, researchers dove deeper into FM pain and the proper focus providers need in order to address patients’ pain thresholds. According to the authors and previous literature they explored, FM treatment must focus on pain relief, physical therapy to fortify the body, and addressing the emotional and psychosomatic components of the disease.1
All of the current medications used for treating FM were previously approved for other conditions like depression and nerve pain. The FDA has approved pregabalin (Lyrica), duloxetine (Cymbalta), and milnacipran (Savella). However, these medications typically present a cost burden for patients and have demonstrated limited and varied evidence regarding efficacy, paving the way for researching options like nutraceuticals.
“Pharmaceutical drugs available today to treat FM have adverse effects, including physical dependence and tolerance,” they continued.1 “Therefore, the great availability of nutraceuticals has drawn considerable attention from patients seeking relief from chronic pain conditions.”
By addressing patients’ common oxidative and inflammatory stress in FM, the properties of various nutraceuticals become active and provide the proper mechanisms for relieving pain. “In particular, the [mitogen-activated protein kinase (MAPK)] signaling pathway, which induces the inflammation process, stimulates microglial activation and pain sensitization via many signaling molecules, such as chemokines, cytokines, and kinases regulated by the p38 protein,” according to the authors.
The nutraceuticals that researchers explored included: palmitoylethanolamide, capsaicin, Ashwagandha and withania somnifera, curcumin, coenzyme Q10, alpha-lipoic acid, carnitine, a variety of vitamins, various minerals, carotenoids, and polyphenols. As they noted, a significant amount of research has been dedicated to these nutraceutical agents. However, with their necessary anti-oxidative and -inflammatory effects, polyphenols stood out as a key nutraceutical for future FM pain management.
With the collection of further evidence for the management of pain in patients with FM, researchers are highlighting the strides they are making in the development of innovative phytochemicals. From safety to efficacy, greater, less invasive options are becoming available for patients with chronic pain of all types, not just when triggered by FM.
“Both clinical and preclinical studies have investigated the analgesic potential of natural substances, including plant extracts, for the management of FM. The successful clinical use of these products, with no significant reports of adverse effects, emphasizes the advancements made in utilizing natural products, such as polyphenols, for the treatment and management of FM,” concluded authors of the study.1
READ MORE: Q&A: Why Educating Patients on Emerging Pain Technology is Key
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