Palmitoylethanolamide for chronic pain, minding your PEAs and Qs

Palmitoylethanolamide, or PEA, is supplying another alternate path to treat chronic pain symptoms for patients seeking natural remedies

It is almost impossible these days to turn on a TV, read a magazine, or go online without coming across a news segment or article about the current opioid crisis in the United States. In 2015, as many as 126 million adults reported experiencing pain in the previous three months, with more than 11% (more than 25 million) reporting daily chronic pain during that time period.

Furthermore, more than 10 % rated their pain as severe.¹

Unfortunately, standard treatment for chronic pain often involves opioids, which can lead to addiction or death by overdose. A 2017 government report found that as many as 25% of patients with non-cancer chronic pain struggled with addiction to long-term prescription opioids. This had increased from a previous report stating that almost 2 million Americans were addicted to prescription opioids.²

For these patients, nonaddictive alternatives, such as cannabidiol CBD or palmitoylethanolamide (PEA), may be viable means of pain control. While there is a healthy body of research on CBD, research on PEA is still ongoing. What is PEA? What is its mechanism of action? What does the research show about its efficacy and comparison to CBD?

Fatty acid PEA

Palmitoylethanolamide (PEA) is a fatty acid that the body produces to reduce certain chronic pain and inflammatory conditions, including diabetic and chemotherapeutic neuropathy, carpal tunnel syndrome, sciatic pain, osteoarthritis, low-back pain, dental pain, neuropathic pain from stroke and multiple sclerosis, pelvic pain, post-herpetic neuralgia, and vaginal pain.⁴

PEA binds to certain receptors to turn off pain and inflammatory responses. Its main target is thought to be the peroxisome proliferator-activated receptor alpha (PPAR-α), which regulates genes that control pain and inflammation. In doing this, it switches off a particular set of signals that are pro-inflammatory.⁴

What does the research say?

A 2012 article in the Journal of Pain Research presented a case series of seven patients treated with PEA after standard therapies to treat pain and inflammation failed.⁴

The researchers concluded that PEA appeared to be a promising addition to similar analgesics for treating various chronic pain conditions. In addition, they found that the odds of serious side effects or adverse drug interactions were minimal, as PEA is also found in certain dairy foods, such as eggs and milk.⁴

A 2016 article in the British Journal of Clinical Pharmacology reviewed the findings from a group of 23 papers on the efficacy and safety of PEA, in order to determine a pattern of similarity among the findings.⁵

The researchers concluded: “The available clinical data support the contention that PEA has analgesic actions and motivate further study of this compound, particularly with respect to head‐to‐head comparisons of unmicronized vs. micronized formulations of PEA and comparisons with currently recommended treatments.”

With the current state of the opioid crisis, you should expect to see an increase in the number of patients in your practice who are seeking alternate ways to treat their chronic pain symptoms. PEA supplements may well provide them with the relief they seek.

References