| Abstract: |
Neuropathic pain is a chronic disorder that can severely impair health and quality of life, caused by a lesion or dysfunction in the somatosensory nervous system with an estimated prevalence between 7–10% of world population. Conventional pharmacological modalities, such as gabapentinoids, tricyclic antidepressants and serotonin-norepinephrine reuptake inhibitors are partially effective but commonly associated with dose-limiting side effects. Research on herbal remedies has been attracting more scientific interest as possible alternative or adjuvant treatments. Design: Double-blind, randomized controlled trial Setting: A total of 120 patients with a clinical diagnosis of chronic neuropathic pain were randomly assigned to one or more active herbal interventions curcumin [Curcuma longa], ginger extract [Zingiber officinale], boswellic acid [Boswellia serrata] and topical capsaicin in the form of a cream +2% Cannabis sativa dose regimens over an intervention period lasting >12 weeks. Visual Analogue Scale (VAS) and Neuropathic Pain Symptom Inventory(NPSI) were used as the primary outcome assessment. The secondary outcomes were the levels of pro-inflammatory biomarkers (TNF-α, IL-6 and CRP), quality-of-life indices (SF-36) as well as post intervention Patient Global Impression of Change scale (PGIC). In the structural analysis of pooled data, all five herbal interventions produced a greater than or equal to 30% reduction in pain scores as compared with placebo (all p < 0.001). The mean VAS reduction was also greatest with CBD oil (4.5 points, 62.5%), capsaicin (3·7 points, 48·7%) and curcumin (4-4points);58・8%). Blood-based inflammatory biomarker analysis showed consistent and significantly greater reductions in TNF-α and IL-6 among those assigned to active treatment groups. The adverse event profile was mildly-moderate and controllable in every herbal group. In conjunction, these findings bolster the pharmacological validation of enrolled standardised herbal extracts as efficacious and tolerable treatment possibilities for chronic neuropathic pain management. |
