Scaturro Dalila, Asaro Chiara, Lauricella Lorenza, Tomasello Sofia, Varrassi Giustino, Letizia Mauro Giulia
Department of Physical Medicine and Rehabilitation, University Hospital "P. Giaccone", Palermo, Italy.
School of Medicine and Surgery, University of Palermo, Palermo, Italy.
Pain Ther. 2020 Jun;9(1):319-326. doi: 10.1007/s40122-019-00140-9. Epub 2019 Dec 20.
Chronic low back pain (LBP) caused by intervertebral disc herniation was reported in the 2010 Global Burden of Disease study to be the main reason for years lived with disability. It causes significant personal, social, and economic burdens. Many of those who suffer from LBP find conventional medical treatments to be unsatisfactory for treating their pain, so they are increasingly resorting to complementary and alternative medicine (CAM) therapies. Given that the population is aging, there is an urgent need to characterize the combinations of complementary therapies that yield the best outcomes and treatments, even for prolonged periods. This observational study aimed to evaluate the effect of ultramicronized palmitoylethanolamide (umPEA) + CAM (daily functional rehabilitation + decontracting massage) therapies on chronic pain in patients suffering from multiple herniated discs in the lumbar spine.
Eligible patients received 600 mg of umPEA twice a day in combination with a daily functional rehabilitation session according to the McKenzie Method of Mechanical Diagnosis and Therapy plus a decontracting massage for 20 consecutive days, followed by 600 mg of umPEA once a day for 40 days in addition to standard therapy.
The results showed that the average pain intensity score, evaluated via the Numeric Rating Scale, progressively decreased during the study period, reaching a value that was not clinically relevant at the end of the observation period. Pain relief was paralleled by improvements in the physical and mental components of quality of life as evaluated with the SF-36 questionnaire as well as in disability for low back pain as evaluated with the Oswestry Disability Questionnaire. Collectively, the results demonstrate that umPEA in combination with CAM therapies could be an important strategy for combating LBP.
The multiple action of PEA in combination with CAM therapies may represent the multitarget approach needed to tackle the as-yet unsolved problem of chronic pain resistant to conventional therapies.
2010年全球疾病负担研究报告称，椎间盘突出引起的慢性腰痛（LBP）是导致残疾生存年数的主要原因。它造成了巨大的个人、社会和经济负担。许多腰痛患者发现传统医学治疗对缓解疼痛并不令人满意，因此他们越来越多地求助于补充和替代医学（CAM）疗法。鉴于人口老龄化，迫切需要确定即使长期使用也能产生最佳效果的补充疗法组合。这项观察性研究旨在评估超微化棕榈酰乙醇酰胺（umPEA）+CAM（每日功能康复+放松按摩）疗法对腰椎多节段椎间盘突出症患者慢性疼痛的影响。
符合条件的患者每天两次接受600毫克umPEA，同时根据麦肯齐机械诊断与治疗方法进行每日功能康复训练，并连续20天进行放松按摩，随后除标准治疗外，每天一次服用600毫克umPEA，持续40天。
结果显示，通过数字评分量表评估的平均疼痛强度评分在研究期间逐渐下降，在观察期结束时达到无临床意义的值。疼痛缓解的同时，用SF-36问卷评估的生活质量的身体和心理成分以及用Oswestry残疾问卷评估的腰痛残疾情况也有所改善。总体而言，结果表明umPEA与CAM疗法联合使用可能是对抗LBP的重要策略。
PEA与CAM疗法的多重作用可能代表了解决传统疗法难以治愈的慢性疼痛这一尚未解决的问题所需的多靶点方法。
