TY - JOUR
T1 - Efficacy and Safety of Magnesium for the Management of Chronic Pain in Adults
T2 - A Systematic Review
AU - Park, Rex
AU - Ho, Anthony M-H
AU - Pickering, Gisele
AU - Arendt-Nielsen, Lars
AU - Mohiuddin, Mohammed
AU - Gilron, Ian
PY - 2020/9
Y1 - 2020/9
N2 - Chronic pain is a highly prevalent and complex health problem that is associated with a heavy symptom burden, substantial economic and social impact, and also, very few highly effective treatments. This review examines evidence for the efficacy and safety of magnesium in chronic pain. The previously published protocol for this review was registered in International Prospective Register of Systematic Reviews (PROSPERO), MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials (CENTRAL) databases were searched until September 2018. We included randomized controlled trials (RCTs) comparing magnesium (at any dose, frequency, or route of administration) with placebo using participant-reported pain measures. A total of 9 RCTs containing 418 participants were included. Three studies examined neuropathic pain (62 participants), 3 examined migraines (190 participants), 2 examined complex regional pain syndrome (86 participants), and 1 examined low back pain with a neuropathic component (80 participants). Heterogeneity of included studies precluded any meta-analyses. No judgment could be made about safety because adverse events were inconsistently reported in the included studies. Evidence of analgesic efficacy from included studies was equivocal. However, reported efficacy signals in some of the included trials provide a rationale for more definitive studies. Future, larger-sized trials with good assay sensitivity and better safety assessment and reporting, as well as careful attention to formulations with optimal bioavailability, will serve to better define the role of magnesium in the management of chronic pain.
AB - Chronic pain is a highly prevalent and complex health problem that is associated with a heavy symptom burden, substantial economic and social impact, and also, very few highly effective treatments. This review examines evidence for the efficacy and safety of magnesium in chronic pain. The previously published protocol for this review was registered in International Prospective Register of Systematic Reviews (PROSPERO), MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials (CENTRAL) databases were searched until September 2018. We included randomized controlled trials (RCTs) comparing magnesium (at any dose, frequency, or route of administration) with placebo using participant-reported pain measures. A total of 9 RCTs containing 418 participants were included. Three studies examined neuropathic pain (62 participants), 3 examined migraines (190 participants), 2 examined complex regional pain syndrome (86 participants), and 1 examined low back pain with a neuropathic component (80 participants). Heterogeneity of included studies precluded any meta-analyses. No judgment could be made about safety because adverse events were inconsistently reported in the included studies. Evidence of analgesic efficacy from included studies was equivocal. However, reported efficacy signals in some of the included trials provide a rationale for more definitive studies. Future, larger-sized trials with good assay sensitivity and better safety assessment and reporting, as well as careful attention to formulations with optimal bioavailability, will serve to better define the role of magnesium in the management of chronic pain.
KW - Analgesics/administration & dosage
KW - Chronic Pain/diagnosis
KW - Humans
KW - Magnesium Compounds/administration & dosage
KW - Pain Management
KW - Pain Measurement
KW - Patient Safety
KW - Randomized Controlled Trials as Topic
KW - Risk Factors
KW - Treatment Outcome
UR - http://www.scopus.com/inward/record.url?scp=85090568062&partnerID=8YFLogxK
U2 - 10.1213/ANE.0000000000004673
DO - 10.1213/ANE.0000000000004673
M3 - Review article
C2 - 32049671
SN - 0003-2999
VL - 131
SP - 764
EP - 775
JO - Anesthesia and Analgesia
JF - Anesthesia and Analgesia
IS - 3
ER -