Combination of Rehabilitative Therapy with Ultramicronized Palmitoylethanolamide for Chronic Low Back Pain: An Observational Study

Dalila Scaturro; Chiara Asaro; Lorenza Lauricella; Sofia Tomasello; Giustino Varrassi; Giulia Letizia Mauro

doi:10.1007/s40122-019-00140-9

Combination of Rehabilitative Therapy with Ultramicronized Palmitoylethanolamide for Chronic Low Back Pain: An Observational Study

Pain Ther. 2020 Jun;9(1):319-326. doi: 10.1007/s40122-019-00140-9. Epub 2019 Dec 20.

Authors

Dalila Scaturro¹, Chiara Asaro², Lorenza Lauricella¹, Sofia Tomasello³, Giustino Varrassi⁴, Giulia Letizia Mauro¹

Affiliations

¹ Department of Physical Medicine and Rehabilitation, University Hospital "P. Giaccone", Palermo, Italy.
² Department of Physical Medicine and Rehabilitation, University Hospital "P. Giaccone", Palermo, Italy. chiarasaro@virgilio.it.
³ School of Medicine and Surgery, University of Palermo, Palermo, Italy.
⁴ Paolo Procacci Foundation, Via Tacito 7, 00193, Rome, Italy.

Abstract

Introduction: 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.

Methods: 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.

Results: 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.

Conclusions: 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.

Keywords: Chronic low back pain; Complementary and alternative medicine; Multidisciplinary therapies; Multitarget approach; Ultramicronized palmitoylethanolamide.