Accurate Education - Nutraceutical Protocols: Myofascial Pain Syndrome (MPS)

Nutraceutical Protocols:

Myofascial Pain Syndrome (MPS)

Myofascial pain syndrome (MPS) is a chronic musculoskeletal condition characterized by localized muscle pain and sensitive “trigger points” within muscles and connective tissues (fascia). Key symptoms include deep aching pain, muscle tightness, reduced range of motion, and referred pain (pain that travels when trigger points are pressed or stretched. Causes include muscle injury, chronic stress, and repetitive motions. Treatment may include acupuncture, physical therapy, trigger point injections, dry needling, and pain medications. The use of nutraceutical compounds may also help with MPS pain.

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Definitions and Terms Related to Pain

Nutraceutical Protocols:

Myofascial Pain Syndrome (MPS)

Myofascial Pain Syndrome (MPS) is a chronic regional pain condition characterized by trigger points (TrPs) —hyperirritable spots within taut bands of muscle fibers that cause localized and referred pain.[1][2] MPS affects 30–93% of patients presenting to pain clinics and is often underrecognized due to symptom overlap with fibromyalgia, neuropathic pain, and joint disorders.[1][3]

One theory of the cause of MPS involves the “energy crisis hypothesis” in which excessive acetylcholine release at dysfunctional motor endplates leads to sustained muscle contraction, local ischemia, ATP depletion, and accumulation of sensitizing substances (substance P, CGRP, bradykinin, serotonin, norepinephrine, TNF-α, IL-1β, IL-6, IL-8).[4][5][6]

Pathophysiology to be targeted by nutraceuticals:

Energy crisis at motor endplates
ATP depletion
Local ischemia/hypoxia
Oxidative stress
Neuroinflammation (substance P, CGRP release)
Peripheral and Central Sensitization
Mitochondrial dysfunction
Micronutrient deficiencies

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MECHANISTIC RATIONALE FOR NUTRACEUTICAL APPROACH

The pathophysiology of MPS involves several mechanisms targetable by nutraceuticals:

1. Energy crisis/ATP depletion: Sustained muscle contraction depletes ATP, creating local ischemia. CoQ10, ALC, magnesium, and riboflavin support mitochondrial ATP production.[7][5]

2. Oxidative Stress: Local hypoxia generates reactive oxygen species. ALA, NAC, CoQ10, and resveratrol address oxidative stress.[34]

3. Neurogenic inflammation: Elevated substance P, CGRP, and proinflammatory cytokines sensitize nociceptors. PEA, curcumin, and omega-3 reduce neurogenic inflammation.[8][6]

4. Peripheral sensitization: Sensitizing substances lower nociceptor thresholds. Magnesium (NMDA antagonism) and PEA (endocannabinoid modulation) reduce sensitization.[9]

5. Central sensitization: Chronic MPS can lead to central sensitization. Melatonin, magnesium, and resveratrol address central mechanisms.[34]

6. Micronutrient deficiencies: Deficiencies in vitamin D, magnesium, B vitamins, and iron are associated with muscle pain and may perpetuate TrPs.[10][11][12]

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NUTRACEUTICAL PROTOCOL FOR MPS

Tier 1: Core Agents (Strongest Mechanistic Rationale)

Agent	Dosing Protocol	Mechanism/Rationale	References
Magnesium	400–600 mg daily (glycinate or malate)	NMDA receptor antagonism; essential for ATP production (Mg-ATP complex); muscle relaxation; deficiency common in chronic pain	[1], [2], [3], [4]
CoQ10	200–300 mg daily	Mitochondrial cofactor; addresses energy crisis; Reduces oxidative stress; Effective in fibromyalgia (related condition)	[5], [6]
PEA (Palmitoylethanolamide)	600 mg BID (ultramicronized)	Reduces neurogenic inflammation; Modulates mast cells; Effective for musculoskeletal pain; Reduces substance P/CGRP effects	[7], [8], [9]
Vitamin D3	25(OH)D Optimize level: 40–60 ng/mL	Deficiency causes: Skeletal muscle hypersensitivity and sensory hyperinnervation; Associated with muscle pain	[10], [11], [12]

[24][10][9][11] [7][25][8][26][27][28][12]

Magnesium Rationale: Magnesium is essential for ATP production (ATP exists as Mg-ATP complex), muscle relaxation, and NMDA receptor modulation. Deficiency is associated with chronic pain, and supplementation has shown analgesic effects in various pain conditions.[24][9] A cross-sectional analysis found higher incidence of magnesium deficiency in subjects with severe chronic pain.[11]
CoQ10 Rationale: The energy crisis hypothesis of MPS involves ATP depletion at trigger points.[5] CoQ10 is essential for mitochondrial ATP production and has demonstrated efficacy in fibromyalgia, a related condition with overlapping pathophysiology.[7][25]
Vitamin D Rationale: Vitamin D deficiency promotes skeletal muscle hypersensitivity and sensory hyperinnervation through increased nociceptor axon sprouting.[12] A meta-analysis found significantly lower 25(OH)D concentrations in patients with muscle pain (MD: -8.97 nmol/L) compared to controls.[28]

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Tier 2: Mitochondrial and Anti-Inflammatory Support

Agent	Dosing Protocol	Mechanism/Rationale	References
Acetyl-L-Carnitine (ALC)	500 mg 2–3x/day	Supports mitochondrial energy metabolism; analgesic via mGlu2 receptor upregulation; Effective in fibromyalgia; synergistic with PEA	[1], [2], [3], [4]
Riboflavin (B2)	100–400 mg/day	Mitochondrial cofactor (FAD); Supports energy production; Deficiency associated with muscle pain	[5]
Alpha-Lipoic Acid (ALA)	600 mg daily	Antioxidant; Addresses oxidative stress from local ischemia; synergistic with ALC	[6]
Curcumin	500 mg 3x/day (high bioavailability)	Anti-inflammatory; reduces TNF-α, IL-1β, IL-6; Inhibits NF-κB	[34]

[29][30][31][32][10][34]

ALC + PEA Synergy: A 2025 retrospective study found that adding ALC and PEA to standard care in fibromyalgia patients with small fiber involvement produced a significant median reduction in FIQR scores (-19.0 points, p<0.001) compared to no significant change with standard care alone.[30] A 2025 study of ALC + PEA + ALA combination in acute low back trauma showed significant reductions in neuropathic pain scores and reduced NSAID consumption.[31]
ALC in Fibromyalgia: A double-blind RCT found ALC (1500 mg oral + 500 mg IM daily) significantly improved tender point count, musculoskeletal pain, depression, and quality of life compared to placebo in fibromyalgia patients.[32]

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Tier 3: Supporting Agents

Agent	Dosing Protocol	Mechanism/Rationale	References
Omega-3 (EPA/DHA)	2 g daily	Anti-inflammatory; Reduces proinflammatory cytokines; Supports muscle membrane integrity	[34]
Melatonin	3–5 mg QHS	Addresses sleep disruption (common in MPS); Anti-inflammatory; Central Sensitization modulation	[34]
B-Complex	Daily (B1, B6, B12)	Deficiencies associated with muscle pain; Neural support; B12 deficiency lower in chronic pain	[1], [2]
Iron	If deficient (ferritin <50 ng/mL)	Iron deficiency associated with muscle pain and fatigue; check levels before supplementing	[3]

[10][11] [10]

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COMPREHENSIVE MPS PROTOCOL

Phase 1: Foundation (Weeks 1–4)

Goal: Address deficiencies, support energy metabolism

Magnesium (glycinate or malate): 400 mg daily (start 200 mg, titrate up)
Vitamin D3: Check 25(OH)D; if <30 ng/mL, load with 50,000 IU weekly × 8 weeks; maintenance 2,000–5,000 IU daily to target 40–60 ng/mL
CoQ10: 200 mg daily
B-Complex: Daily
Check iron studies; supplement if ferritin <50 ng/mL

Phase 2: Intensification (Weeks 4–8)

Goal: Address neurogenic inflammation and oxidative stress

Continue Phase 1 agents
Add PEA (ultramicronized): 600 mg BID
Add ALC: 500 mg BID
Increase Magnesium to 400–600 mg daily if tolerated
Increase CoQ10 to 300 mg daily

Phase 3: Optimization (Weeks 8–12+)

Goal: Full multimodal support

Continue effective agents
Add ALA: 600 mg daily
Add Omega-3: 2 g daily
Add Curcumin: 500 mg TID (high-bioavailability)
Consider Melatonin: 3–5 mg QHS if sleep disruption present
Transition PEA to 600 mg QD if pain well-controlled

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TRIGGER POINT-SPECIFIC CONSIDERATIONS

TrP Characteristic	Priority Nutraceuticals	Rationale	References
Active TrPs (spontaneously painful)	PEA, Magnesium, CoQ10	Higher concentrations of sensitizing substances; need anti-inflammatory and energy support	[1], [2]
Latent TrPs (painful only on compression)	Magnesium, Vitamin D, B-vitamins	Address underlying deficiencies; prevent activation	[3]
Multiple TrPs / Regional MPS	Full protocol; emphasize ALC + PEA	More extensive energy crisis; may overlap with fibromyalgia	[4]
Post-traumatic TrPs	PEA, Omega-3, Curcumin	Inflammatory component; tissue healing	[5]
Chronic/Refractory TrPs	Full protocol + Melatonin	Central sensitization likely; sleep optimization	[34]

[4][6] [10][11] [30] [31]

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REGIONAL MPS PROTOCOLS

Upper Trapezius / Cervical MPS

Priority	Agent	Dosing	Rationale	References
1st	Magnesium	400–600 mg daily	Muscle relaxation; NMDA antagonism	[1]
2nd	PEA	600 mg 2x/day	Reduces neurogenic inflammation	[2]
3rd	CoQ10	200–300 mg daily	Energy crisis support	[3]
4th	Vitamin D3	Optimize to 40–60 ng/mL	Muscle hypersensitivity	[4]
5th	Melatonin	3–5 mg at night	Often associated with tension headache; sleep	[5]

[24][9][11][25] [8][12][26]

Lumbar / Gluteal MPS

Priority	Agent	Dosing	Rationale	34
1st	Magnesium	400–600 mg daily	Muscle relaxation; common deficiency	[1]
2nd	PEA + ALC	PEA 600 mg 2x/day + ALC 500 mg 2x/day	Synergistic for low back pain	[2]
3rd	Vitamin D3	Optimize to 40–60 ng/mL	Muscle function	[3]
4th	Omega-3	2 g daily	Anti-inflammatory	[34]
5th	Curcumin	500 mg TID	Anti-inflammatory	[34]

[24][9][11][30][31][12]

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INTEGRATION WITH STANDARD MPS TREATMENT

Nutraceuticals should complement, not replace, evidence-based MPS treatments. The 2025 MPS review notes that local anesthetic injections have sufficient evidence, while dry needling, acupuncture, manual therapy, and physical therapy have some evidence of efficacy.[1]

Standard Treatment	Nutraceutical Synergy	Rationale	References
Trigger Point Injections	Magnesium CoQ10 PEA	Address underlying energy crisis and inflammation; may reduce injection frequency	[1], [2]
Dry Needling	PEA, ALC	Reduce neurogenic inflammation; Support tissue healing	[3]
Physical Therapy / Stretching	Magnesium, Vitamin D	Muscle function; reduce cramping	[4]
Manual Therapy / Massage	Omega-3 Curcumin	Anti-inflammatory support	[34]
Heat Therapy	CoQ10 ALC	Enhance blood flow and energy metabolism	[5]

[1][2][30][31][10][12] [7]

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ADDRESSING PERPETUATING FACTORS

MPS is often perpetuated by systemic factors that nutraceuticals can address:

Perpetuating Factor	Nutraceutical Approach	Rationale	References
Vitamin D deficiency	Vitamin D3 optimization	Causes muscle hypersensitivity and hyperinnervation	[1]
Magnesium deficiency	Magnesium 400–600 mg/day	Essential for muscle relaxation and ATP	[2]
Iron deficiency	Iron supplementation if ferritin <50	Associated with muscle pain and fatigue	[3]
B-vitamin deficiency	B-complex daily	B12, folate deficiency associated with chronic pain	[4]
Sleep disruption	Melatonin 3–5 mg at night	Poor sleep perpetuates pain; Common in MPS	[34]
Oxidative stress	ALA, NAC, CoQ10	Local ischemia generates ROS	[34]

[12] [9][11] [10] [11]

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Expected Timeline:

Weeks 1–2: Possible improvement in sleep (melatonin), muscle relaxation (magnesium)
Weeks 2–4: Initial anti-inflammatory effects; possible modest pain reduction
Weeks 4–8: More substantial improvement if responding; vitamin D levels normalizing
Weeks 8–12: Full assessment of efficacy; trigger point reassessment

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SPECIAL CONSIDERATIONS

MPS vs. Fibromyalgia: MPS and fibromyalgia have overlapping features but are distinct conditions. MPS is regional with identifiable trigger points, while fibromyalgia is widespread with tender points and central sensitization.[1][33] Patients with chronic MPS may develop fibromyalgia-like features. The nutraceutical approach for MPS overlaps significantly with fibromyalgia protocols, particularly for patients with multiple trigger points or central sensitization features.
Occupational/Postural Factors: MPS is often perpetuated by muscle overuse and postural imbalance.[1] Nutraceuticals address the biochemical consequences but do not replace ergonomic interventions and postural correction.
Psychological Factors: Psychological and behavioral influences contribute to MPS persistence.[1] Consider addressing stress, anxiety, and depression, which may benefit from omega-3, magnesium, and melatonin.

Drug Interactions:

Magnesium: May reduce absorption of certain antibiotics and bisphosphonates; separate dosing
ALC: Generally well-tolerated; may enhance anticoagulant effects
CoQ10: May reduce warfarin efficacy; monitor INR

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PATIENT EDUCATION HANDOUT

Managing Myofascial Pain: Your Supplement Guide

Understanding Myofascial Pain Syndrome

Myofascial pain syndrome (MPS) is a common condition that causes muscle pain and tenderness. It’s caused by “trigger points”—tight, tender knots in your muscles that can cause pain both at the spot and in other areas of your body (referred pain).

Trigger points develop when muscles are overworked, injured, or held in awkward positions for too long. Inside these trigger points, there’s an “energy crisis”—the muscle fibers are stuck in a contracted state and can’t relax properly because they’re not getting enough energy (ATP) and oxygen.

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Why Supplements May Help

The supplements your healthcare provider has recommended target the underlying problems in trigger points:

– Supporting energy production in your muscles

– Reducing inflammation around trigger points

– Correcting nutrient deficiencies that can make muscle pain worse

– Helping muscles relax properly

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Your Core Supplements

Magnesium – 400–600 mg daily

– Essential for muscle relaxation and energy production

– Many people with chronic pain are low in magnesium

– Best forms: magnesium glycinate or magnesium malate (gentler on stomach)

– Start with 200 mg and increase gradually to avoid loose stools

Coenzyme Q10 (CoQ10) – 200–300 mg daily

– Helps your muscles produce energy (ATP)

– Addresses the “energy crisis” in trigger points

– Also a powerful antioxidant

– Take with food for better absorption

Vitamin D3 – Dose based on your blood level

– Low vitamin D can make muscles more sensitive to pain

– Your provider will check your level and recommend the right dose

– Goal is usually 40–60 ng/mL

PEA (Palmitoylethanolamide) – 600 mg twice daily

– A natural substance that reduces inflammation in muscles and nerves

– Helps calm the pain signals from trigger points

– Very well tolerated with few side effects

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Additional Helpful Supplements

Acetyl-L-Carnitine (ALC) – 500 mg twice daily

– Supports energy production in muscles

– Has pain-relieving properties

– Works well together with PEA

Alpha-Lipoic Acid – 600 mg daily

– A powerful antioxidant

– Helps with the oxidative stress caused by poor blood flow in trigger points

B-Complex Vitamins – Daily

– Support energy production and nerve function

– Deficiencies are common in people with chronic pain

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What to Expect

Trigger points take time to resolve, and supplements work gradually:

– Weeks 1–2: You may notice improved sleep and less muscle tension

– Weeks 2–4: Some people begin to notice reduced pain

– Weeks 4–8: More noticeable improvement if supplements are helping

– Weeks 8–12: Full assessment of how well the program is working

Be patient – these supplements address the underlying causes of your trigger points, not just the symptoms.

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Important Safety Information

– Continue any treatments recommended by your healthcare provider (physical therapy, injections, etc.)

– Tell your provider about all supplements you take

– Magnesium may cause loose stools – start low and increase gradually

– CoQ10 may interact with blood thinners – let your provider know if you take warfarin

– Most side effects are mild (stomach upset)

When to Contact Your Healthcare Provider:

– If your pain significantly worsens

– If you develop new symptoms

– If you experience any concerning side effects

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Tips for Success

1. Be consistent: Take supplements at the same time each day

2. Address the cause: Supplements work best alongside physical therapy and ergonomic changes

3. Stay hydrated: Dehydration can worsen muscle pain

4. Stretch regularly: Gentle stretching helps release trigger points

5. Manage stress: Stress can tighten muscles and activate trigger points

6. Improve posture: Poor posture is a common cause of trigger points

7. Get enough sleep: Poor sleep makes pain worse

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Working With Your Healthcare Team

These supplements are meant to work alongside other treatments for myofascial pain, such as:

– Physical therapy and stretching

– Trigger point injections or dry needling

– Massage and manual therapy

– Heat therapy

– Ergonomic improvements

Together with your healthcare team, you can find the best combination of treatments to reduce your trigger points and improve your quality of life.

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Clinical Implementation Notes

The evidence for nutraceuticals specifically in MPS is limited, as most studies focus on the related condition of fibromyalgia or general chronic musculoskeletal pain. However, the mechanistic rationale is strong given the energy crisis hypothesis of trigger point pathophysiology.[4][5][6]

Magnesium has the strongest rationale given its essential role in ATP production (ATP exists as Mg-ATP complex), muscle relaxation, and NMDA receptor modulation. A systematic review found equivocal but promising evidence for magnesium in chronic pain.[24]

CoQ10 addresses the mitochondrial dysfunction and ATP depletion central to trigger point pathophysiology. While direct MPS studies are lacking, efficacy in fibromyalgia (a related condition) supports its use.[7][25]

PEA has demonstrated efficacy for musculoskeletal pain (SMD -0.74) in meta-analysis.[8] Its mechanism of reducing neurogenic inflammation and modulating mast cells is relevant to the elevated substance P, CGRP, and inflammatory cytokines found at trigger points.[6]

Vitamin D deficiency causes skeletal muscle hypersensitivity and sensory hyperinnervation through increased nociceptor axon sprouting.[12] Optimization is particularly important given the high prevalence of deficiency in chronic pain populations.[11][28]

ALC + PEA combination has emerging evidence in fibromyalgia with small fiber involvement and acute low back pain, suggesting synergistic effects.[30][31]

Important caveats: The 2025 MPS review notes that pharmacological treatments (NSAIDs, muscle relaxants, antidepressants, gabapentin, opioids) have insufficient or inconclusive evidence.[1] Nutraceuticals should be viewed as part of a multimodal approach that includes physical therapy, trigger point injections, and ergonomic interventions. The evidence base for nutraceuticals in MPS specifically requires further development through well-designed clinical trials.

References

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Myofascial Pain – A Major Player in Musculoskeletal Pain. Lam C, Francio VT, Gustafson K, et al. Best Practice & Research. Clinical Rheumatology. 2024;38(1):101944. doi:10.1016/j.berh.2024.101944.
Treatment and Management of Myofascial Pain Syndrome. Urits I, Charipova K, Gress K, et al. Best Practice & Research. Clinical Anaesthesiology. 2020;34(3):427-448. doi:10.1016/j.bpa.2020.08.003.
New Views of Myofascial Trigger Points: Etiology and Diagnosis. Simons DG. Archives of Physical Medicine and Rehabilitation. 2008;89(1):157-9. doi:10.1016/j.apmr.2007.11.016.
Acupotomy Alleviates Energy Crisis at Rat Myofascial Trigger Points. Zhang Y, Du NY, Chen C, et al. Evidence-Based Complementary and Alternative Medicine : eCAM. 2020;2020:5129562. doi:10.1155/2020/5129562.
Myofascial Trigger Points Then and Now: A Historical and Scientific Perspective. Shah JP, Thaker N, Heimur J, et al. PM & R : The Journal of Injury, Function, and Rehabilitation. 2015;7(7):746-761. doi:10.1016/j.pmrj.2015.01.024.
Targeted Treatment of Age-Related Fibromyalgia With Supplemental Coenzyme Q10. Hargreaves IP, Mantle D. Advances in Experimental Medicine and Biology. 2021;1286:77-85. doi:10.1007/978-3-030-55035-6_5.
Meta-Analysis of Palmitoylethanolamide in Pain Management: Addressing Literature Gaps and Enhancing Understanding. Viña I, López-Moreno M. Nutrition Reviews. 2025;83(7):e1604-e1618. doi:10.1093/nutrit/nuae203.
Magnesium in Pain Research: State of the Art. Srebro D, Vuckovic S, Milovanovic A, et al. Current Medicinal Chemistry. 2017;24(4):424-434. doi:10.2174/0929867323666161213101744.
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Micronutrients and Chronic Pain: A Cross-Sectional Analysis. Goon M, Schmidt N, Berwal D, et al. Pain Practice : The Official Journal of World Institute of Pain. 2025;25(5):e70053. doi:10.1111/papr.70053.
Vitamin D Deficiency Promotes Skeletal Muscle Hypersensitivity and Sensory Hyperinnervation. Tague SE, Clarke GL, Winter MK, et al. The Journal of Neuroscience : The Official Journal of the Society for Neuroscience. 2011;31(39):13728-38. doi:10.1523/JNEUROSCI.3637-11.2011.
Management of Central Poststroke Pain: Systematic Review and Meta-Analysis. Tamasauskas A, Silva-Passadouro B, Fallon N, et al. The Journal of Pain. 2025;26:104666. doi:10.1016/j.jpain.2024.104666.
Guidelines for Adult Stroke Rehabilitation and Recovery: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Winstein CJ, Stein J, Arena R, et al. Stroke. 2016;47(6):e98-e169. doi:10.1161/STR.0000000000000098.
Pharmacotherapy to Manage Central Post-Stroke Pain. Choi HR, Aktas A, Bottros MM. CNS Drugs. 2021;35(2):151-160. doi:10.1007/s40263-021-00791-3.
MED1/BDNF/TrkB Pathway Is Involved in Thalamic Hemorrhage-Induced Pain and Depression by Regulating Microglia. Infantino R, Schiano C, Luongo L, et al. Neurobiology of Disease. 2022;164:105611. doi:10.1016/j.nbd.2022.105611.
The Role of the Immune System in the Generation of Neuropathic Pain. Calvo M, Dawes JM, Bennett DL. The Lancet. Neurology. 2012;11(7):629-42. doi:10.1016/S1474-4422(12)70134-5.
P2X4R Contributes to Central Disinhibition via TNF-α/TNFR1/GABAaR Pathway in Post-Stroke Pain Rats. Lu J, Guo X, Yan M, et al. The Journal of Pain. 2021;22(8):968-980. doi:10.1016/j.jpain.2021.02.013.
A Novel Endoplasmic Reticulum-Targeted Metal-Organic Framework-Confined Ruthenium (Ru) Nanozyme Regulation of Oxidative Stress for Central Post-Stroke Pain. Bai Q, Han Y, Khan S, et al. Advanced Healthcare Materials. 2024;13(2):e2302526. doi:10.1002/adhm.202302526.
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Palmitoylethanolamide in the Treatment of Chronic Pain Caused by Different Etiopathogenesis. Gatti A, Lazzari M, Gianfelice V, et al. Pain Medicine (Malden, Mass.). 2012;13(9):1121-30. doi:10.1111/j.1526-4637.2012.01432.x.
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Effect of Coenzyme Q10 Evaluated by 1990 and 2010 ACR Diagnostic Criteria for Fibromyalgia and SCL-90-R: Four Case Reports and Literature Review. Alcocer-Gómez E, Cano-García FJ, Cordero MD. Nutrition (Burbank, Los Angeles County, Calif.). 2013 Nov-Dec;29(11-12):1422-5. doi:10.1016/j.nut.2013.05.005.
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Nutraceutical Interactions with Opioid Pain Processing

Emphasis on Education

Accurate Clinic promotes patient education as the foundation of it’s medical care. In Dr. Ehlenberger’s integrative approach to patient care, including conventional and complementary and alternative medical (CAM) treatments, he may encourage or provide advice about the use of supplements. However, the specifics of choice of supplement, dosing and duration of treatment should be individualized through discussion with Dr. Ehlenberger. The following information and reference articles are presented to provide the reader with some of the latest research to facilitate evidence-based, informed decisions regarding the use of conventional as well as CAM treatments.

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Should you wish more information regarding any of the subjects listed – or not listed – here, please contact Dr. Ehlenberger. He has literally thousands of published articles to share on hundreds of topics associated with pain management, weight loss, nutrition, addiction recovery and emergency medicine. It would take years for you to read them, as it did him.

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