Accurate Education - Nutraceutical Protocols: Preventing the Transition From Acute to Chronic Pain After Trauma or Surgery.

Nutraceutical Protocols:

Preventing the Transition From Acute to Chronic Pain After Trauma or Surgery

Chronic post-surgical pain (CPSP) is defined as “pain persisting for at least 2–3 months or longer, following a surgical procedure. It often results from nerve damage or severe acute pain and may affect up to 10–50% of patients. Key risk factors include preoperative pain, anxiety, and specific surgeries like amputations or mastectomies. Prevention requires managing pre-operative, intra-operative, and post-operative pain.

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Acute Pain, Avoiding Transition to Chronic Pain

Nutraceutical Protocols:

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Definitions and Terms Related to Pain

Nutraceutical Protocols:

Preventing the Transition From Acute to Chronic Pain After Trauma or Surgery.

When conditions are right, (actually wrong), the usual acute pain associated with a new traumatic injury or surgery persists rather than resolves normall, leading to a transition from acute to chronic pain. A thorough review of the risks and factors that contribute to this transition is beyond the scope of this page, but can be found here: Acute Pain, Avoiding Transition to Chronic Pain.

This section focuses specifically on protocols for the use of nutraceuticals to combat the processes that contribute to the transition of acute to chronic pain. These pathologic processes are summarized here:

Pathophysiology Targeted:

Peripheral and Central Sensitization – Changes in nerves causing pain to become magnified
Neuroinflammation- immune system activation causing pain to persist with greater severity
Oxidative Stress – nerve damage from build-up of toxic compounds like free radical
Nerve injury-induced plasticity – the nervous system’s capacity to reorganize its structure and function following damage. While aiding functional recovery, this plasticity can cause pathologic outcomes like chronic pain or phantom limb sensations.

PROTOCOL OVERVIEW

The protocols are divided into three phases:

Preoperative Optimization (2–4 weeks before surgery)
Perioperative Window (day of surgery through 72 hours)
Postoperative Transition Prevention (1–12 weeks).

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PHASE 1: PRE-OPERATIVE OPTIMIZATION (2–4 Weeks Before Surgery)

Agent	Dosing Protocol	Mechanism/Rationale	References
Vitamin D3	Dose to achieve 25(OH)D ≥30 ng/mL; loading dose 50,000 IU weekly × 2–4 weeks if deficient	Vitamin D3 deficiency: increases CPSP risk; increases perioperative opioid use; modifies opioid signaling	[1], [2], [3], [4]
Omega-3 (EPA/DHA)	2 g daily starting 10–14 days preoperatively	Reduces postoperative pain and CRP; anti-inflammatory; prevents neuropathic pain	[5], [6], [7], [8]
Magnesium	400–500 mg daily (glycinate or citrate)	Preoperative optimization; NMDA receptor modulation; enhances opioid analgesia	[9], [10], [11]
Palmitoylethanolamide (PEA)	600 mg BID starting 1–2 weeks preoperatively	Reduces immune (glial) activation; neuroprotective; delays opioid tolerance	[36] ][12]
Curcumin	500 mg TID (high-bioavailability) starting 1 week preoperatively	Reduces neuroinflammation; inhibits NF-κB, COX-2; may prevent central sensitization	[13], [14]

[24][3][19][25][26][27][5][6][7][8][28][9][29]

Preoperative Assessment Checklist:

Check blood Vitamin 3 25(OH)D level; correct deficiency aggressively (target ≥30 ng/mL, ideally 40–60 ng/mL)
Identify high-risk patients: preoperative chronic pain, anxiety, depression, catastrophizing, younger age, female sex[4]
Consider low-saturated fat, low-added sugar dietary pattern to reduce baseline neuroinflammation[3]

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PHASE 2: PERIOPERATIVE WINDOW (Day of Surgery Through 72 Hours)

Agent	Dosing Protocol	Mechanism/Rationale	References
Magnesium sulfate IV	30–50 mg/kg bolus, then 6–20 mg/kg/hr infusion intraoperatively; continue oral 400 mg daily postoperatively	Reduces postoperative pain (WMD -0.74 at ≤4h) and opioid consumption (WMD -10.52 mg morphine equivalents); prevents Grin1 upregulation	[1], [2], [3], [4], [5]
Omega-3 (EPA/DHA)	Continue 2 g daily	Maintains anti-inflammatory state; reduces surgical stress response	[6], [7]
PEA	600 mg BID	Reduces spinal glial activation; enhances opioid analgesia; neuroprotective	[36]
Melatonin	5–10 mg QHS starting night of surgery	Reduces NLRP3 inflammasome; opioid synergy; sleep optimization critical for recovery	[36][8]
Vitamin C	1–2 g daily	Reduces oxidative stress; may reduce CRPS risk after limb surgery	[9]

[24][31][27][5][32][6][33][7]

Perioperative Magnesium Evidence: A 2013 meta-analysis of 20 RCTs (1,257 subjects) found perioperative magnesium significantly reduced pain at rest (WMD -0.74 at ≤4h; -0.36 at 24h) and opioid consumption (WMD -10.52 mg morphine IV equivalents).[6] A 2025 narrative review confirmed magnesium reduces postoperative pain intensity and opioid requirements across various surgical populations through NMDA receptor antagonism and reduction of central sensitization.[5]
Preclinical Evidence for CPSP Prevention: A single preoperative magnesium sulfate injection reduced mechanical hyperalgesia for 17 days in a rat CPSP model and prevented Grin1 mRNA upregulation in the spinal cord dorsal horn.[7]

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PHASE 3: POSTOPERATIVE TRANSITION PREVENTION (1–12 Weeks)

This phase is critical for preventing the transition from acute to chronic pain. The goal is to address ongoing neuroinflammation, oxidative stress, and central sensitization while supporting tissue healing.

Agent	Dosing Protocol	Duration	Mechanism/Rationale	References
Palmitoylethanolamide (PEA)	600 mg BID × 4 weeks → 600 mg QD × 8 weeks	12 weeks total	Reduces glial activation; neuroprotective; prevents opioid tolerance; effective for CPSP	[1], [2], [3]
Magnesium	400–500 mg daily	12 weeks	Maintains NMDA receptor modulation; prevents central sensitization	[4], [5]
Alpha-Lipoic Acid (ALA)	600 mg daily	8–12 weeks	Reduces oxidative stress; prevents nerve damage; synergistic with NAC	[36][6]
Omega-3 (EPA/DHA)	2 g daily	12 weeks minimum	Anti-inflammatory; accelerates nerve regeneration; prevents neuropathic pain	[7], [8], [9]
Melatonin	3–10 mg QHS	4–8 weeks	Sleep optimization; NLRP3 inhibition; opioid synergy	[36]
Curcumin	500 mg TID (high-bioavailability)	8–12 weeks	Anti-inflammatory; inhibits CaMKIIα; prevents tolerance	[36][10]
Vitamin D3	Maintain 25(OH)D 40–60 ng/mL	Ongoing	Modulates opioid signaling; reduces CPSP risk	[11], [12], [13]
B-Complex vitamins	B1 100 mg, B6 100 mg, B12 1000 mcg daily	8–12 weeks	Neural metabolism support; synergistic with gabapentin for neuropathic pain	[6], [14]

[24][34][15][19][26][35][13][8][9][29]

Combination Evidence: B vitamins combined with gabapentin show efficacy for CPSP including neuropathic pain; B vitamins combined with diclofenac are effective against low back pain.[24] ALA combined with NAC shows enhanced effects on morphine tolerance and dependence.[Document]

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SURGERY-SPECIFIC CONSIDERATIONS

Surgery Type	CPSP Incidence	High-Risk Features	Additional Nutraceutical Considerations	References
Thoracotomy	30–50%	Intercostal nerve damage	Emphasize ALA, PEA, B-vitamins for nerve protection	[1]
Mastectomy	20–50%	Axillary dissection, young age	PEA, ALA, omega-3; consider higher melatonin doses	[1]
Amputation	50–85%	Phantom limb pain risk	Aggressive multimodal approach; all agents at higher doses	[1], [2]
Knee arthroplasty	10–34%	Preoperative pain, vitamin D deficiency	Optimize vitamin D; curcumin, Boswellia for joint inflammation	[3], [4]
Hernia repair	5–35%	Mesh placement, nerve entrapment	PEA, ALA for nerve protection; omega-3 for inflammation	[1]
Cesarean section	6–18%	Emergency surgery, preoperative anxiety	Magnesium, melatonin, omega-3	[1]
Orthopedic trauma	Variable	Nerve injury, prolonged immobilization	Full protocol; emphasize omega-3 for nerve regeneration	[5], [6]

[1][2][26][4][8][29]

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RISK STRATIFICATION AND PROTOCOL INTENSITY

Risk Level	Patient Characteristics	Protocol Intensity	References
Low Risk	No preoperative pain, no anxiety/depression, minor surgery, adequate vitamin D	Core agents only: Magnesium, Omega-3, Vitamin D optimization	[1], [2]
Moderate Risk	Mild preoperative pain, some anxiety, moderate surgery	Core + PEA, Melatonin, Curcumin	[1], [2][3]
High Risk	Significant preoperative pain, anxiety/depression, catastrophizing, major surgery, nerve injury risk, vitamin D deficiency	Full protocol: All agents at higher doses; longer duration (12+ weeks)	[1], [2][3][4]

[1][2][4][8][9]

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TIMELINE SUMMARY

Preoperative (2–4 weeks before)

Optimize vitamin D (target ≥30 ng/mL)
Start omega-3 2 g daily (10–14 days before)
Start magnesium 400 mg daily
Start PEA 600 mg BID (1–2 weeks before)
Start curcumin 500 mg TID (1 week before)
Detary optimization: low-saturated fat, low-added sugar

Day of Surgery

IV magnesium bolus + infusion
Continue all oral supplements (with sips of water if permitted)
Melatonin 5–10 mg night of surgery

Postoperative Days 1–7

Transition to oral magnesium 400 mg daily
Continue PEA 600 mg BID
Continue omega-3 2 g daily
Continue melatonin 5–10 mg QHS
Add ALA 600 mg daily
Add B-complex vitamins
Add vitamin C 1–2 g daily

Postoperative Weeks 2–4

Continue all agents
Assess pain progress; if pain not resolving as expected, intensify protocol
Monitor for signs of central sensitization (allodynia, hyperalgesia, spreading pain)

Postoperative Weeks 4–12

Transition PEA to 600 mg QD if pain well-controlled
Continue magnesium, omega-3, ALA, vitamin D
Taper melatonin if sleep normalized
Continue curcumin for ongoing inflammation

Beyond 12 Weeks

Reassess; if pain-free, consider gradual discontinuation
Maintain vitamin D optimization long-term
Consider ongoing omega-3 for general health benefits

Detailed Process Summary:

The transition from acute to chronic pain involves central sensitization, neuroinflammation with glial activation, and NMDA receptor-mediated plasticity.[3][4] A network meta-analysis found that IV lidocaine, ketamine, and gabapentinoids reduce CPSP incidence at ≤6 months, with analgesics more effective at higher baseline risk.[1] Perioperative magnesium reduces postoperative pain and opioid consumption through NMDA receptor antagonism and may prevent CPSP by modulating Grin1 expression in the spinal cord.[5][6][7] Vitamin D deficiency increases the risk of moderate-to-severe persistent pain after surgery (OR 2.64) and is associated with higher perioperative opioid consumption.[8][9]

When conditions are right, (actually wrong), the usual acute pain associated with a new traumatic injury or surgery persists rather than resolves normally leading to a transition from acute to chronic pain. A thorough review of the risks and factors that contribute to this transition is beyond the scope of this page, but can be found here: Acute Pain, Avoiding Transition to Chronic Pain.

This section focuses on the use of nutraceuticals to help combat the processes that contribute to the transition of acute to chronic pain. These pathologic processes are summarized here:

Pathophysiology Targeted:

Peripheral and Central Sensitization – Changes in nerves causing pain to become magnified
Neuroinflammation- immune system activation causing pain to persist with greater severity
Oxidative Stress – nerve damage from build-up of toxic compounds like free radical
Nerve injury-induced plasticity – the nervous system’s capacity to reorganize its structure and function following damage. While aiding functional recovery, this plasticity can cause pathologic outcomes like chronic pain or phantom limb sensations.

Key Aspects of Nerve Injury-Induced Plasticity

Cortical Reorganization: Within minutes to weeks after injury, cortical regions that formerly processed inputs from the damaged nerve become silent and are soon invaded by adjacent cortical areas. This can lead to functional changes where stimulation of one area causes sensation in another (e.g., phantom limb sensations).
Maladaptive vs. Adaptive Changes:
- Positive/Adaptive: The brain reconfigures to allow for recovery of function.
- Negative/Maladaptive: The reorganization leads to persistent issues such as neuropathic pain, phantom sensations, and improper motor control.
Central Sensitization (Chronic Pain): Peripheral nerve injuries lead to long-term potentiation (LTP)-like changes in the spinal cord, increasing the sensitivity of neurons to pain. This is associated with molecular changes like protein kinase Mζ (PKMζ) signaling and increased synaptic activity.
Structural and Functional Changes:
- Structural: Involves axonal sprouting, increased dendritic spine density, and changes in perineuronal nets (PNNs).
- Functional: Involves increased neuronal excitability and changes in excitatory/inhibitory balance, often resulting in increased inhibitory interneuron activity in the deprived cortex.
Stages of Plasticity:
1. Immediate: Initial damage and loss of cortical pathways.
2. Short-term: Rapid functional reorganization (“unmasking” of inactive connections).
3. Long-term: Structural remodeling, including axonal sprouting

Key Mechanisms

Homeostatic Plasticity: Neurons alter receptor trafficking to the synapse in response to changes in firing rates.
Molecular Signaling: Involves pathways such as Protein kinase C (PKC), MAPK, and BDNF, which contribute to pain sensitization.
Epigenetic Regulation: Dynamic changes in gene expression without altering DNA sequences help drive structural and functional remodeling. [3, 7, 8, 10, 11]

Clinical Notes

The evidence for preventing CPSP with nutraceuticals is emerging but mechanistically sound. Perioperative magnesium has the strongest evidence, with meta-analyses demonstrating reduced postoperative pain and opioid consumption.[6][33] A preclinical study showed single preoperative magnesium injection prevented CPSP behavior for 17 days by modulating Grin1 expression.[7]
Vitamin D deficiency is a modifiable risk factor for CPSP. Hypovitaminosis D increased the risk of moderate-to-severe persistent pain after knee arthroplasty (OR 2.64).[8] Patients with deficient vitamin D levels had 1.7 more days of opioid use per year and were more likely to develop opioid use disorder (HR 2.41).[9]
Omega-3 fatty acids administered preoperatively reduced postoperative pain (VAS 10.9 vs 25 mm) and CRP levels in a randomized trial.[25] Preclinical evidence shows omega-3 supplementation accelerates nerve regeneration and prevents neuropathic pain behavior.[26]
PEA has demonstrated efficacy across nociceptive, neuropathic, and nociplastic pain types and delays opioid tolerance development.[Document] Its role in CPSP prevention is supported by its mechanism of reducing spinal glial activation.[10]
Important caveats: While the mechanistic rationale is strong, large-scale RCTs specifically evaluating nutraceutical combinations for CPSP prevention are lacking. The network meta-analysis of pharmacological agents for CPSP prevention noted that “extremely little progress has been made since 2013, likely due to study designs being insufficient to address the complexities of this multifactorial problem.” This nutraceutical approach should complement, not replace, established multimodal analgesia protocols including regional anesthesia, NMDA antagonists, and gabapentinoids where indicated.[2]

References

Non-Opioid Analgesics for the Prevention of Chronic Postsurgical Pain: A Systematic Review and Network Meta-Analysis. Doleman B, Mathiesen O, Sutton AJ, et al. British Journal of Anaesthesia. 2023;130(6):719-728. doi:10.1016/j.bja.2023.02.041.
Pharmacotherapy for the Prevention of Chronic Pain After Surgery in Adults: An Updated Systematic Review and Meta-Analysis. Carley ME, Chaparro LE, Choinière M, et al. Anesthesiology. 2021;135(2):304-325. doi:10.1097/ALN.0000000000003837.
Nutritional Intervention in Chronic Pain: An Innovative Way of Targeting Central Nervous System Sensitization?. Nijs J, Tumkaya Yilmaz S, Elma Ö, et al. Expert Opinion on Therapeutic Targets. 2020;24(8):793-803. doi:10.1080/14728222.2020.1784142.
Persistent Postsurgical Pain: Risk Factors and Prevention. Kehlet H, Jensen TS, Woolf CJ. Lancet (London, England). 2006;367(9522):1618-25. doi:10.1016/S0140-6736(06)68700-X.
Clinical Efficacy of Magnesium in Perioperative Pain Management: A Narrative Review. Ahmadzadeh S, Wentling JG, Ford BM, et al. Current Pain and Headache Reports. 2025;29(1):117. doi:10.1007/s11916-025-01422-y.
Perioperative Systemic Magnesium to Minimize Postoperative Pain: A Meta-Analysis of Randomized Controlled Trials. De Oliveira GS, Castro-Alves LJ, Khan JH, McCarthy RJ. Anesthesiology. 2013;119(1):178-90. doi:10.1097/ALN.0b013e318297630d.
Effects of Magnesium Sulfate Administration in Attenuating Chronic Postsurgical Pain in Rats. Kido K, Katagiri N, Kawana H, et al. Biochemical and Biophysical Research Communications. 2021;534:395-400. doi:10.1016/j.bbrc.2020.11.069.
Effect of Hypovitaminosis D on Postoperative Pain Outcomes and Short-Term Health-Related Quality of Life After Knee Arthroplasty: A Cohort Study. Lee A, Chan SKC, Samy W, Chiu CH, Gin T. Medicine. 2015;94(42):e1812. doi:10.1097/MD.0000000000001812.
Perioperative Serum 25-Hydroxyvitamin D Levels as a Predictor of Postoperative Opioid Use and Opioid Use Disorder: A Cohort Study. Kim Y, Zhang F, Su K, et al. Journal of General Internal Medicine. 2020;35(9):2545-2552. doi:10.1007/s11606-020-06001-y.
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.
Ultramicronized N-Palmitoylethanolamine Associated With Analgesics: Effects Against Persistent Pain. Nobili S, Micheli L, Lucarini E, et al. Pharmacology & Therapeutics. 2024;258:108649. doi:10.1016/j.pharmthera.2024.108649.
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.
Efficacy and Safety of Magnesium for the Management of Chronic Pain in Adults: A Systematic Review. Park R, Ho AM, Pickering G, et al. Anesthesia and Analgesia. 2020;131(3):764-775. doi:10.1213/ANE.0000000000004673.
Clinical Guidelines for the Use of Chronic Opioid Therapy in Chronic Noncancer Pain. Chou R, Fanciullo GJ, Fine PG, et al. The Journal of Pain. 2009;10(2):113-30. doi:10.1016/j.jpain.2008.10.008.
A Systematic Review and Meta-Analysis on the Role of Nutraceuticals in the Management of Neuropathic Pain in in Vivo Studies. Ilari S, Proietti S, Russo P, et al. Antioxidants (Basel, Switzerland). 2022;11(12):2361. doi:10.3390/antiox11122361.
Exploring Mechanistic Insights by Carotenoids in Neuropathic and Inflammatory Pain. Abbaszadeh F, Jorjani M, Amirian R, Fakhri S, Khan H. Current Neuropharmacology. 2025;:CN-EPUB-149147. doi:10.2174/011570159X371386250619064416.
The Non-Surgical Management of Hip & Knee Osteoarthritis (OA) (2020). Matthew Bair MD MS, John Cody MD, Jess Edison MD, et al. Department of Veterans Affairs.
The Analgesic Effect of Curcumin and Nano-Curcumin in Clinical and Preclinical Studies: A Systematic Review and Meta-Analysis. Hajimirzaei P, Eyni H, Razmgir M, et al. Naunyn-Schmiedeberg’s Archives of Pharmacology. 2025;398(1):393-416. doi:10.1007/s00210-024-03369-0.
Effects of Omega-3 Fatty Acids on Chronic Pain: A Systematic Review and Meta-Analysis. Xie L, Wang X, Chu J, et al. Frontiers in Medicine. 2025;12:1654661. doi:10.3389/fmed.2025.1654661.
Non-Analgesic Effects of Opioids: Interactions Between Opioids and Other Drugs. Heiskanen T, Kalso E. Current Pharmaceutical Design. 2012;18(37):6079-89. doi:10.2174/138161212803582423.
Implications of Opioid Analgesia for Medically Complicated Patients. Smith H, Bruckenthal P. Drugs & Aging. 2010;27(5):417-33. doi:10.2165/11536540-000000000-00000.
From Fibrositis to Fibromyalgia to Nociplastic Pain: How Rheumatology Helped Get Us Here and Where Do We Go From Here?. Clauw DJ. Annals of the Rheumatic Diseases. 2024;83(11):1421-1427. doi:10.1136/ard-2023-225327.
Bioactive Compounds for Neuropathic Pain: An Update on Preclinical Studies and Future Perspectives. Shen CL, Castro L, Fang CY, et al. The Journal of Nutritional Biochemistry. 2022;104:108979. doi:10.1016/j.jnutbio.2022.108979.
Non-Drug Pain Relievers Active on Non-Opioid Pain Mechanisms. Marchesi N, Govoni S, Allegri M. Pain Practice : The Official Journal of World Institute of Pain. 2022;22(2):255-275. doi:10.1111/papr.13073.
Preoperative Administration of Omega-3 Fatty Acids on Postoperative Pain and Acute-Phase Reactants in Patients Undergoing Roux-en-Y Gastric Bypass: A Randomized Clinical Trial. Ruiz-Tovar J, Blanca M, Garcia A, et al. Clinical Nutrition (Edinburgh, Scotland). 2019;38(4):1588-1593. doi:10.1016/j.clnu.2018.07.026.
Long-Chain Omega-3 Fatty Acids Supplementation Accelerates Nerve Regeneration and Prevents Neuropathic Pain Behavior in Mice. Silva RV, Oliveira JT, Santos BLR, et al. Frontiers in Pharmacology. 2017;8:723. doi:10.3389/fphar.2017.00723.
N-3 Fatty Acids, Inflammation, and Immunity–Relevance to Postsurgical and Critically Ill Patients. Calder PC. Lipids. 2004;39(12):1147-61. doi:10.1007/s11745-004-1342-z.
Effects of Hypovitaminosis D on Preoperative Pain Threshold and Perioperative Opioid Use in Colorectal Cancer Surgery: A Cohort Study. Xia J, Li D, Yu G, et al. Pain Physician. 2022;25(7):E1009-E1019.
Effects of Preoperative Serum Vitamin D Levels on Early Clinical Function Outcomes and the Moderate-to-Severe Pain Prevalence in Postmenopausal Women After Primary Total Knee Arthroplasty. Song Y, Liu SF, Wu Z, et al. Menopause (New York, N.Y.). 2021;28(8):893-898. doi:10.1097/GME.0000000000001789.
Perioperative Nutrition: Recommendations From the ESPEN Expert Group. Lobo DN, Gianotti L, Adiamah A, et al. Clinical Nutrition (Edinburgh, Scotland). 2020;39(11):3211-3227. doi:10.1016/j.clnu.2020.03.038.
Effects of Omega-3 Polyunsaturated Fatty Acids, Docosahexaenoic Acid and Eicosapentaenoic Acid, on Post-Surgical Complications in Surgical Trauma Patients: Mechanisms, Nutrition, and Challenges. Ouagueni A, Al-Zoubi RM, Zarour A, Al-Ansari A, Bawadi H. Marine Drugs. 2024;22(5):207. doi:10.3390/md22050207.
The Use of Intravenous Magnesium Sulfate on Postoperative Analgesia in Orthopedic Surgery: A Systematic Review of Randomized Controlled Trials. Peng YN, Sung FC, Huang ML, Lin CL, Kao CH. Medicine. 2018;97(50):e13583. doi:10.1097/MD.0000000000013583.
Effects of Systemic Magnesium on Post-Operative Analgesia: Is the Current Evidence Strong Enough?. Guo BL, Lin Y, Hu W, et al. Pain Physician. 2015 Sep-Oct;18(5):405-18.
Insights on Nutrients as Analgesics in Chronic Pain. Bjørklund G, Chirumbolo S, Dadar M, et al. Current Medicinal Chemistry. 2020;27(37):6407-6423. doi:10.2174/0929867326666190712172015.
N-3 Fatty Acids Modulate Repeated Stress-Evoked Pain Chronicity. Aizawa F, Sato S, Yamazaki F, et al. Brain Research. 2019;1714:218-226. doi:10.1016/j.brainres.2019.03.001.
Nutraceutical Interactions with Opioid Pain Processing

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