Chronic pain and group B vitamins
https://doi.org/10.14412/1996-7012-2025-1-91-97
Abstract
Chronic pain (CP) impairs quality of life and increases the risk of non-communicable diseases and mortality. Pain is variable, and different mechanisms of its development determine the tactics of patient treatment. Researching pathogenesis of different types of pain can serve as a prerequisite for the development of more effective treatment approaches. The introduction of drug combinations into clinical practice enables a better response to treatment with lower doses, thereby reducing drug burden and potential toxicity.
The review presents studies that address the question of how the efficacy of chronic pain therapy can be increased by including adjuvants in the treatment regimen, particularly a vitamin B complex.
About the Authors
E. V. Zonova
Novosibirsk State Medical University, Ministry of Health of Russia
Russian Federation
Russian Federation
52, Krasny Prospect, Novosibirsk 630091
L. I. Alekseeva
V.A. Nasonova Research Institute of Rheumatology;
Russian Medical Academy of Continuing Professional Education, Ministry of Health of Russia
Russian Federation
Russian Federation
34A, Kashirskoe Shosse, Moscow 115522;
2/1, Barrikadnaya Street, Build. 1, Moscow 125993
A. M. Lila
V.A. Nasonova Research Institute of Rheumatology;
Russian Medical Academy of Continuing Professional Education, Ministry of Health of Russia
Russian Federation
Russian Federation
34A, Kashirskoe Shosse, Moscow 115522;
2/1, Barrikadnaya Street, Build. 1, Moscow 125993
References
1. Raja SN, Carr DB, Cohen M, et al. The revised International Association for the Study of Pain definition of pain: concepts, challenges, and compromises. Pain. 2020 Sep 1; 161(9):1976-1982. doi: 10.1097/j.pain.0000000000001939.
2. Scholz J, Finnerup NB, Attal N, et al. The IASP classification of chronic pain for ICD-11: chronic neuropathic pain. Pain. 2019 Jan;160(1):53-59. doi: 10.1097/j.pain.0000000000001365.
3. WHO. Musculoskeletal Conditions. World Health Organization. https://www.who.int/news-room/fact-sheets/detail/musculoskeletal-conditions. Published 2019. 2020
4. Parfenov VA, Yakhno NN Kukushkin ML, et al. Acute nonspecific (musculoskeletal) low back pain Guidelines of the Russian Society for the Study of Pain (RSSP). Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2018;10(2): 4-11. (In Russ.). doi: 10.14412/2074-2711-2018-2-4-11
5. Yakhno NN, Kukushkin ML, Churyukanov MV, Syrovegin AV. The results of the open multicenter MERIDIAN study on the assessment of the prevalence of pain syndromes in outpatient practice and therapeutic preferences of doctors. Rossiiskii zhurnal boli. 2012;(3): 10-14. (In Russ.).
6. Ray BM, Kelleran KJ, Fodero JG, HarvellBowman LA. Examining the Relationship Between Chronic Pain and Mortality in U.S. Adults. J Pain. 2024 Oct;25(10):104620. doi: 10.1016/j.jpain.2024.104620. Epub 2024 Jun 26.
7. Cohen SP, Vase L, Hooten WM. Chronic pain: an update on burden, best practices, and new advances. Lancet. 2021 May 29;397(10289): 2082-2097. doi: 10.1016/S0140-6736(21)00393-7.
8. Cao B, Xu Q, Shi Y, et al. Pathology of pain and its implications for therapeutic interventions. Signal Transduct Target Ther. 2024; Jun 8;9(1):155. doi: 10.1038/s41392-024- 01845-w.
9. Dydyk AM, Givler A. Central Pain Syndrome. Treasure Island: StatPearls Publishing; 2022.
10. Aldamluji N, Burgess A, Pogatzki-Zahn E, et al. PROSPECT guideline for tonsillectomy: systematic review and procedure-specific post operative pain management recommendations. Anaesthesia. 2021 Jul;76(7):947-961. doi: 10.1111/anae.15299. Epub 2020 Nov 17.
11. Qaseem A, Harris RP, Forciea MA, et al. Management of acute and recurrent gout: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2017 Jan 3;166(1):58-68. doi: 10.7326/ M16-0570. Epub 2016 Nov 1.
12. Qaseem A, McLean RM, O'Gureket D, et al. Nonpharmacologic and pharmacologic management of acute pain from non-low back, musculoskeletal injuries in adults: a clinical guideline from the American College of Physicians and American Academy of Family Physicians. Ann Intern Med. 2020 Nov 3;173(9):739-748. doi: 10.7326/M19-3602. Epub 2020 Aug 18.
13. Arden NK, Perry TA, Bannuru RR, et al. Non-surgical management of knee osteoarthritis: comparison of ESCEO and OARSI 2019 guidelines. Nat Rev Rheumatol. 2021 Jan; 17(1):59-66. doi: 10.1038/s41584-020-00523-9. Epub 2020 Oct 28.
14. Calderon-Ospina CA, Nava-Mesa MO. B Vitamins in the nervous system: Current knowledge of the biochemical modes of action and synergies of thiamine, pyridoxine, and cobalamin. CNS Neurosci Ther. 2020 Jan; 26(1):5-13. doi: 10.1111/cns.13207. Epub 2019 Sep 6.
15. Calderon-Ospina CA, Nava-Mesa MO, Arbelaez Ariza CE. Effect of combined diclofenac and B vitamins (thiamine, pyridoxine, and cyanocobalamin) for low back pain management: systematic review and metaanalysis. Pain Med. 2020 Apr 1;21(4):766-781. doi: 10.1093/pm/pnz216.
16. Calderуn-Ospina CA, Palacios-Sanchez L, Nava-Mesa MO, et al. Vitaminas B neurotrуpicas y neuropatнa perifй rica: estado del arte y acuerdo de expertos. Acta Neurol Colomb. 2023;39(4):1201. doi: 10.22379/anc.v39i4.1201.
17. Nava-Mesa MO, Aispuru Lanche GR. Role of B vitamins, thia mine, pyridoxine, and cyanocobalamin in back pain and other musculoskeletal conditions: a narrative review. Semergen. 2021 Nov-Dec;47(8): 551-562. doi: 10.1016/j.semerg.2021.01.010. Epub 2021 Apr 14.
18. Paez-Hurtado AM, Calderon-Ospina CA, Nava-Mesa MO. Mechanisms of action of vitamin B1 (thiamine), B6 (pyridoxine), and B12 (cobalamin) in pain: a narrative review. Nutr Neurosci. 2023 Mar;26(3):235-253. doi: 10.1080/1028415X.2022.2034242. Epub 2022 Feb 14.
19. Lonsdale D. A review of the biochemistry, metabolism and clinical benefits of thiamin(e) and its derivatives. Evid Based Complement Alternat Med. 2006 Mar;3(1):49-59. doi: 10.1093/ecam/nek009.
20. Hrubsa M, Siatka T, Nejmanova I, et al; On Behalf Of The Oemonom. Biological Properties of Vitamins of the B-Complex, Part 1: Vitamins B, B, B, and B. Nutrients. 2022; Jan 22;14(3):484. doi: 10.3390/nu14030484.
21. Shen S, Liang Y, Zhao Y, et al. Dietary supplementation of vitamin B1 prevents the pathogenesis of osteoarthritis. Proc Natl Acad Sci U S A. 2024; Jul 23;121(30):e2408160121. doi: 10.1073/pnas.2408160121.
22. Dakshinamurti K, Sharma SK, Bonke D. Influence of B vitamins on binding properties of serotonin receptors in the CNS of rats. Klin Wochenschr. 1990 Jan 19;68(2):142-5. doi: 10.1007/BF01646863.
23. Hartvig P, Lindner KJ, Bjurling P, et al. Pyri doxine effect on synthesis rate of serotonin in the monkey brain measured with positron emission tomography. J Neural Transm Gen Sect. 1995;102(2):91-7. doi: 10.1007/BF01276505.
24. Fu QG, Carstens E, Stelzer B, Zimmermann M. B vitamins sup press spinal dorsal horn nociceptive neurons in the cat. Neurosci Lett. 1988 Dec 19;95(1-3):192-7. doi: 10.1016/0304-3940(88)90655-6.
25. Sharma SK, Bolster B, Dakshinamurti K. Effects of pyridoxine on nociceptive thalamic unit activitya. Ann N Y Acad Sci. 1990;585(1): 549–53.
26. Delgado-Garcia P, Alcocer-Herrera JB, Urenda-Quesada A, et al. A randomized controlled trial of a combination of dexketoprofen/vitamin B (thiamine, pyridoxine, and cyanocobalamin) in a fixed dose for grade I-II posttraumatic cervical sprains. Clin Drug Investig. 2024 Jun;44(6):413-424. doi: 10.1007/s40261-024-01370-2. Epub 2024 Jun 6.
27. Buesing S, Costa M, Schilling JM, Moeller-Bertram T. Vitamin B12 as a Treatment for Pain. Pain Physician. 2019; Jan; 22(1):E45-E52.
28. Calderon-Ospina CA, Nava-Mesa MO, Paez-Hurtado AM. Update on safety profiles of vitamins B1, B6, and B12: A narrative review. Ther Clin Risk Manag. 2020 Dec 22:16: 1275-1288. doi: 10.2147/TCRM.S274122. eCollection 2020.
29. Sathienluckana T, Palapinyo S, Yotsombut K, et al. Expert consensus guidelines for community pharmacists in the management of diabetic peripheral neuropathy with a combination of neurotropic B vitamins. J Pharm Policy Pract. 2024; Feb 7;17(1):2306866. doi: 10.1080/20523211.2024.2306866.
30. Freynhagen R, Parada HA, Calderon-Ospina CA, Chen J, Rakhmawati Emril D, Fernandez-Villacorta FJ, et al. Current understanding of the mixed pain concept: a brief narrative review. Curr Med Res Opin. 2019 Jun; 35(6):1011-1018. doi: 10.1080/03007995.2018.1552042. Epub 2019 Jan 3
31. Ortiz MI, Molina MA, Arai YC, Romano CL. Analgesic drugs combinations in the treatment of different types of pain. Pain Res Treat. 2012:2012:612519. doi: 10.1155/2012/612519. Epub 2012 Jun 11.
32. Tamaddonfard E, Tamaddonfard S, Cheraghiyan S. Effects of intracerebroventricular injection of vitamin B(12) on formalin induced muscle pain in rats: role of cyclooxygenase pathway and opioid receptors. Vet Res Forum. 2018 Fall;9(4):329-335. doi: 10.30466/vrf.2018.33104. Epub 2018 Dec 15.
33. Calderуn-Ospina CA, Nava-Mesa MO. B Vitamins in the nervous system: Current knowledge of the biochemical modes of action and synergies of thiamine, pyridoxine, and cobalamin. CNS Neurosci Ther. 2020 Jan; 26(1):5-13. doi: 10.1111/cns.13207. Epub 2019 Sep 6.
34. Clinical recommendations of the Ministry of Health of the Russian Federation "Musculoskeletal (nonspecific) pain in the lower back". 2023.
35. Paez-Hurtado AM, Calderon-Ospina CA, Nava-Mesa MO. Mechanisms of action of vitamin B1 (thiamine), B6 (pyridoxine), and B12 (cobalamin) in pain: a narrative review. Nutr Neurosci. 2023; Mar;26(3):235-253. doi: 10.1080/1028415X.2022.2034242.
36. Filatova ES, Karateev AE, Shakhramanova EL, et al. Evaluation of the efficacy of complex analgesic therapy, including a combination of B vitamins, in patients with combination of osteoarthritis and chronic non-specific low back pain (results of an open-label pilot clinical trial). Sovremennaya revmatologiya = Modern Rheumatology Journal. 2024; 18(2):56-61. (In Russ.). doi: 10.14412/1996-7012-2024-2-56-61
37. Magaсa-Villa MC, Rocha-Gonzalez HI, Fernandez del Valle-Laisequilla C, et al. B-vitamin mixture improves the analgesic effect of diclofenac in patients with osteoarthritis: a double blind study. Drug Res (Stuttg). 2013; Jun;63(6):289-92. doi: 10.1055/s-0033-1334963.
38. Dehghan M. Comparative effectiveness of B and e vitamins with diclofenac in reducing pain due to osteoarthritis of the knee. Med Arch. 2015; Apr;69(2):103-6. doi: 10.5455/medarh.2015.69.103-106.
39. Muraki S, Akune T, En-Yo Y, et al. Association of dietary intake with joint space narrowing and osteophytosis at the knee in Japanese men and women: the ROAD study. Mod Rheumatol. 2013 Mar 16. doi: 10.1007/s10165-013-0860-9. Online ahead of print.
40. Fang Z, Hu Q, Liu W. Vitamin B6 alleviates osteoarthritis by suppressing inflammation and apoptosis. BMC Musculoskelet Disord. 2024; Jun 6;25(1):447. doi: 10.1186/s12891-024-07530-x.
41. Kaur J, Rani S, Gulia A, et al. Role of Vitamin B complex as an add-on therapy to diclofenac in patients with primary osteoarthritis of the knee. J Pharmacol Pharmacother. 2021;12:68-72.
42. Golovacheva VA, Golovacheva AA. Adjunctive therapy for acute musculoskeletal pain. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2021;13(5):102-8. (In Russ.). doi: 10.14412/2074-2711-2021-5-102-108.
43. Golovacheva VA, Golovacheva AA. B vitamins and nonsteroidal anti-inflammatory drugs: the efficacy of the combination for nonspecific back pain. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2020;12(5):117-122. (In Russ.). doi: 10.14412/2074-2711-2020-5-117-122
44. Khitrov NA. Osteoarthritis and osteoarthritis – from new perspectives in pathogenesis to a new name. Trudnyi patsient. 2014;(3):30-34. (In Russ.).
45. Voznyuk KO, Churyukanov MV, Bakhtadze MA. Comparison of the painfulness of injections of B vitamins containing and not containing lidocaine. Rossiiskii zhurnal boli. 2020; 18(3):20-24. (In Russ.).
46. Gaskell H, Derry S, Wiffen PJ, Moore RA. Single dose oral ketoprofen or dexketoprofen for acute postoperative pain in adults. Cochrane Database Syst Rev. 2017 May 25; 5(5):CD007355. doi: 10.1002/14651858. CD007355.pub3.
47. Barinov AN, Makhinov KA, Komarova OA. Preliminary results of the open multicenter all-Russian observation "MINERVA" (MILGAMMA in diseases of the nervous system and Algic syndromes). Russkii meditsinskii zhurnal. 2016;(24):1650-1656. (In Russ.).
48. Danilov AB. The use of B vitamins for back pain: new analgesics? Russkii meditsinskii zhurnal. 2008;16(30):35-39. (In Russ.).
Review
For citations:
Zonova EV, Alekseeva LI, Lila AM. Chronic pain and group B vitamins. Sovremennaya Revmatologiya=Modern Rheumatology Journal. 2025;19(1):91-97. (In Russ.) https://doi.org/10.14412/1996-7012-2025-1-91-97
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