🧠 Magnesium and Chronic Pain: Could This Common Mineral Rewire Your Nervous System?

What if pain relief for chronic low back pain wasn’t just about stronger drugs—but smarter neuroscience?

Millions suffer from chronic low back pain with a neuropathic twist—sharp, burning sensations, hypersensitivity, and a constant fog of discomfort. Standard treatments like NSAIDs, opioids, anticonvulsants, and antidepressants often fail to deliver lasting relief. But emerging research suggests a surprising ally in this battle: magnesium.

🔬 The Study: Magnesium as a Neurological Pain Modulator

A 2013 double-blinded RCT conducted in Egypt investigated the effects of sequential intravenous and oral magnesium therapy in 80 patients with chronic low back pain and confirmed neuropathic features (LANSS score ≥ 12).

Patients were divided into two groups:

• Magnesium Group: 2 weeks of daily IV magnesium sulfate, followed by 4 weeks of oral magnesium oxide + gluconate.

• Control Group: Placebo infusions and sugar pills.

Both groups continued standardised treatments (gabapentin, amitriptyline, celecoxib) and physical therapy.

📉 Key Results: Pain and Mobility Improvements That Lasted

Pain Scores (NRS)

• Magnesium group dropped from 7.5 to 4.7 at 6 months (p = 0.034)

• Control group pain scores returned to near baseline by 6 months

Lumbar Mobility (at 6 months):

• Flexion: ↑ from 22.2° to 34.7° (p = 0.018)

• Extension: ↑ from 11.8° to 16.9° (p = 0.039)

• Lateral Flexion: ↑ from 11.4° to 17.2° (p = 0.035)

Side Effects? Mild diarrhoea in 4 participants. That’s it.

🧬 The Science Behind It: Why Magnesium Might Work

Pain, especially neuropathic pain, often involves a process called central sensitization—where the spinal cord and brain become hypersensitive to stimuli. The NMDA receptor is a key player in pain "wind-up."

Magnesium naturally blocks the NMDA receptor’s ion channel, reducing calcium influx, which thereby dampens hyperexcitability in dorsal horn neurons (sensory processing nerves in your spine). Ketamine also blocks the NMDA receptor, but it has other effects that making daily supplementation problematic.

Think of magnesium as a bouncer, preventing overstimulation of your spinal cord’s pain circuits.

This study is supported by other findings that magnesium can:

• Reduce the need for anaesthesia during and after surgery (Koinig et al., 1998)

• Potentiate opioid effects without increasing dose (Kulik et al., 2021)

• Offer benefits in cancer-related neuropathic pain (Crosby et al., 2000)

🖼️ The Bigger Picture

We often think of pain as a mechanical issue. But neuroscience tells a deeper story: the brain and spinal cord are plastic—capable of learning and unlearning pain.

Magnesium isn’t magic. But it may be a missing link in a more neuroscience-informed approach to chronic pain. It’s affordable, safe when used correctly, and supported by growing evidence. Magnesium supplementation may be worth adding to a comprehensive treatment plan.

References

Crosby, V., Wilcock, A., & Corcoran, R. (2000). The safety and efficacy of a single dose (500 mg or 1 g) of intravenous magnesium sulfate in neuropathic pain poorly responsive to strong opioid analgesics in patients with cancer. Journal of pain and symptom management, 19(1), 35–39. https://doi.org/10.1016/s0885-3924(99)00135-9

Koinig, H., Wallner, T., Marhofer, P., Andel, H., Hörauf, K., & Mayer, N. (1998). Magnesium sulfate reduces intra- and postoperative analgesic requirements. Anesthesia and analgesia, 87(1), 206–210. https://doi.org/10.1097/00000539-199807000-00042

Kulik, K., Żyżyńska-Granica, B., Kowalczyk, A., Kurowski, P., Gajewska, M., & Bujalska-Zadrożny, M. (2021). Magnesium and Morphine in the Treatment of Chronic Neuropathic Pain-A Biomedical Mechanism of Action. International journal of molecular sciences, 22(24), 13599. https://doi.org/10.3390/ijms222413599

Yousef, A. A., & Al-deeb, A. E. (2013). A double-blinded randomised controlled study of the value of sequential intravenous and oral magnesium therapy in patients with chronic low back pain with a neuropathic component. Anaesthesia, 68(3), 260–266. https://doi.org/10.1111/anae.12107