Publication:

A cross-sectional survey assessing clinical utilization and physician perspectives on PEA-based therapy in the management of neuropathic pain

Background Neuropathic pain is a chronic condition associated with substantial morbidity and impaired quality of life. Palmitoylethanolamide (PEA), an endogenous lipid mediator with anti-inflammatory and neuroprotective properties, has emerged as a potential adjunctive therapy for neuropathic pain. This survey evaluated physicians’ utilization patterns, therapeutic positioning, perceived effectiveness, and safety of PEA-based formulations in routine clinical practice.

Methods A descriptive, questionnaire-based cross-sectional survey was conducted among orthopedic surgeons attending IOACON-2025, Guwahati, India. A structured nine-item questionnaire was administered electronically, and responses from 93 physicians were analyzed using descriptive statistics.

Results Most physicians reported frequent (49.5%) or very frequent (9.7%) prescribing of PEA-based formulations. Neuropathic pain (71.0%), chronic low back pain (60.2%), and peripheral nerve injury (57.0%) were the most common indications. More than half of the respondents (60.2%) initiated PEA-based therapy as an early adjunct to first-line treatment, while 26.9% prescribed it following an inadequate response to gabapentinoids. Overall efficacy was rated as highly effective by 24.7% and moderately effective by 69.9% of physicians. Symptom improvement was observed within 1-2 weeks by 40.9% of respondents and within 2-4 weeks by 30.1%. PEA-based formulations were considered highly or moderately effective in improving pain, burning sensation, tingling, paresthesia, and sleep disturbances by 94.6% of physicians. Most respondents (83.9%) reported excellent tolerability with minimal adverse effects. Once-daily dosing and improved patient compliance were identified as the most important factors influencing prescribing preference. Additionally, 94.6% considered PEA-based formulations suitable for routine or selective long-term maintenance therapy.

Conclusions PEA-based formulations are widely utilized in clinical practice and are perceived by physicians as effective, well tolerated, and suitable for both adjunctive and long-term management of neuropathic pain. These findings support the growing role of PEA-based therapy in contemporary neuropathic pain management.