Once again on the treatment of nociceptive pain – is it worth to combine diclofenac with B vitamins?

Monika Białecka

Affiliation and address for correspondence
Aktualn Neurol 2017, 17 (4), p. 221–226
DOI: 10.15557/AN.2017.0025

Spine pain is a frequent ailment with a complex pathophysiology. The guidelines for treatment oscillate between physiotherapeutic procedure, pharmacotherapy and surgical treatment. It seems that every patient requires an individual approach which is especially important in case of elderly patients – due to multiple morbidities and polytherapy. The article presents the benefits and the limitations of the therapy applying diclofenac and B vitamins in the treatment of pain, mainly osteo-articular pain. Diclofenac belongs to the group of non-steroidal analgesic and anti-inflammatory drugs. It demonstrates high therapeutic efficacy in the scope of nociceptive pain, however, it also causes significant adverse effects including arterial hypertension. The analgesic effect of group B vitamins has not been fully explained; it seems that they may affect the increase of the secretion of serotonin in the central nervous system, regulate afferent conduction in the scope of the spinal cord or – as indicated by some, more optimistic, authors – enhance the release of endogenous opioids. The article includes information referring to combining both drugs in the context of the efficacy and safety of treating nociceptive pain.

non-steroidal analgesics, B vitamins, pharmacotherapy of pain

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