The Emergent Role of Low-Dose Naltrexone in the Symptomatic Management of Chronic Musculoskeletal and Neuropathic Pain

As a result of the intricate mechanisms of pain transmission, traditional analgesics used alone, as well as concomitantly, often do not provide consistent and/or adequate pain relief for patients suffering with chronic pain conditions. Many analgesics, as well as antineuropathic and antispastic drugs, demonstrate synergistic CNS side effects, increasing the risk of respiratory depression and overdose when used in combination. Given the steady rise of opioid-related overdose deaths in the USA, pursuit of novel treatment options, such as low dose naltrexone (LDN) regimens, are of particular interest to researchers. Although multiple reliable studies exist which demonstrate the potential for LDN in pain management, large-scale, high-quality studies are lacking, or are in progress. This review article aims to analyze the currently available literature regarding low dose naltrexone therapy in order to evaluate its potential role in the management of chronic inflammatory, neuropathic, and generalized pain symptoms. Although promising, available data is limited in its utility, warranting further research and development regarding the clinical role and place in therapy of LDN in chronic pain management.