Magnesium for Pain Relief | Robert A. Erickson, M.D., F.A.A.F.P.

Magnesium is the fourth most abundant mineral in the body and is essential to good health. Approximately 50% of total body magnesium is found in bone. The other half is found predominantly inside cells of body tissues and organs. Only 1% of magnesium is found in blood, but the body works very hard to keep blood levels of magnesium constant. Magnesium is needed for more than 300 biochemical reactions in the body. It helps maintain normal muscle and nerve function, keeps heart rhythm steady, supports a healthy immune system, and keeps bones strong. Magnesium also helps regulate blood sugar levels, promotes normal blood pressure, and is known to be involved in energy metabolism and protein synthesis. Dietary magnesium is absorbed in the small intestines. Magnesium is excreted through the kidneys.Early signs of magnesium deficiency include loss of appetite, nausea, vomiting, fatigue, and weakness. As magnesium deficiency worsens, numbness, tingling, muscle contractions and cramps, seizures (sudden changes in behaviors caused by excessive electrical activity in the brain), personality changes, abnormal heart rhythms, and coronary spasms can occur. Severe magnesium deficiency can result in low levels of calcium in the blood (hypocalcemia). Magnesium deficiency is also associated with low levels of potassium in the blood (hypokalemia). Many of these symptoms are general in nature and can result from a variety of medical conditions other than magnesium deficiency so it is important to have a physician evaluate any health complaints.Magnesium deficiency can occur from taking diuretic and other medications e.g. tetracycline and certain anti-neoplastic drugs. Magnesium deficiency is also seen in alcoholics, poorly controlled diabetics, elderly patients in general, and individuals with malabsorption problems such as Crohn’s disease. The RDA for magnesium in adults is between 250mg and 400mg daily. Magnesium deficiency is very common in this country due to depletion of this mineral in the soils and because of food processing. Oral magnesium is very inexpensive. We suggest using a chelated form such as magnesium citrate rather than the oxide form, which is not well absorbed.

There is a growing interest among traditional physicians in using magnesium for cardiovacular disease, diabetes and hypertension. For decades, intravenous magnesium sulfate has been used in the treatment of pregnant females with pre-eclampsia or eclampsia (characterized by elevated blood pressure and seizures). Among most holistic physicians, magnesium is used for pain management. This is not an FDA (Food and Drug Administration) approved or recognized therapy.

Our clinical experience at the Preventive Medicine Center has shown magnesium can be an effective treatment for pain, especially for patients with either fibromyalgia, muscle strains or migraine headaches. The reason magnesium can help muscle pain is clear – it helps muscles “relax.” Why magnesium helps neurogenic pain (nerve pain conditions) is less clear.

A major mechanism of pain is the excessive stimulation of a brain chemical called “NMDA” or N-methyl-D-aspartate. A study on rats was published in November 2010 in The Journal of Physiology confirms our clinical experience that magnesium decreases nerve pain — while also pointing to how it works through the NMDA receptors. Magnesium seems to settle down NMDA without the toxicity of drugs. There are a number of drugs that block the NMDA receptor providing analgesia in nerve pain. These include dextromethorphan (a cough suppressant, but at higher doses than those needed to block cough), ketamine (an anesthetic), and amantadine (an anti-viral drug and Parkinson’s disease drug).

Magnesium can be used intravenously for a very rapid and powerful effect. Our experience has shown an acute migraine attack can often be broken by intravenous magnesium sulfate. It is also very helpful for settling down fibromyalgia pain, which has a muscle and nerve component. Unlike oral magnesium where high doses cause bowel upset or diarrhea (e.g. Milk of Magnesia effect), I.V. magnesium bypasses the gut and is very well tolerated at higher than oral doses. It has an added benefit of also calming a person.