Does Cymbalta help spinal stenosis? (+5 treatment options)
By
Ivan Kahwa
Author bio
Mr Ivan Kahwa is a chemist and phytopharmaceutical scientist with expertise in chemistry, pharmacology, phytochemistry, and Nanobiotechnology. He writes and reviews content on these topics.
Mr Ivan Kahwa’s Highlights:
Guest Researcher at the University of Leipzig, Senior Research Fellow/Scientist, and Lecturer at the Department of Pharmacy, Faculty of Medicine, Mbarara University of Science and Technology.
Professional Experience:
Mr Ivan joined PHARMBIOTRAC as a research fellow/scientist during his master of science tenure. He contributed to the development of most of the phytopharmaceutical products in the project. Furthermore, he participated in carrying out the pharmacological activities of the developed products in laboratory animals such as mice and rats in order to develop proper doses hence leading to pre-clinical studies.
With the above relevant research experience, Ivan started to work with the University of Leipzig on collaborative projects with Mbarara University to develop the chemistry of Ugandan Medicinal plants and their pharmacological activities. This was coupled with several consultative positions by different German NGOs. Mr. Kahwa is also a supporting in the teaching and learning at the Departments of Pharmacy and Pharmaceutical Sciences, Faculty of Medicine, Mbarara University of Science and Technology.
With the increase in antimicrobial resistance globally, Ivan retooled his thinking towards developing new naturally derived antibiotic regimens from Ugandan propolis with the assistance of nanotechnology to improve their delivery to microbial cells. Kahwa has also published over 28 articles in peer-reviewed journals and he is currently reviewing for many journals.
Education:
2023-2027: PhD in Pharmaceutical Sciences (ongoing) with a focus on Pharmaceutical Microbiology and Nanobiology at Mbarara University of Science and Technology.
2022: 2Msc. in Pharmacognosy and Natural Medicine Science at Mbarara University of Science and Technology.
2018: Bachelor of Science (Chemistry) at Mbarara University of Science and Technology.
Publications:
▪ Iqbal, S., Jabeen, F., Kahwa, I., & Omara, T. 2023. Suberosin Alleviates Thiazolidinedione-Induced Cardiomyopathy in Diabetic Rats by Inhibiting Ferroptosis via Modulation of ACSL4-LPCAT3 and PI3K-AKT Signaling Pathways. Cardiovascular Toxicology. https://doi.org/10.1007/s12012-023-09804-7
▪ Gupta, A. K., Yadav, R., Sharma, S., Sawale, J., & Kahwa, I. 2023. Anti-ageing Activity and Antioxidant Activity of Methanol Extracts of Leaves and Flowers of Salvia officinalis and Rosmarinus officinalis. Journal of Young Pharmacists, 15(3), 448–455. https://doi.org/10.5530/jyp.2023.15.60
▪ Tolo, C.U., Kahwa, I., Nuwagira, U., Weisheit, A. and Ikiriza, H., 2023. Medicinal plants used in treatment of various diseases in the Rwenzori Region, Western Uganda. Ethnobotany Research and Applications, 25, pp.1-16.
https://ethnobotanyjournal.org/index.php/era/article/view/4683
▪ Kahwa, I., Ajayi, C.O., Yadav, R., Chauhan, N.S., Shah, K., Abdelgadir, A.A., Shegena, E.A., Daniel, S., Omara, T., Asiimwe, J.B. and Ikiriza, H., 2023. Pharmacognostic and phytochemical studies as an invaluable approach for correct identification of medicinal plants: The case of Artemisia vulgaris L. substituted for Artemisia annua L. in Western Uganda. TMR Integr Med, 7, p.e23004.
https://doi.org/10.53388/TMRIM202307004
▪ Nalimu, F., Oloro, J., Kahwa, I. and Ogwang, P.E., 2021. Review on the phytochemistry and toxicological profiles of Aloe vera and Aloe ferox. Future Journal of Pharmaceutical Sciences, 7, pp.1-21.
https://doi.org/10.1186/s43094-021-00296-2
▪ Elamin, O.H.S., Ali, M.A., Elgezuli, I.A.A., Bashir, M.A. and Kahwa, I., 2021. Diagnosis of pre-and post-treatment of echinococcus granulosus with counter current immune electrophoresis and bacterial co-agglutination. Journal of Microbiology and Infectious Diseases, 11(02), pp.88-94.
https://doi.org/10.5799/jmid.951600
Published book Chapter
▪ Kahwa, I., Ayesiga, I., Nakalema, S., Alinaiswe, R., Mbabazi, R. and Iqbal, S., 2023. Natural products in the management of onchocerciasis. In Natural Products in Vector-Borne Disease Management (pp. 63-80). Academic Press. Book Chapter.
https://doi.org/10.1016/B978-0-323-91942-5.00012-4
Submitted manuscripts Under Review:
▪ Comparison of the Wound Healing Activity of the Leaf and Leaf Ash Extracts of Vernonia amygdalina in Rats. Journal name: Clinical Phytoscience
▪ Ethnobotanical Survey of Medicinal plants used in the management of cancer in Uganda. Journal name: Journal of Herbal Medicine
▪ Ethnobotanical survey and phytochemical screening of medicinal plants used in treatment of epilepsy by PROMETRA-Uganda Traditional Health Practitioners in Mpigi District, Uganda. Journal name: Journal of Ethnopharmacology
Submitted book chapters under review
1.Book title: Algae as a Natural Solution for Water-Food-Energy Nexus, Section 4: Microalgae and cyanobacteria for food applications, Chapter 4.6: Safety, toxicological and allergenic aspects of using algae for food. Authors: Christine Kyarimpa, Tom Omute, Caroline K. Nakiguli, Alice V. Khanakwa4, Christopher Angiro, Ivan Kahwa, Fortunate Ahumuza, Timothy Omara*. Publisher: Springer Nature Singapore Pte Ltd. 152 Beach Road, #21-01/04 Gateway East, Singapore 189721, Singapore.
2.Book title: Nutraceuticals Inspiring the Contemporary Therapy for Lifestyle Diseases. Chapter: Nutraceutical applications of Seaweeds and their Phytocompounds in Nutrition and Treatment of Diseases. Authors: Ivan Kahwa, Timothy Omara , Innocent Ayesiga , Gael Noel Neh Neba Ambe , Zehbanaz Javidbhai Panwala , Rachel Mbabazi , Shabnoor Iqbal , Christine Kyarimpa , Christine Betty Nagawa , Kamal Shah ,Nagendra Singh Chauhan* Publisher: CRC Press
You can view my works on the following professional sites:
Research Gate: https://www.researchgate.net/profile/Ivan-Kahwa
Google Scholar: https://scholar.google.com/citations?user=tOwrvqoAAAAJ&hl=en
ORCID: https://orcid.org/0000-0002-6440-3437
Linkedin: https://de.linkedin.com/in/ivan-kahwa-865450159
In this article, we will discuss the use of Cymbalta in managing the pain associated with spinal stenosis. We will also discuss the research studies linking the use of Cymbalta and spinal stenosis as well as the limitations of Cymbalta in managing spinal stenosis. Additionally, we will discuss the alternatives to Cymbalta for managing spinal stenosis.
Does Cymbalta help spinal stenosis?
Cymbalta does not help with spinal stenosis. However, Cymbalta may help in reducing the pain associated with spinal stenosis, it is not used as a first-line treatment for spinal stenosis. It is commonly used for conditions like depression, anxiety, and fibromyalgia.
Cymbalta is an antidepressant medication that works by interfering with the levels of serotonin and norepinephrine in the brain. By increasing the levels of these neurotransmitters, Cymbalta helps in the regulation of mood and alleviation of various symtoms of mental disorders (1).
In specific cases where neuropathic pain is a significant component of spinal stenosis symptoms, medications like Cymbalta may be considered to reduce pain. Cymbalta is sometimes used to manage chronic pain conditions, including those associated with lower back pain and cervical spinal surgery.
What does research suggest?
In a research study, Cymbalta was utilized in managing pain associated with surgery for spinal stenosis. The medication was well-tolerated by patients, initiated at a minimal dose, and gradually increased to 60mg before the surgery. The treatment was sustained until one week after the operation, demonstrating its effectiveness (2).
These research findings suggest the role of Cymbalta in managing pain after spinal stenosis surgery, however, there is no research evidence directly linking the use of Cymbalta for treating spinal stenosis.
What are the limitations of Cymbalta in treating spinal stenosis?
While Cymbalta is sometimes used to manage chronic pain, including those associated with nerve compression, it has limitations in treating spinal stenosis. Its effectiveness in managing spinal stenosis-related pain is limited for several reasons such as:
- The mechanism of action of Cymbalta is not specifically tailored to address the physical compression of nerves in the spine, which is a characteristic feature of spinal stenosis.
- Cymbalta may help manage associated pain, but it does not address the structural issue causing the compression during spinal stenosis.
- Individuals with spinal stenosis may respond differently to medications. While some may experience relief, others may find minimal or no benefit from Cymbalta for their specific symptoms.
What are the approved treatment strategies for spinal stenosis?
The approved treatment strategies for spinal stenosis typically include a combination of pharmacological and nonpharmacological approaches, tailored to the severity of symptoms and individual patient factors. Pharmacological intervention uses medications for the management of spinal stenosis and its associated symptoms. These medications may include:
- analgesics such as paracetamol, diclofenac, naproxen (for pain management)
- muscle relaxants such as tizanidine (for managing muscle spasms)
- gabapentin (for neuropathic pain)
- corticosteroids (to reduce inflammation)
- opioids (for severe pain)
These medications are designed to alleviate discomfort, address severe pain, and target muscle spasms associated with spinal stenosis. It’s essential to understand that while these medications can offer symptomatic relief for spinal stenosis symptoms, they do not address the underlying structural problem causing the compression.
Additionally, the long-term use of specific medications, particularly opioids, necessitates a thoughtful evaluation of potential risks and benefits. In cases of severe symptoms that are unresponsive to conventional treatments, surgical interventions may be considered as an alternative.
What are the non-pharmacological approaches for managing spinal stenosis?
There are several non-pharmacological approaches that can help manage spinal stenosis and its associated symptoms. These may include:
- Exercises that are tailored to enhance suppleness, strengthen core muscles, and promote overall movement of muscles. These activities can be effective in managing symptoms.
- The use of supportive devices like braces and walkers can reduce the spinal load and help improve movement.
- Strategic avoidance of activities that worsen symptoms, such as extended periods of standing or sitting, coupled with adjustments to daily routines, plays a crucial role in managing symptoms.
- Surgical interventions may be necessary in some cases. Procedures involving the reduction of pressure on the spinal cord or nerves, such as decompressive surgeries, are undertaken. Additionally, in specific cases, spinal fusion surgery is recommended.
In my opinion, Cymbalta is not a suitable choice of drug for managing spinal stenosis. It may help in reducing the pain associated with this condition but overall Cymbalta does not improve the quality of life of patients with spinal stenosis.
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References
1.-
Dhaliwal JS, Spurling BC, Molla M. Duloxetine. 2023 May 29. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan–. PMID: 31747213. https://pubmed.ncbi.nlm.nih.gov/31747213/
2.-
Govil N, Parag K, Arora P, Khandelwal H, Singh A; Ruchi. Perioperative duloxetine as part of a multimodal analgesia regime reduces postoperative pain in lumbar canal stenosis surgery: a randomized, triple blind, and placebo-controlled trial. Korean J Pain. 2020 Jan 1;33(1):40-47. doi: 10.3344/kjp.2020.33.1.40. PMID: 31888316; PMCID: PMC6944370.
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