A case study from the Institute for Neuropathic Pain concludes that combining acupuncture with palmitoylethanolamide (PEA) has a synergistic effect in reducing central neuropathic pain for patients with multiple sclerosis (MS). The combination reduces both pain intensity and the duration of pain relief. PEA is an endogenous fatty acid amide and is an endocannabinoid with an affinity for the cannabinoid-like receptors GPR55 and GPR119. Unlike THC (a psychoactive component in marijuana), PEA does not bind to CB1 and CB2 cannabinoid receptors.

The researchers note that acupuncture partially reduced the 61 year old female patient’s pain. After adding PEA to the regime of care, the patient’s pain levels decreased even further than with acupuncture as the only treatment modality. Additionally, the patient needed less frequent acupuncture care when using PEA to help control pain levels. The researchers suggest that a "multimodal stepped care approach is demonstrated" with both acupuncture and PEA affecting activated glial cells, which are important cells in relation to the control of neuropathic pain.

Reference:
Acupunct Med 2012; 30:53-55 doi:10.1136/acupmed-2011-010119. Multimodal stepped care approach with acupuncture and PPAR-α agonist palmitoylethanolamide in the treatment of a patient with multiple sclerosis and central neuropathic pain. David J Kopsky, Jan M Keppel Hesselink.