Magnesium for chronic pain: a condensed review

My interest in magnesium stems from looking for alternative relief after my back surgery in 2012. Magnesium is known to be a muscle relaxant and much of my discomfort with secondary to muscle spasms. My training is it is as an anesthesiologist and critical care physician.

Magnesium levels are often measured in assessing electrolyte values. But the emphasis in my training was focused on other electrolytes and minerals and their known impact on health. But magnesium was often glossed over.   In researching information my eyes were open to a whole literature specifically focusing on this particular mineral that I did not know existed.

I have used both oral and transdermal forms of magnesium for 7 years now. I get great relief from my back spasms most days.  If I forget to use the cream for more than one day, I am aching and have trouble moving easily about.  Recently I didn’t have any immediately available for 2 weeks. My body was very unforgiving. 


The following below is a review of some literature regarding the uses of magnesium, several focusing on its efficacy in chronic pain.

Early in the 20th century, it was known that magnesium had a sedative effect and functioned as a muscle relaxant, as well as having analgesic properties. The most easily readable book is Dr. Carolyn Dean’s “Magnesium Miracle,” describing its effect on everyday life. A more in-depth but also understandable reference is from the University of Oregon Linus Pauling Institute.  It goes into great detail describing the effect on the cardiovascular system, possible impact on reliving asthma, up-regulation of insulin receptor function in DM 2, bone structure, enzymatic function, and importance in pregnancy.   A very dense description of magnesium and the brain, edited out of Australia, devotes 24 chapters to the impact of magnesium on the brain.  The last couple chapters of that book describe using magnesium to help withdraw from drugs in a healthy manner

  1. Dr. Mildred Seelig describes in her book “Magnesium deficiency in the Pathogenesis of Disease” why magnesium is important in development of the fetus. Magnesium deficiency during pregnancy affects mitochondrial function and cellular respiration and can contribute to neuromuscular disorders in the newborn.

In an article from Anesthesia and Analgesia in 2020 (September 2020-volume 131 – Issue 3 p764-775) there is a review of multiple studies studying the efficacy and safety of magnesium for the management of chronic pain in adults.  To get technical for a moment: The analgesic (pain relief) effects of magnesium are through blocking the N-methyl d- aspartate receptors (NMDA)  in the spinal cord. These receptors contribute to pain transmission and mediate the process of central sensitization which is a process where acute pain transitions to chronic pain. Painful stimuli activate the NMDA receptors, initiating a series of events leading to pain.  Administering magnesium can attenuate the process of central sensitization and lessen  the effect of the increased activity occurring in the spinal neurons, thus decreasing pain

In this article, many different studies were reviewed, reviewing oral and intravenous, and intramuscular routes of administering magnesium. The overall evidence did not sway one way or another to its efficacy, AND all the studies were 6 weeks or less, rather than over an extended time. Further, there was no study of transdermal application reviewed in this article. The most positive finding in the reviews was regarding chronic back pain. And because magnesium is safer than ketamine, which also blocks  the NMDA receptors to provide pain relief, but can lead to dysphoria, magnesium continues to be studied as an alternative for pain relief

Journals Nutrients Volume 13 Issue 5 10.3390/nu13051397

In this study of multiple articles regarding the efficacy of magnesium either intravenously for acute post-op pain or orally for chronic pain, the use of typical analgesics was decreased when IV magnesium was given peri-operatively. The use of oral magnesium was less apparent in relieving pain. It suggests more clinical trials need to be done to better optimize the use of magnesium in pain and in co-morbidities associated with pain. Again, transdermal use was not reviewed in these studies.

Transdermal application has the advantage over oral forms in being immediately available to areas of discomfort such as muscle creams. When applied to the soles of the feet, given the vascularity of the foot, there is better systemic absorption without needing to be absorbed through the gut. This eliminates some of the GI effects that can occur with some of the oral formulations.  This is why we advocate the transdermal application of our product, as it is easy to apply.