Pain Management Q&A by Dr. Helm
Cymbalta (duloxetine) is approved for the treatment of diabetic peripheral neuropathy, which is a form of neuropathic pain. It acts by preventing the reuptake of serotonin and norepinephrine, which are both neurotransmitters in the central nervous system.
In neuropathic pain, the nervous system itself is the source of pain. One of the things that the nervous system does is to filter out information being sent to it, so that only important information is sent on to the brain. One way that this happens is by having more of the neurotransmitters such as serotonin and norepinephrine present in the spinal cord and brainstem. It seems reasonable to conclude that if increasing the neurotransmitters helps for one type of neuropathic pain, then it might also help with other types of neuropathic pain, such as might occur after nerve damage in the cervical spine. While this use of Cymbalta is off-label (meaning that it has not been FDA approved for this indication), most pain physicians would be very willing to try a safe drug like Cymbalta to see if it worked.
Thank you for your question.
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