Analgesia and silymarin: What are the opportunities and challenges?

Pain is an unpleasant sensory and emotional sensation about actual or possible tissue damage that can cause remarkable health and economic problems. For pain relief, analgesic drugs are commonly utilized; however, their prolonged use can cause different side effects from mild to severe stages. Therefore, discovering new and alternative choices for analgesic purposes is of importance. Hopeful evidence has shown that flavonoid compounds have various therapeutic and pharmacological potentials. Among these, silymarin, obtained from the milk thistle plant Silybum marianum, has addressed its competence in medicine, as demonstrated by its capacity against metabolic diseases, malignancies, inflammatory-related disorders, and organ toxicities. In the recent decade, some documents have stated the analgesic influences of silymarin, especially in some pathological situations like rheumatoid arthritis and neuropathic pain. Also, there is promising information regarding the possible synergistic effects of silymarin and some pharmacological or bioactive compounds. For these reasons, this narrative literature review aims to summarize and discuss the analgesic abilities of this flavonoid agent in pathological and nonpathological conditions and its interactions with other drugs with a focus on the involved mechanisms.