Medicinal Plants and Phytochemicals in Neuropathic Pain: Mechanistic Insights and Therapeutic Potential

Neuropathic pain (NP) is a multifaceted condition with severe symptoms that have proven difficult to treat with conventional pharmacotherapies, which are hampered by partial efficacy and adverse effects. This review presents a comprehensive evaluation of the evolving scientific literature, demonstrating the pivotal role of medicinal plants and isolated phytochemicals as promising therapeutic alternatives for managing NP. This review also elucidates the complexity of NP pathophysiology, including peripheral and central sensitization, neuroinflammation, ion channel dysregulation, and oxidative stress. The article subsequently details a broad range of plant-derived compounds (e.g., curcumin, quercetin, and rosmarinic acid) and whole-plant extracts that have demonstrated efficacy in preclinical models, including chronic constriction injury (CCI), spared nerve injury (SNI), and chemotherapy-induced peripheral neuropathy (CIPN), through anti-inflammatory, antioxidant, ion channel modulatory, and neuroimmune mechanisms. In addition, we note that combining herbal therapeutics with conventional drugs yields synergistic effects that maximize analgesia and minimize side effects. Although there are good preclinical outcomes, further clinical research is required, including standardization, bioavailability issues, and the undeniable need for convincing human clinical studies. The review concludes that plant-based therapies can be considered a potential multi-target approach to NP. Further, the review underscores that the move to clinical practice requires advanced delivery platforms, well-designed clinical research, and a combination of strategies.