Palmitoylethanolamide (PEA) has been investigated as a potential treatment for neuropathic pain, including neuralgia and neuritis, and there is a growing body of scientific evidence supporting its use. PEA is an endogenous fatty acid amide that acts primarily as an anti-inflammatory and neuroprotective agent, modulating mast cell activity and interacting with the endocannabinoid system (mainly through PPAR-α receptors). Several randomized controlled trials and meta-analyses have examined PEA's efficacy in neuropathic pain conditions. For example, a 2017 meta-analysis by Paladini et al. (Pain Physician) included multiple clinical trials and concluded that PEA supplementation resulted in significant reductions in pain intensity in chronic and neuropathic pain syndromes, with minimal side effects.

While these studies suggest a positive effect, the sample sizes are often small and the methodological quality varies. Nonetheless, PEA is used in some European countries as a supplement for conditions like sciatic pain, carpal tunnel syndrome, and other forms of neuralgia and neuritis. Its favorable safety profile and lack of significant drug interactions further support its consideration as an adjunct therapy. However, larger and higher-quality studies are needed to firmly establish its efficacy and to determine optimal dosing and duration. Thus, the scientific evidence is promising but not definitive, warranting a moderate evidence rating.