Cymbalta (Duloxetine) for Pain

Cymbalta is FDA approved for chronic painful conditions, including diabetic peripheral neuropathy, fibromyalgia, chronic osteoarthritis pain, and chronic low back pain. It is indicated for adults who require daily treatment for an extended period of time.

Duloxetine offfers the following benefits in pain management 2:

  • New treatment option with a different mode of action.
  • Proven efficacy in diabetic peripheral neuropathic pain, fibromyalgia, osteoarthritis, and chronic low back pain.
  • Pain-relieving effect comparable to that of NSAIDs and opioids.

Low back pain

Cymbalta is used for the management of chronic low back pain. It significantly reduces pain, improves functioning and activity level 1.

Duloxetine is non-addictive and can be taken once a day, every day, to help relieve back pain. While the exact way how duloxetine works is unknown, it is believed to relieve chronic pain by enhancing the body's natural pain-suppressing system by increasing the activity of serotonin and norepinephrine in the brain and spinal cord.

Dosage for back pain: 30 mg once daily for 1 week, then increase to 60 mg once daily as tolerated.

Neuropathic pain

Neuropathic pain (or nerve pain) is a pain caused by damage, injury or dysfunction of nerves. When this damage is to nerves outside the spinal cord it is called a peripheral neuropathy. Although Cymbalta won't prevent nerve damage, it can help manage nerve pain.

Studies have shown that Cymbalta can significantly relieve diabetic nerve pain. Many patients notice an analgesic effect within the first week.

Dosage for nerve pain: the recommended starting and maintenance dose is 60 mg daily.

Further reading


  • 1. Skljarevski V, Desaiah D, Liu-Seifert H, Zhang Q, Chappell AS, Detke MJ, Iyengar S, Atkinson JH, Backonja M. Efficacy and safety of duloxetine in patients with chronic low back pain. Spine (Phila Pa 1976). 2010 Jun 1;35(13):E578-85.
  • 2. Duloxetine for the Management of Chronic Pain. PDF

Author: OriginalDrugs Team
Last reviewed: February, 2015

Quick facts

  • Duloxetine mechanism of action in pain conditions is different from that of opioids and NSAIDs.
  • Duloxetine does not have synergistic toxicity with other analgesics.