This literature review explores the plausibility of a sometimes-observed association between neuropathic pain and statin use.

Statins are complex drugs that work to lower cholesterol by reversibly inhibiting enzyme 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase and they likewise reduce C-reactive protein levels and may decrease the levels of pro-inflammatory cytokines.

Neuropathic pain occurs in 1.5% to 6.9% of the general population and is particularly prevalent among people with type 2 diabetes.

In animal studies, statins appear to reduce neuropathic pain but in humans, lowered cholesterol has been observed in association with increased neuropathic pain.

Impaired mitochondrial transport has been implicated as playing a role in the development of neuropathy and is associated with deficits in vitamin E.

Statins can inhibit the synthesis of ubiquinone (co-enzyme Q) and it is not yet elucidated if this may be associated with neuropathy.

The American Heart Association has stated that there is “no convincing evidence for a causal relationship” between statins and peripheral neuropathy although such observations persist in medicine

Statins are pleiotropic drugs and are associated with many effects, of which only a subset has been elucidated, but there is no clear link between statins and neuropathic pain.