Nutrition and Chronic Pain

By Malik Tiedt, BSPH Student in Nutrition

Imagine what it feels like to pull a muscle. It’s debilitating, painful, and often results in weeks or months of rehabilitation. However, there’s always a component of hope – the prospect that you will return to normal and regain your strength. 

Now, imagine what it would feel like to pull a muscle and never improve. Despite the medication you try or the doctor you see, there is a constant, dull ache that prevents you from getting out of bed. It sounds like a nightmare, right?

When lasting more than 3 to 6 months, these symptoms are often diagnosed as chronic pain, which may refer to anything from musculoskeletal pain to persistent migraines. Nearly 20% of adults around the globe experience this condition, causing many international organizations to consider it as a major medical priority. 

This article explores how nutrition may be related to the development of chronic pain, and how improving dietary quality may play a role in managing chronic pain symptoms.

What is the cause of chronic pain?

Every case of chronic pain is different. For some, it may have started with poor posture or a traumatic injury – for others, it may be related to a disease such as diabetes, rheumatoid arthritis, cancer, ulcers, or multiple sclerosis. Yet, there are still some cases of chronic pain that have no obvious physical cause. Ultimately, the etiology of chronic pain remains a conundrum for researchers, clinicians, and patients alike. 

The exact physiological mechanisms of chronic pain are not well understood, especially since pain is a subjective experience (people experience pain differently). However, it is generally proposed that pain results from changes in nerve cells or signaling involved in the central nervous system. 

How is nutrition related to chronic pain?

Several of the National Institutes of Health’s objectives to treat chronic pain involve nutrition-related phenomena, such as researching the gut-brain-microbiome pathway, the utilization of probiotics, and the relationship between antioxidants and pain. These aims primarily focus on reducing inflammation: a common condition of the aforementioned diseases. Inflammation is characterized by swelling, increased blood flow, and the release of proinflammatory hormones such as histamine and bradykinin, both of which can irritate nerves and send pain signals to the brain. 

The western diet is heavy in processed meat, sugar, refined grains, and low intake of fruits and vegetables. This results in the overproduction of proinflammatory hormones and free radicals that have negative implications on neuron functioning. Increasing fruit and vegetable intake helps increase the intake of molecules called antioxidants, which are protective against inflammatory molecules. 

The general idea proposed by researchers is that reducing intake of proinflammatory foods and increasing intake of unsaturated fats, fruits, and vegetables reduces inflammation. Eating an anti-inflammatory diet can also enhance the function of nervous, immune, and endocrine systems that directly impact pain experiences. 

Recommendations

Please consult a Registered Dietitian or physician if you are looking for medical advice regarding chronic pain or making changes to your diet. To find a Registered Dietitian near you, please click here. For general information about eating an anti-inflammatory diet, the Mayo Clinic offers a few rules of thumb: 

1. Eat more plants (fruits, veggies, whole grains)
2. Focus on antioxidants (look for colorful berries and leafy greens)
3. Get your omega-3s (eat more healthy fats in fish, walnuts, flaxseed, and soy)
4. Eat less red meat (try substituting with fish, nuts, or soy-based protein)
5. Cut out processed foods (no sugary drinks, fired foods, pastries) 

Peer-edited by Tejaswini Petkar, Msc Microbiology

Image credit: Malik Tiedt