The Sandbox Trifecta includes: physical fitness, therapy & nutrition. It’s no different if you’re trying to lose weight or battle chronic pain.

However, for those of us dealing with chronic pain, nutrition might play a bigger role than we thought.

There is a reason though that we say “you are what you eat” and that “food is medicine”.

Chronic pain is a growing epidemic, especially in developed countries like Canada and the United States. The reasons for this are many, however, particular scrutiny is on our growing reliance on convenience foods. And that’s just a polite way of saying junk food, the highly processed, often deep fried, and nutrient deficient stuff we’ve come to crave.

Like we said above though, “you are what you eat.” If you’re eating garbage it makes sense that you’ll feel like garbage. It might not be the nicest way to put it, but it’s true.

“A lot of chronic pain is the result of chronic inflammation, and the evidence is quite strong that your diet can contribute to increased systemic inflammation…but your diet is also one of the best ways to reduce it” (2021).

So before we look at how diet can help reduce inflammation in the body, let’s take a look at how it functions in the first place.

Inflammation

It’s good. It’s bad. And it’s sometimes ugly.

Inflammation, though it gets a bad rap, is an important part of our bodies’ healing process and immune response. Essentially, inflammation is how our body responds to injuries and harmful or foreign stimuli; and, “many types of cell injury can cause inflammation, including hypoxia, physical agents such as trauma and burns, chemical agents and drugs, infectious agents, immunologic reactions, genetic derangements, and nutritional imbalances involving both deficiencies and excesses of various nutrients” (Seaman, 2002).

Just as pain is either acute or chronic, so too is inflammation. The role of inflammation is to last until tissue damage has been repaired and then wane. Inflammation stops being a part of the healing process and becomes a disease in itself when it lingers in excess in the body; according to one article, “modern authors agree that inflammation should lead to tissue repair and remodelling, which allows for restoration of function. However, when acute inflammation becomes chronic, tissue healing cannot occur” (Seaman, 2002).

Not only does chronic inflammation then inhibit the healing process leading to chronic pain and degenerative disease, but it becomes a driving factor in 6/10 of the leading causes of death in countries like the United States: coronary heart disease, cancer, stroke, diabetes, atherosclerosis, and chronic liver disease and cirrhosis (Seaman, 2002).

So, what do we do? 

Well, studies have shown that diet can reduce inflammation. The why and how of it are not altogether clear, but “evidence suggests that deficiencies in various micronutrients–like zinc, selenium, iron, folic acid, vitamins A, B6, C, and E–may alter immune system function” (2021). Additionally, studies have unequivocally shown that micronutrient supplements, especially for omega-3 fatty acids, vitamins B1, B3, B6, B12 and vitamin D, magnesium zinc and β-carotene, have helped alleviate chronic pain in test groups (Dragan et al., 2020).

In 2020, a group of researchers scoured the PubMed database, one of the most comprehensive databases for medical literature, using the key words “chronic pain” and “diet” in an attempt to elucidate the relationship between specific diets and their impact on pain. They narrowed their search down from thousands of hits to 38 clinical studies and randomized controlled trials which were “analyzed, in an attempt to characterize present-day dietary patterns and interventions to alleviate chronic pain” (Dragan et al., 2020).

Their article is fascinating.

Furthermore, it shows that there is without a doubt a correlation between eating habits and pain.

Their article shows that a number of different mainstream diets, when adhered to by those suffering from chronic pain, were able to reduce the frequency of painful episodes, as well as the intensity of pain in many cases. Intermittent Fasting, Ketogenic diets, low carb restricted FODMAP diets, plant based diets and elimination diets (to name but a few), all saw a positive outcome in pain management

It’s particularly interesting that all of the above mentioned diets were successful in reducing pain given the conflicting nature of many of them. A plant based diet is often higher in carbohydrates and lower in protein consumption, while a ketogenic diet is high in protein and fat but low in carbs. Many elimination diets exclude dairy products while a low carb or ketogenic diet might lean more heavily on them.

The one thing all of these diets did have in common, was their reliance on whole, unprocessed foods, including plenty of fruits and vegetables. These diets heavily restricted processed foods that are higher in calories and lower in all around nutritional value. These diets all, in very different ways, reduced proinflammatory foods and increased foods high in micronutrients and anti-oxidants. As a result of these improved eating habits, many subjects involved in these studies saw an unintended but significant decrease in body weight. The reduction in body weight likely reduced the load on joints and in addition to decreasing inflammation, which could have also contributed to the overall improvement of pain.

So, we would argue that the specific diet you choose to combat pain is less important than:

• finding a diet you can stick with long term
• eating a variety of different coloured fruits and vegetables
• increasing your fibre intake
• supplementing where necessary
• eliminating highly processed, nutrient deficient, deep fried foods and foods high in sugar

**It is important to note though, that people who suffer from diseases like Celiac or diabetes may need to adhere to a more specific diet, as per their doctor’s recommendations. Never make drastic changes to your diet or introduce supplements without first consulting your family physician.

Ultimately

“Inflammation and oxidative stress are the main pathophysiological path ways of chronic pain…”(Dragan et al., 2020); however, we are able to combat the process with changes to our diet.

Diets filled with a variety different coloured fruits and green leafy vegetables, whole grains, healthy fats (like nuts and seeds), legumes, and lean protein are both anti-inflammatory and packed with the micronutrients and anti-oxidants required to combat existing inflammation and oxidative stress in the body.

It is important to address chronic pain as soon as possible as it has been linked to additionally issues like weight gain, risk of multi-morbidity, poor eating habits and decreased diet quality (likely due to the pain associated with standing and cooking).

If you need help with your nutrition or managing chronic pain, never hesitate to reach out.

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References:

Can diet heal chronic pain? Harvard Health. (2021, February 15). Retrieved April 12, 2023, from https://www.health.harvard.edu/pain/can-diet-heal-chronic-pain

Dragan, S., Șerban, M.-C., Damian, G., Buleu, F., Valcovici, M., & Christodorescu, R. (2020, August 19). Dietary patterns and interventions to alleviate chronic pain. Nutrients. Retrieved April 12, 2023, from https://www.ncbi.nlm.nih.gov/pmc/Dietary Patterns and Interventions to Alleviate Chronic Painarticles/PMC7551034/

Nutrition and chronic pain. International Association for the Study of Pain (IASP). (2021, July 11). Retrieved April 12, 2023, from https://www.iasp-pain.org/resources/fact-sheets/nutrition-and-chronic-pain/

Seaman, D. R. (2002). The diet-induced proinflammatory state:: A cause of chronic pain and other degenerative diseases? Journal of Manipulative and Physiological Therapeutics, 25(3), 168–179. https://doi.org/10.1067/mmt.2002.122324