What is the best diet for people who experience persistent pain? Can pain relief be found in certain foods? What is a pain care practitioner’s role in guiding clients towards better dietary habits?
This is Part 2 of How to Manage Pain Using Nutrition
How to Manage Pain Using Nutrition Part 1 reviewed some of the powerful evidence supporting the role nutrition plays in chronic pain management. Though most of these studies are still in their infancy in terms of how food x causes pain experience y, it is generally accepted that an anti-inflammatory diet can “reduce the prevalence of many chronic diseases that are associated with pain.” (1)
The Anti-Inflammatory Diet in a Nutshell
Generally speaking, an anti-inflammatory diet is comprised of unprocessed whole foods, including, but not entirely limited to:
- Whole grains
Table 1 shows a list of pro- and anti-inflammatory foods, though a more detailed description of the anti-inflammatory diet can be found here. Nutritional science has taken research to the next level by exploring specific vitamins and minerals that prove to be highly effective at improving pain, inflammation, and healing. (2,3)
|Anti-Inflammatory Foods||Pro-Inflammatory Foods|
|Leafy green vegetables||Bread|
|Beans and lentils||Processed cereals|
|Whole grains||White rice|
|Quinoa and buckwheat||Red meat|
|Nuts and seeds||Potatoes|
|All berries||Fried foods|
3 Supplements Shown to Alleviate Chronic Pain
Richly available in whole foods, the following supplements are also available for purchase in pure form. These supplements are affordable, and have shown great potential to improve chronic pain conditions.
- Vitamin D
Deficiencies in vitamin D are associated with inflammation and susceptibility to illness, and many people with chronic pain have shown significant vitamin D deficiencies. (1) Taking one vitamin D supplement each day may be enough to lessen pain intensity. (4-7) Foods considered high in vitamin D include fatty fish, such as tuna, mackerel, and salmon. You can also purchase foods that are fortified in vitamin D, including healthy cereals, tofu, and yogurt.
- Vitamin B12
Studies show that chronic pain is one consequence of B12 deficiency. Researchers have even found that pain patients taking B12 injections experience reduced pain scores and less analgesic use. (1,8) Foods that are high in vitamin B12 include fish; organic, free-range chicken and eggs; and fortified food products.
- Omega-3 Oils
Much research supports the relationship between increased consumption of omega-3 fatty acids and decreased pain. Omega-3s are shown to impact the anti-inflammatory pathways in the brain and are currently being studied for their ability to influence headache pain. (9) Researchers have also shown that people suffering from chronic conditions such as arthritis and joint discomfort experience less pain and a reduction in NSAID consumption with a diet that is high in omega-3 oils. (10,11) Omega-3 oils can be found in flaxseed oil, soybeans, chia seeds, fish, and organic free-range eggs.
Read this 2018 meta-analysis and systematic review on the benefits of ω-3 polyunsaturated fatty acids on rheumatoid disease activity.
5 Ways Practitioners Can Educate Clients on the Benefits of Nutrition
When statistics report that junk food makes up approximately one-third of the average American’s diet, it’s not surprising that obesity, depression, and chronic pain are also escalating at staggering rates. (12)
Mounting evidence for nutrition’s importance makes it our responsibility as modern pain care practitioners to plant the seeds of dietary awareness at the very least. In this way, we can stress the importance of nutrition in achieving optimum health and enhanced quality of life.
Dr. Tatta’s simple and effective pain assessment tools. Quickly and easily assess pain so you can develop actionable solutions in less time.
5 Simple Ways We Can Help:
1) Convey the importance of dietary habits in treating pain.
2) Explain how an anti-inflammatory diet can help reduce pain.
3) Screen for nutritional deficiencies and make positive dietary suggestions.
4) Include lifestyle habits as part of a patient’s assessment questionnaire or health history form.
5) Make relevant dietary resources readily available or have a list of resources on hand.
How do you address nutrition and lifestyle habits into your clinical practice?
What role does nutritional guidance play in your clinic? Do you have any patient success stories you’d like to share? We’d love to hear from you!
- Tick H. Nutrition and pain. Phys Med Rehabil Clin Am 2015;26:309-20.
- Tick H. Holistic Pain Relief. Novato (CA): New World Library; 2013.
- Bethesda MD. Dietary and herbal supplements. National Center for Complementary and Alternative Medicine (NCCAM); 2013. Available at: http://nccam.nih.gov/health/supplements.
- Plotnikoff GA, Quigley JM. Prevalence of severe hypovitaminosis D in patients with persistent, nonspecific musculoskeletal pain. Mayo Clin Pric 2003;78(12):1463-70.
- Macfarlane GJ, Palmer B, Roy D, et al. An excess of widespread pain among South Asians: are low levels of vitamin D implicated? Ann Rheum Dis 2005;64(8):1217-9.
- Al Faraj S, Al Mutairi K. Vitamin D deficiency and chronic low back pain in Saudi Arabia. Spine 2003;28(2):177-9.
- de Torrente de la Jara G, Pecoud A, Favrat B. Musculoskeletal pain in asylum seekers and hyptovitaminosis D3. BMJ 2004;329(7458):156-7.
- Mauro GL, Martorana U, Cataldo P, et al. Vitamin B12 in low back pain: a randomised, double-blind, placebo-controlled study. Eur Rev Med Pharmacol Sci 2000;4(3):53-8.
- Ramsden CE, Mann JD, Faurot KR, et al. Low omega-6 vs. low omega-6 plus high omega-3 dietary intervention for chronic daily headache: protocol for a randomized clinical trial. Trials 2011;12:97.
- Maroon JC, Bost JW. Omega-3 fatty acids (fish oil) as an anti-inflammatory: an alternative to nonsteroidal anti-inflammatory drugs for discogenic pain. Surg Neurol 2006;65(4):326-31.
- Lee YH, Bae SC, Song GG. Omega-3 polyunsaturated fatty acids and the treatment of rheumatoid arthritis: a meta-analysis. Arch Med Res 2012;43(5):356-62.
- Block G. Foods contributing to energy intake in the US: data from NHANES III and NHANES 1999-2000. J Food Compost Anal 2004;17:439-47.