Pain is a master at concealing its true identity. Why is pain so difficult to treat? And why does it persist? It draws your attention to one area, distracting you from the real origin of your pain. In my experience, the real magic and relief in healing pain begins with healing the gut. If you have an inflammatory condition such as diabetes, an autoimmune disease, arthritis, neuromuscular disease or chronic unrelenting joint pain this is where to begin. You may just find eliminating your pain occurs alongside reducing inches from your waistline.
Your Gut, Home of Your Immune System
Inflammation is often present if there is pain, and it is associated with many chronic diseases you struggle with today. Most of us think of our immune system as cells floating around in our bloodstream that attack a virus or bacteria when we are sick. What most people don’t realize is that the majority of your immune system lives in their gut. Upwards of 70 percent of your immune system is located in your digestive tract, making a healthy gut a major focal point if you want to maintain optimal health. (1) Why is the majority of your immune system located in your gut? Because the first wave of attack from foreign invaders, such as bacteria, fungus, viruses, toxins, and even food particles you are allergic to or have an intolerance to happens in your gut. The days of looking at the digestive tract as a passive tube where food enters is “digested” and exits is an outdated and simplistic view of how nutrition affects your overall health. A healthy and robust immune system is our number one defense system against inflammation, pain, and obesity—the link to all disease. The root of your pain is often inflammation, and it begins in your gut.

The Microbiome and Immunity
There are more than 500 species and more than 100 trillion bacteria that coexist and have coevolved with humans. You are more microbiome than you are human. This symbiotic relationship in our gut exists to provide the positive health effects of producing vitamins B and K and short-chain fatty acids, lowering pH, producing anti-microbial compounds, and stimulating the immune system. (2)
The Gut-Joint Connection
Hippocrates, the father of modern medicine, stated that all healing begins in the gut. Diet plays a crucial role in maintaining the delicate balance of our microbiome and the proper amount and type of bacteria, fungi, and viruses, as well as avoiding multiple organ dysfunction syndrome (MODS). When alterations of our microbiome are compromised, dysbiosis occurs, meaning that there is a microbial imbalance, which can lead to a variety of illnesses from inflammatory bowel disease to cancer. This is not only observed in the gut but also in parts of the body where no direct anatomical connection exists. This new area of science is beginning to identify “gut-related axes.” Of particular interest is the existence of a gut-joint axis and its relation to musculoskeletal pain. (3)

Regarding diet, a relationship between obesity, inflammation, and the gut microbiome has been established. (4) Obesity is a disorder of chronic low-grade inflammation and has been implicated in increased intestinal permeability and dysbiosis. Pro-inflammatory cytokines in obese patients disrupt tight junctions, impairing the intestinal barrier. Microbiome changes in the gastrointestinal tract can have multiple effects, however, the primary considerations causing inflammation are:

• over absorption of bacterial cellular debris
• nutrient malabsorption
• intestinal permeability or leaky gut

The passage of antigenic material (toxins, bacteria, food antibodies/allergies, and microbes) through the lining of your gut and into circulation can deposit them in your joints, tendons, synovial sheaths, muscles, and ligaments. The link between obesity, inflammation, and our microbiome is beginning to reveal how previously thought chronic musculoskeletal problems, such as osteoarthritis, are not simply one of physical wear and tear. This may explain why a large number of obese patients develop osteoarthritis in non-weight bearing joints, such as the wrist joints, pointing to a systemic inflammatory cause. (5)
Do You Have a Leaky Gut?
Your gut is a barrier between the inside of your body and the outside world. The inner lining of your intestines acts as a physical barrier, closely controlling what is absorbed and allowed to pass through. Maintaining the integrity of this barrier is crucial. The inner lining of your gut wall is one cell thick. These single-celled warriors stand side by side, forming what is known as a “tight junction.” Nothing is able to pass in between these single cells unless it is a vitamin, mineral, or a food particle that has been thoroughly digested and broken down into the smallest possible size.
When these tight junctions begin to break down, it is known as “intestinal permeability.” In other words, the one-cell barrier of your gut becomes inflamed and develops holes that begin allowing for the passage of bacteria, toxins, and undigested food particles that normally are too large to pass. (6) And worse, with the lining of your intestine inflamed, it is unable to perform the crucial job of absorbing nutrients. You have a double blow of not allowing the good to be absorbed while the bad barge on through. While the technical name for this is intestinal permeability, most of us now refer to it as “leaky gut syndrome.” Leaky gut is a condition whereby toxic food particles, environmental chemicals, and bacteria leak through your digestive tract and enter your body. Mainstream medicine generally does not recognize leaky gut as a contributing factor to disease and illness, but once you heal it, you will be amazed at the far-reaching beneficial health effects of tightly sealing your gut.

7 Signs You Have a Leaky Gut

1. Digestive issues (bloating, gas, diarrhea, constipation, reflux)
2. Seasonal allergies or asthma
3. Autoimmune diseases, such as celiac disease, RA, or lupus
4. Chronic joint and muscle pain or fatigue
5. Mood issues, including depression, anxiety, ADD
6. Acne, rosacea, eczema, psoriasis
7. Food allergies and intolerances

Leaky Gut and Your Pain
When foreign invaders pass through a leaky gut and enter the bloodstream, they are known as an antigen, which is basically a foreign substance that induces an immune response in the body. In return, your immune system creates antibodies to attack and destroy the foreign invaders (antigens), such as bacteria, viruses, or undigested food particles or proteins. The antibody will bind with the antigen in an attempt to render it harmless. This binding of antigen and antibody is called an immune complex. With a persistent leaky gut, there is an overproduction of immune complexes, which can act like antigens of their own and may cause chronic systemic inflammation. These immune complexes circulate around the body and are deposited in various tissues and organs. (7) The largest “organ” in your body is skeletal muscle! Many of these immune complexes are deposited in your joints, muscles, synovial membranes, and tendons throughout your musculoskeletal system. Once deposited in tissues, they cause yet another local inflammatory response. At times your immune system can even attack your body’s own cells, tissues, and organs. The immune complexes can set off inflammation in any joint or muscle, which will cause pain, swelling, and stiffness, and you unknowingly believe the problem is localized to a specific joint or joints. Now you know the root cause of your inflammation actually stems from your gut!
Contributors to a Leaky Gut

• Alcohol
• Corticosteroids
  

  

• Stress
• Sugar
• Food intolerance & allergies
• Overtraining/endurance exercise
• Infections
• Toxins
• NSAIDs
• Nutrient deficiencies
• Caffeine
• Yeast overgrowth
• Antibiotics

Leaky Gut and Autoimmunity
Leaky gut or intestinal permeability is also a critical factor when it comes to the approximately 50 million Americans who suffer from an autoimmune disease. (8) One in twelve Americans—and one in nine women—will develop an autoimmune disorder. And since it is clear that not every patient with an autoimmune disease is correctly diagnosed, the prevalence is certainly higher than that, with women suffering more than men. There are as many as 80+ different types of autoimmune diseases. There are three factors that are needed for autoimmunity to develop
1) A genetic predisposition.
2) A trigger.
3) Leaky gut.
ALL three must be present; just having one, such as a genetic predisposition, is not enough. A poor diet can be enough of a trigger to cause leaky gut and turn on a gene for autoimmunity, which leads to pain. By sealing your leaky gut, you will put out the fire that feeds your inflammation, calm your immune system, and decrease your pain.
5 Steps to Heal Your Gut and Pain
1. Glutens Gotta Go
Previously I have spoken of the benefits to eliminating gluten 100% as a means to heal pain naturally. A 2015 study in the Annals of Nutrition and Metabolism cited the most common non-intestinal symptom of gluten sensitivity was brain fog; headaches; fatigue; bone, muscle, and joint pain; leg or arm numbness; skin rashes; and depression. (9) A 2016 paper in the Journal of Clinical Rheumatology supported the hypothesis of non-celiac gluten sensitivity and its association with fibromyalgia, spondyloarthritis, and various autoimmune conditions. Gluten not only affects your musculoskeletal system and creates pain but it also affects your nervous system.
2. Gut Healing Nutrients
Maintaining a healthy gut is the key to maintaining overall wellness. Poor gut integrity such as leaky gut, ulcerations, and other damage from increased exposure to GMOs, pesticides, and challenges within the Standard American Diet can easily lead to food sensitivities and compromised nutrient assimilation. The amino acid, L-Glutamine, has been shown to heal intestinal permeability (leaky gut) and restore the function of the intestinal lining. (10) In addition nutrients such as N-acetyl- glucosamine, MSM, DGL, slippery elm, marshmallow, chamomile, okra extract, cat’s claw, quercetin, and mucin help to promote optimal gastrointestinal function. A gut healing formula offers support for optimum gastrointestinal health and function including:

• Rejuvenates intestinal mucosal health.
• Promotes proper intestinal function.
• Provides healing for ulceration and inflammation

The lining of the gut must have proper permeability and integrity so it can not only absorb nutrients but also prevent toxins, allergens, and microbes from gaining access to the bloodstream.
3. Regular Relaxation

Viva la vagus! Running yourself ragged, ignoring stress and poor sleep habits are a sure way to keep your body in sympathetic overdrive. The parasympathetic nervous system and especially the function of the vagus nerve plays a role in modulating tight junction and decreases intestinal epithelial permeability (leaky gut). (11) This finding may provide a novel approach for treating and preventing many chronic conditions. Importantly, physical activity is associated with increased resting parasympathetic (vagal) activity and lower risk of chronic diseases. What types of activities promote healthy vagal tone and relaxation? Proper sleep (7-9 hours), meditation, restorative yoga, singing, and diaphagramic breathing (belly breathing).
4. Powerful Probiotics
Changes in the microbiome of the gastrointestinal tract increased permeability of the GI tract, and food sensitivities are among the factors that may cause or aggravate the disease. Dietary deficiencies also may render patients more susceptible to inflammatory conditions and disorders of the immune system. To restore the beneficial flora of the microbiome 50-100 CFU’s probiotic with combination bifidobacterium lactis and Lactobacillus rhamnosus will help restore the microbiome, decrease inflammation and modulate healthy immune function. (12) 
5. Nix the NSAID’s

Non-steroidal anti-inflammatory drugs (NSAIDs) are ibuprofen, Advil or Alleve. Just one or two little pills can increase intestinal permeability in as little as twelve hours. And within 10 days of NSAID use inflammation is visibly present in the stomach and small intestine! (13) Furthermore, NSAIDs have been implicated in poor tendon and bone healing. Extreme complications, including gastric ulcers, bleeding, myocardial infarction, and even deaths, are associated with their use. (14) An alternative treatment with fewer side effects that also reduces the inflammation and thereby reduces pain are omega-3 fatty acids found in fish oil. A dosage of 2000 mg of omega-3 fatty acids will decrease inflammation in combination with a gluten free and dairy free diet. (15)
There are many ways to heal pain naturally without side-effects.
Pain is multifactorial and a master at concealing its true identity.
To life beyond pain,
Dr. Joe Tatta, DPT, CNS