Whether it’s the aches and pain of osteoarthritis, chronic back pain, or an old sports injury, many people fight a battle with chronic pain. According to the Centers for Disease Control and Prevention, one out of five Americans suffers from chronic pain. Pain is a tough symptom to deal with on a daily basis! It can interfere with day-to-day activities and make it hard to sleep at night.
Plus, we’re now more aware than ever of the risks and side effects of medications used to control chronic pain. The opioid epidemic is a growing crisis, and even over-the-counter medications, like ibuprofen, are linked with side effects. Studies suggest that taking NSAIDs increases the risk of a heart attack, kidney problems, stroke, and bleeding from the gastrointestinal tract. There’s really not a safe way to control pain from a pharmaceutical standpoint.
No wonder so many people are looking for natural ways to relieve chronic pain. Alternative therapies like massage, exercise, meditation, physical therapy, and heat therapy can be beneficial–but what about diet? It’s true that what we eat has a major impact on hormones and signaling molecules that play a role in pain perception and inflammation, the underlying driver of many types of pain. But what evidence is there that diet can help and what should you eat if you suffer from chronic pain?
The Role Diet Plays in Chronic Pain Control
The evidence is mounting that diet plays a key role in pain perception. As mentioned, much of the pain people suffer from is the product of chronic, low-grade inflammation. The body releases a variety of chemicals when the body is inflamed. These include C-reactive protein, cytokines, eicosanoids, and matrix metalloproteinases. Studies also show that one of the most common causes of chronic pain, joint osteoarthritis, is marked by increased levels of arachidonic acid in joint tissues. Arachidonic acid is an eicosanoid that the body converts to chemicals that cause inflammation. Studies suggest that consuming a diet with a high ratio of omega-6 fatty acids to omega-3 fatty acids increases the amount of inflammation-causing chemicals that are produced. In contrast, shifting the ratio lower by consuming more omega-3s has the opposite effect. Most Americans consume a diet that has a ratio of omega-6 to omega-3 of between 15 and 20 to 1. Ideally, that ratio should be closer to 2 to 1.
The Role of an Anti-Inflammatory Diet
We hear a lot about eating anti-inflammatory foods and following an anti-inflammatory diet, and there is some evidence that following such a dietary approach can help with chronic pain. According to Dr. Fred Tabung, a researcher affiliated with TH School of Public Health at Harvard:
“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, and diet is also one of the best ways to reduce it.”
So, what dietary approach is best? Highly processed foods are made with oils, like soybean oil, that is high in omega-6s and may lower the amount of arachidonic acid that’s available to fuel inflammation. Also, wild-caught fatty fish is high in long-chain omega-3s that tend to counterbalance the omega-6s and have anti-inflammatory activity. Cows that are raised on factory farms eat a diet that increases their omega-6 fatty acid content too. Choosing grass-fed beef over factory farmed also helps increase the dietary omega-3 content.
The Mediterranean Diet
The Mediterranean approach to eating embodies many of the principles of an anti-inflammatory diet. It’s a diet that emphasizes fruits and vegetables, whole grains, nuts, legumes, olive oil, fish, and modest amounts of poultry over processed foods, red meat, refined carbs, and foods with added sugar. A 2017 study of 99 obese individuals with osteoarthritis found that eating a Mediterranean diet was linked with weight loss and a reduction in some markers of joint inflammation and damage. Weight loss is important too since fat cells produce inflammatory chemicals called cytokines that fuel inflammation. In addition, losing weight takes stress off of the joints.
The Mediterranean diet emphasizes fruits and vegetables, a source of anti-inflammatory compounds called polyphenols. Some studies suggest that polyphenols from fruits, vegetables and sources like tea, red wine, and dark chocolate may lessen chronic pain. A 2017 study of fibromyalgia sufferers found that those who consumed the most polyphenols had fewer tender points and a better quality of life. Some specific fruits that research suggests may counter pain include tart cherries. One study found that drinking tart cherry juice two times per week reduced markers of inflammation. Studies also link tart cherries with a lower risk of gout attacks.
Even healthy fats that are staples in the Mediterranean diet may have anti-inflammatory and pain-relieving benefits. According to preliminary research, oleocanthal, a compound in olive oil, blocks enzymes called COX-1 and COX-2 enzymes that drive inflammation. As little as 3 teaspoons of olive oil daily may offer benefits. Plus, nuts, a staple in the Mediterranean diet, also have anti-inflammatory properties. Several studies show a drop in inflammatory markers in people who eat a diet that contains nuts.
Don’t Forget about Spices
Not surprisingly, studies have looked at the anti-inflammatory power of spices. Many herbs and spices have a higher concentration of antioxidant/anti-inflammatory compounds by weight than fruits and vegetables. Spices that show particular promise for reducing inflammation are turmeric and compounds called gingerols in ginger. One problem with turmeric is absorption is low. You can increase absorption by combining turmeric with black pepper and a healthy source of fat, like olive oil. Even capsaicin, the inactive ingredient in hot peppers, is an ingredient in topical creams that helps relieve joint pain.
The Bottom Line?
All in all, there’s some evidence that a Mediterranean-style diet helps keep inflammation in check and this can be helpful if you suffer from inflammatory-type chronic pain. Eat a variety of whole, unprocessed foods, particularly fruits and vegetables, and season with spices when appropriate. Make olive oil and nuts your “go to” sources of fat. Skip the white bread, white pasta, processed meat, and foods with added sugar and high-fructose corn syrup. Punt the soft drinks and enjoy green tea or ginger tea made with fresh ginger. And why not? These are all positive changes for your health in general!
· Centers for Disease Control and Prevention. “Prevalence of Chronic Pain and High-Impact Chronic Pain Among Adults — United States, 2016”
· Practical Pain Management. Volume 12, Issue #10. An Anti-Inflammatory Diet for Pain Patients”
· McGettigan P, Henry D (2011) Cardiovascular Risk with Non-Steroidal Anti-Inflammatory Drugs: Systematic Review of Population-Based Controlled Observational Studies. PLoS Med 8(9): e1001098. doi:10.1371/journal.pmed.1001098.
· Arthritis Today. “How Olive Oil Reduces Inflammation”
· Harvard Health Publishing. “Can diet heal chronic pain?”
· Int J Vitam Nutr Res. 2017 Mar;87(1-2):66-74. doi: 10.1024/0300-9831/a000253. Epub 2016 Nov 21.
· Pharmacol Rev. 2012 Oct; 64(4): 939–971. doi: 10.1124/pr.112.006163.