If you are a chronic pain sufferer, chances are you’ve tried almost everything to get some relief. You may have also thought ‘can nutrition help chronic pain?’. As a chronic pain sufferer and Dietitian, I’m here to help provide some answers.

So, what is chronic pain?

Chronic pain is pain that lasts more than 3 months. About 20% of people have chronic pain. Chronic pain can have different causes and classifications, such as chronic cancer pain, nerve, post-surgical, chronic primary pain, musculoskeletal or be due to conditions such as Endometriosis. 

Role of Nutrition

There is emerging evidence that poor nutrition can play a role in the development, progression and management of chronic pain. Poor nutrition is linked to poor pain outcomes and better nutrition with better outcomes. Food intake may be associated with co-existing conditions and symptoms of chronic pain, such as depression, poor appetite and poor mobility. 

There are a few possible mechanisms to explain the relationship between nutrition and chronic pain, two of these are oxidative stress and inflammation, and the gut-brain axis. 

What is oxidative stress?

Oxidative stress occurs when there is an imbalance of free radicals and antioxidants in the body, which can lead to damage in our cells and tissues. This can be due to factors such as diet, smoking, and stress. Oxidative stress activates our immune cells and increases inflammation. This immune cell activation can then further increase oxidative stress. This creates an oxidative stress-inflammation cycle. 

In situations such as injury or infection this inflammation and immune cell activation is a good thing. It helps our body repair itself. However, when this cycle doesn’t end, we get chronic inflammation, this can lead to chronic pain. The good thing is we can help reduce this inflammation by adding more antioxidants to our diet.

The Gut-Brain Axis

The gut-brain axis is the bi-directional relationship between our gut and brain. This means that our gut health can affect our brain and our brain can affect our gut health. Gut health is essential for our general health as it has a role in structural, protective and metabolic functions in our body. Our gut contains a diverse range of bacteria, this is known as our gut microbiome. This diversity can be affected by mental health, infection and our nutrition. Changes in the gut microbiome have been linked to many conditions including depression, diabetes, and chronic pain. Studies show that nutritional changes that target the gut microbiome play a promising role in pain management. 

What does this mean for you? 

This means that making changes to our nutrition can help to manage pain in for chronic pain sufferers. Now, I’m not saying that improving your diet will eliminate your pain completely. But, making positive changes will improve your gut microbiome, mental health, strength and many factors that will help make the pain easier to manage, alongside traditional medical management. 

So, what nutrition changes do you need to make to help manage chronic pain? 

This means improving your overall dietary pattern, as there isn’t just one food that will improve your pain or one food that will make it worse. In terms of dietary pattern, you want to work towards an anti-inflammatory dietary pattern, such as the Mediterranean diet, traditional Nordic or traditional Japanese. Keep in mind, you don’t need to adhere to the diet perfectly to see benefits.

The following recommendations are a good place to start:

Increase your fruit and vegetable intake, as well as variety.

• Fruits and vegetables contain phytonutrients and antioxidants which help to reduce oxidative stress and inflammation 
• Try to eat the rainbow. Different colours contain different nutrients, as well as variety being good for our gut microbiome

Choose wholegrain and fibre rich grains. 

• These give you a slow sustained amount of energy
• Fibre has prebiotics which feed the bacteria in our gut

Prioritise oily fish, legumes, nuts and seeds. 

• These have healthy fats to help reduce inflammation
• Protein to help with deconditioning, often seen with chronic pain
• Other protein sources: prioritise fish and chicken, small amounts of red meat

Include dairy and their alternatives.

• Milk, cheese and yoghurt have protein and important vitamins and minerals
• If choosing plant based alternatives make sure they’re calcium fortified and include protein. 

Include omega 3 and monounsaturated fats, such as olive oil, avocado, nuts, seeds and oily fish.

• These help to reduce inflammation

Maintain hydration. 

• In general, aim for about 2-3L of water per day
• Dehydration increases sensitivity to pain, so if you’re dehydrated the pain will feel worse 

Reduce intake of ultra processed foods.

• These increase inflammation and oxidative stress. 
• I’m not saying to cut these out completely, as all foods can be a part of a healthy diet, but try to make these types of foods a minimal part of your day to day diet. 

When you might need extra help from a dietitian

• If you have multiple health conditions or concerns
• You have nutrient deficiencies that need addressing
• You have gastrointestinal issues
• History of disordered eating 
• Any other issues that may affect your food intake
• Or you would just like some extra help

If you would like some extra help, book an appointment with me.

🩷 Emma