What Should You Eat For Chronic Pain? | Nutrition for Chronic Pain

Do you suffer from chronic pain? Perhaps you’ve had pain for greater than three months, and you’re not sure how you can support nutritionally? Fortunately, there is so much high-quality evidence to support how diet therapy can make a profound difference in chronic pain.

Chronic pain is associated with pro-inflammatory states which are linked to peripheral and central sensitization. This is when the brain perceives that there’s pain, and even a heightened sense of pain with very little stimuli, yet there is no tissue damage.

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Additionally, the mitochondria, which is essentially the powerhouse of our cells, are also associated with chronic pain. The damage to the mitochondria can be driven by how we eat. Consuming pro-inflammatory foods, such as the Standard American Diet—the Western Diet—which is rich in sugary foods, alcohol, processed meats, and enriched grains, can contribute to inflammation and even damage the mitochondria. Therefore, with the Standard American Diet, there becomes an imbalance between our essential fatty acids, which we need for optimal health, and pro-inflammatory markers. That’s where a specific diet therapy comes in.

The first thing we want to do is address the inflammatory markers. The Mediterranean diet is one of the best and well-researched diets that has been shown to decrease inflammation. Think of a diet comprised of fish, legumes, olive oil, low in grains, and high in vegetables – also referred to as an anti-inflammatory diet.

5 ways that you address your chronic pain through diet

1) Decreasing Inflammation

The best way to do this is through an elimination diet. Eliminate the potentially pro-inflammatory foods for at least three weeks and then slowly reintroduce them, one at a time. These include gluten, dairy, sugar, alcohol, caffeine, coffee, tea, corn, soy, processed meats, red meat, chocolate, tea, coffee, and shellfish. If you don’t want to do a full elimination diet, you can do a modified version—eliminate gluten and dairy, for example. These two definitely can play a role in inflammation, and specifically chronic pain. If you’re eating a lot of sugar, this is also a great place to start. Sugar is a massive pro-inflammatory agent, so decreasing sugar in your diet would be very beneficial.

 2) Calorie Reduction

When we are consuming fewer calories than required by our basal metabolic rate, then we can not only increase our brain’s ability to generate new neurons by decreasing free radicals, but we can also increase ATP, the energy source of the cells, and we can increase our number of mitochondria. These all could play a huge role in inflammation and pain.

3) Intermittent Fasting

Intermittent fasting, an eating pattern that cycles between periods of fasting and eating, can help turn on genes that help cells survive by reducing inflammation. There are many different ways to include intermittent fasting in your life. Fasting from seven o’clock at night until seven o’clock in the morning would be a 12-hour fast. You can slowly increase that to a 16 hour fast, or you can do 24-hour fast two days a week. There are many options to suit your lifestyle and it is strongly recommended to start slowly.

4) Specific Nutrient Supplementation

Omega 3’s, vitamin D, vitamin E, vitamin B-12, and magnesium have all been shown to impact chronic pain. There are other nutrients that also help specifically with chronic pelvic pain, such as vitamin E, B1, and B3. 

5) Gut Health

Seventy percent of your immune system is in your gut. If there is an inflammation issue, we should start in the gut. So, do you need to include prebiotics, probiotics, or do you need a specific gut health protocol? If you are not managing gut health properly, then you are not managing chronic pain and inflammation well, either. 

These are just a few of the ways that we can use diet to influence chronic pain.  When we have that central sensitization of the nervous systems, our brain still perceives that there’s pain, yet there is likely no tissue damage. Our nervous system is heightened, and we can begin to associate chronic pain with pro-inflammatory markers. We can use diet to decrease inflammation and optimize our micronutrient, antioxidant, and phytonutrient profile to begin to bring our body back into a state of balance and healing. 

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How to do an elimination diet

Have you been experiencing fatigue, chronic pain, allergies, sinus issues, depression, anxiety, bloating, cramping, abdominal pain, diarrhea, and/or constipation? Or maybe you just aren’t feeling your absolute best? If so, you might want to consider the elimination diet. The elimination diet is the gold standard for uncovering food sensitivities and food intolerances that are frequently overlooked as a major contributor to a whole host of inflammatory conditions. It’s been used by allergists and registered dietitians for decades and is currently used frequently in functional medicine.  It can be extremely valuable in finding information.  It uncovers foot triggers that can help you determine what foods are best for you…and of course, what foods are not. There is no one-size-fits-all.  Everyone is unique.

What does the elimination diet do?

The elimination diet helps to decrease inflammation, identify food triggers, reduce intestinal permeability i.e. leaky gut., decrease inflammation, reduce toxic burden, and it is high in phytonutrients and it is not calorie restrictive. If you have already been diagnosed with leaky gut, autoimmune, or any other inflammatory condition (nearly 90% of all conditions), then this would be something that is highly recommended to initiate a gut healing protocol to remove these potentially inflammatory foods. It is not a calorie-restricted plan, so it is not meant to be a weight-loss diet. Instead, it is meant to be an “information diet”, which means it is not a forever plan. This diet is comprised of all whole natural foods, there’s nothing processed. You are eliminating all of the potentially inflammatory foods. Some of those foods include coffee/tea, alcohol, corn, soy, peanuts, processed meats, red meat, gluten, dairy, and so on. (See below) You would be eliminating these foods for at least four weeks.

What foods do you eliminate?

  • corn
  • dairy
  • gluten
  • eggs
  • peanuts
  • white sugar
  • shellfish
  • soy
  • beef
  • processed meats
  • pork
  • coffe, tea, chocolate

How to prepare

For this to be successful, it is vital to have a preparation period. One to three months’ preparation time is recommended to prepare for it so that you can just go into it with ease. The last thing you want it to do is to create stress, ie. Inflammation, on your body.  You’ll want to make sure it is the right time in your life and things are relatively calm. It is extremely challenging to eat out when you are on the elimination diet. Lastly, it’s often easier if you slowly work out one to three foods at a time and find replacements for them before you begin. You want to be fully prepared, which is why it is strongly recommended to work with a professional to guide and support you through the process.   

How to reintroduce

The reintroduction phase is the most important part and many people fail to do this. They sometimes get frustrated and eat something that has multiple inflammatory triggers like pizza that includes gluten, dairy, and tomato sauce. Then, they don’t feel their best and don’t really know why. Was it gluten? The dairy? The tomato sauce with all the preservatives? This is why it’s really important to do a very careful and systematic reintroduction of foods. To give you an example of how that looks, you would do the elimination diet for 30 days. Then, on day 31 you choose a food that you really want to bring back into your life. Let’s say it’s eggs. So, what you would do is have eggs on day 31 in the morning and in the afternoon. You would wait four days, and you would see what kind of symptoms or adverse reactions you may have. A food reintroduction tracker is very helpful for this information. You might have nausea, bloating, abdominal pain, joint pain, etc. If you have negative or adverse symptoms within that four-day window, then eggs, right now, are a ‘no go’. You would wait at least three months before you reintroduce them again. This might mean that your gut needs more time to heal or that eggs are never going to be part of your diet. You can then make a conscious decision to include this in your life knowing the effects it has on you, or now that you have that information, limit or eliminate it. The goal is to find this information, so you know exactly what is helping you feel your best. That means having energy and living with vitality, versus feeling like crap every day, but not really knowing why.

Summary

The elimination diet is extremely valuable when you’re dealing with multiple medical symptoms. It is very challenging for many because they don’t realize just how many of the foods they are consuming on a regular basis. Most people need a lot of support and guidance through the process.  So, again I strongly encourage you to reach out to a registered dietitian or functional medicine doctor to help you through this process.

If you are interested in feeling your best and you need help, reach out to schedule an appointment to get you started on your journey.