Chronic pain and diet: can food be our medicine?

Key takeaways:

• Dietary changes can be effective in improving quality of life and managing chronic pain.
• Focus should be placed on optimizing overall diet quality and nutrient-dense whole foods with anti-inflammatory and antioxidant properties.
• Diets high in sugar, refined carbohydrates and saturated fat have been found to be associated with several chronic pain related problems. 

Most of us know the importance of good nutrition and the great impact it has on our overall health. Recent research also suggests that eating healthy may take on a new level of importance for those dealing with chronic pain. While there is no such thing as a “chronic pain diet”, there are many ways in which improving your diet can help you manage your pain and improve your quality of life.

The goal of this article is to analyze the role that diet plays in chronic pain and overall health, and empower you with the knowledge and practical tips to help get you started.

Benefits of a healthy diet for people with pain

It probably comes as no surprise that chronic pain is often accompanied by other unwanted health challenges. This is why there is good reason to believe that a well-balanced, nutritious diet can provide many benefits for those experiencing ongoing pain.

Fight low-grade systemic inflammation

First it’s important to make a distinction between acute and chronic inflammation. Short-term inflammation is an important immune response that helps heal injuries and fight infections. Swelling, heat, and redness are all signs of a healthy body doing its job! Low-grade systemic inflammation, on the other hand, is a persistent inflammation spread throughout the entire body. It’s this low-grade systemic inflammation simmering underneath the surface that’s problematic.

Low-grade systemic inflammation leads to oxidative stress, which harms cells and organs and plays a central role in developing many chronic diseases, like diabetes and heart disease . Over time, this damage can also cause persistent pain in muscles, tissues, and joints, leading to chronic pain conditions such as arthritis and musculoskeletal pain. In fact, systemic inflammation and chronic pain are in a two-way relationship. Chronic pain itself can make us more susceptible to low-grade inflammation, which in turn can increase our sensitivity to chronic pain.

Fortunately, we know that lifestyle factors, such as diet, play an important role in modulating systemic inflammation. By emphasizing anti-inflammatory foods in our diet, we can help lower the risk of problems related to chronic inflammation.

Strengthen your immune system

Did you know that 70% of our immune system is housed in the gut? Our gut microbiome – the collection of microorganisms living in our intestines – and our immune system are intricately linked. The gut bacteria are incredibly important in the development and function of the immune system, as their job is to elicit an effective immune response when they come in contact with viruses or other pathogens. 

Maintaining a balanced ratio of good to bad bacteria is crucial for our health. The more diverse our gut bacteria, the better. It has been well established that an overpopulation of bad bacteria and reduced microbial diversity can contribute to disease. An imbalance of the gut microbiome is also thought to trigger systemic inflammation and immune dysregulation, which can both amplify and chronify our pain.

The foods we eat can impact the diversity and composition of bacteria in the gut, which in turn affects our immune system. Keep reading to find out what dietary changes can help determine which microbes take up residence in your gut and alter your gut microbiome for the better.

Address the challenges

Living with ongoing pain presents us with extra challenges that a healthy diet can help mitigate. The food we eat becomes the building blocks and fuel our bodies need to function. When we supply our body with adequate energy and highly nutritious foods, we can reduce things like cravings and irregular eating habits, medication-related constipation, as well as nutrient deficiencies. Eating the right foods can also help promote cognitive functioning, improve our mood, and help us to maintain a healthy weight, leading to a positive spiral where we feel more energized making it easier to maintain healthy habits.

To help you put this into practice and be better able to get through the day, we’ve compiled a list of practical tips and actionable advice on how you can set yourself up for success. Hint: you don’t have to do things perfectly or overhaul your entire diet overnight. You can find it at the end of this blog post.

What foods should you be eating to manage chronic pain?

When it comes to the perfect diet, let's face it - we’re all different, and no one perfect diet exists. Despite a lot of research, something as complex as diets and chronic pain are bound to produce complex results and recommendations which seem to conflict with each other. No wonder it’s hard to understand what to believe!

There is some good news, however. Some preliminary evidence do suggest that certain food substances can indirectly reduce pain. In addition, it has been well-established that following certain fundamental dietary principles can help you make healthy choices that will improve your overall health in the long-term. So, let’s dive into some of these core principles that can benefit you on your pain-relief journey.

Optimize diet quality

Scientific research exploring the role of nutrition in pain management emphasizes optimizing diet quality through a balanced, whole foods diet (1). This means emphasizing the consumption of nutrient-dense whole foods, such as vegetables, fruits, berries, legumes, whole grains, as well as some healthful fats and fish. A balanced diet is one that fulfills your nutritional needs, supplying you with all essential macronutrients, vitamins and minerals that are required for optimal health.

Optimizing diet quality through whole foods is important for 3 main reasons: they provide generous amounts of antioxidants, anti-inflammatory omega-3s, and fiber. Fiber-rich foods such as vegetables, whole grains, seeds, beans and lentils, promote the diversity of the gut microbiome, improve digestion and help with blood sugar balance. Fiber also acts to prevent opioid-related constipation. 

Foods rich in antioxidants and anti-inflammatory properties help control inflammation and can therefore play a role in preventing painful flare-ups. Antioxidants can be found in colorful fruits and vegetables such as dark leafy greens, squashes, bell peppers, wild blueberries and citrus fruits. Foods that help fight inflammation include olive oil, fatty fish, berries and avocados.

For example, a plant-based or Mediterranean diet – or healthier eating inspired by these diets – emphasize these types of foods. Numerous studies have found the Mediterranean diet can reduce the risk of chronic diseases and it has long been endorsed by doctors and dietitians. Research has also shown that people who eat a higher proportion of plant-based foods tend to have lower risks of obesity, inflammation and heart disease.

Practical tips to improve your nutrition, pain and health

1.  Reduce processed foods

Processed foods are typically stripped of vitamins, minerals, and fiber during processing, resulting in products containing high levels of overall calories and very low (or no) amounts of beneficial nutrients. In addition, processed foods are often high in unfavorable ingredients, such as saturated fats, sugar and salt, as well as many other additives you wouldn’t use when preparing food at home. 

Western-style diets tend to contain many of these highly processed foods, such as frozen and microwave ready meals, reconstituted meat products such as fish sticks and sausages, sweetened breakfast cereals, chips, cookies, and sugary drinks.

Frequently consuming these highly-palatable food items and beverages are linked to an increased disease risk, as they affect everything from our gut and heart health to blood sugar balance and metabolism. You can’t go wrong by moderating your intake of highly processed foods and saving the fast foods, sweets, and sodas for rare occasions.

Here are some simple and inexpensive solutions:

• Swap white bread, pasta and other wheat-based products for whole-grain options. 
• Limit the amount of added sugar and avoid foods that cause blood sugar spikes by choosing less-processed/sugar-free alternatives.
• Balance your intake of omega-3/6 fats: cook with olive oil, avoid foods high in saturated fats (e.g. butter, cakes, biscuits, sausages, bacon), and favor steaming and simmering over grilling and deep frying.

2.  Eat whole foods

Begin to incorporate whole foods into your daily diet – meaning foods that are not manufactured in a factory or that come pre-packaged with a fancy label! Generally this means eating foods in their original form (or very close to it), such as fresh and frozen produce, legumes, grains, nuts and seeds, fresh or pasteurized milk and plain yogurt, and unprocessed meats. Eating foods that are less processed and in-season helps ensure that you get the highest nutritional value. Here are some practical steps to get you started:

• Eat the rainbow. Plants contain different nutrients, so focusing on eating a variety of colors will ensure you’re getting all essential nutrients and health benefits. Eating the rainbow simply means eating fruits and vegetables of different colors every day! At every meal, aim for half of your plate to be covered with vegetables and try to include veggies and fruits as a snack. Another great option to increase variety is using frozen vegetables and fruits, as they can easily be added to stir-frys, soups and stews.
• Get good quality fats. Increase your intake of healthy anti-inflammatory omega-3s such as olive oil, avocado, fatty fish, nuts and seeds. Use extra virgin olive oil for cooking and salad dressings and aim for 2-3 servings of oily fish per week (or find a high-quality supplement if following a plant-based diet). 
• Feed the gut. This means incorporating fiber-rich, pre- and probiotic foods into your daily diet. Think vegetables, berries, legumes, whole grains, and fermented foods such as kefir, yogurt, and kimchi. The daily fiber recommendation is 0.88oz for women and 1.23oz for men.
• Protein at every meal. Adequate protein intake is essential for facilitating growth and repair within the body. Protein also helps with satiety and blood sugar control. Make sure you are incorporating some healthy protein sources at breakfast, lunch and dinner. Good options are fish, seafood, legumes, and unprocessed meats.
• Drink plenty of water. Water is essential for circulation of nutrients and waste elimination, and dehydration can actually increase pain sensitivity. Aim for 4-6 cups of water per day and avoid or reduce consumption of sugary drinks, caffeine, and alcohol.

Set yourself up for success

Start small. If getting started sounds overwhelming, start with something you know you can commit to, no matter how small. It’s also important to not get hung up on doing things perfectly. Set yourself achievable goals and keep things simple, remembering to celebrate your successes along the way. This is how you build self-efficacy and motivation.

Know your why. When embarking on any changes, it is always important to understand what your personal reasons are for making those changes. Knowing your why helps you to commit to the process long-term and keeps you motivated at times when you feel like giving up.

Add the good. Adding something to your life is easier than taking something away. So, instead of overhauling your entire diet, focus on foods that can be added rather than on the ones that should be removed. Simply begin by adding 1 simple nutritious addition to your current routine – swap sugary drinks for unflavoured mineral water, add a different coloured vegetable to your meal, or choose healthy convenient snack options such as fruit, veggie sticks, yogurt, or nuts.

Focus on health. Make your primary goal be about improving your health in the long term, and focus on how you feel in your body. This is about your health and well-being. When you care for yourself, you can steer your life in a healthier direction and begin creating a cycle where you are feeling and sleeping better, moving more, and living with less pain.

Set yourself up for success. Find ways to incorporate strategies to help cook more meals at home, such as preparing meals in bulk and freezing leftovers. This way you have a quick, easy and healthy meal to enjoy when you experience a flare up and do not feel like cooking. You can also keep simple snacks on hand like boiled eggs, yogurt, cherry tomatoes, fruits and nuts. How could you make healthy eating as simple and successful as possible, for you? 

Eating a healthy diet is not a quick-fix solution nor will it magically cure your pain. However, it can significantly improve your pain management and make a positive difference to your pain levels in the long run. Most importantly, it’s a way of giving your body and mind the energy and nutrients it needs to function properly so you can live a vibrant, meaningful life.