Nutrition and Persistent Pain

How are nutrition and persistent pain related? We understand that to be fit and healthy we need to sleep well, exercise daily, and manage our stress with deep breathing practices or mediation. Developing healthy lifestyle choices improves our health and overall well-being. We must also ask ourselves what impact food and nutrition has on our health, and how it can impact pain.

Hydration

Our body, muscles, ligaments, discs, and nerves need water for proper function and health. Did you know that 60% of our body is made of water?

With this in mind, have you looked in the toilet recently to see the color of your urine? If it is dark and has a strong odor, then this can indicate that you’re not hydrating enough. 

However, there is no set rule for how much water you should have per day. It is recommended that you eat at least 2 servings of fresh fruits and 3 servings of fresh vegetable per day. Food such as melons, oranges, and salads are very hydrating.  Good fluids include water and herbal teas (not caffeinated). Unfortunately, coffee, high sugar juices, colas, and beer are not great sources of hydration, so you should try not to consume them very often.

If you have any bladder issues such as urgency, frequency, or if you have interstitial cystitis, then these non-hydrating fluids can be a source of irritation to your bladder.  You should consider weaning yourself off these fluids and start increasing both water, fruits, and veggies. This is especially important for those who suffer from constipation. Proper hydration helps our intestinal motility and helps soften stool consistency. This will help reduce pain and straining when you have bowel movements.

Next time you go to the washroom have a look at your pee. If it’s slightly yellow and does not have a strong smell, then you are well hydrated.

What About Food?

In this day and age, there is a lot of conflicting information out there about what the “best” diet is, so it’s really hard to know who and what to believe. What we do know for sure is that the body requires proper nutrients to survive. What we eat makes a huge impact on our psychological and physical health. If we eat a diet with all the proper nutrients, vitamins, and minerals then our tissues, muscles, and nerves remain healthy. Food is fuel, and to help you manage pain you need to have the proper fuel in your body to function optimally. The energy (fuel) needed to function properly is made in our mitochondria, which is found in every cell of our body.

How Do We Nourish our Cells?

• Proper sleep.
• Reducing our exposure to environmental toxins.
• Managing our stress.
• Exercising daily.
• Nutrients needed:
  
  • CoQ10 (found in lever, pork, sirloin).
  • Magnesium.
  • Omega-3s.
  • All B vitamins (helps produce serotonin and are found in eggs, meat, fish, chicken, organ meats).
  • L-carnitine (amino acid found in red meat).
  • D-ribose (beef, poultry, eggs, fish, spinach, broccoli).

Have you been to your doctor lately to see if you have any deficiencies in iron, B12, or vitamin D?  Do you have any food sensitivities to gluten or dairy? Are you celiac?  Nowadays, you can get food sensitivity and allergy tests done to confirm if there are any foods you should stay away from and any foods you should be getting more of. Receiving this knowledge is a good baseline to see where your body may be lacking specific nutrients to help you feel better.

What About Vitamin D?

Studies have shown a link between vitamin D deficiency, persistent pain, and depression. Vitamin D deficiency is especially common in many countries like Canada, due to our long winters.

What Can We do to Increase our Vitamin D?

• Expose yourself to midday sun for 15 minutes at least twice per week. 
• If you have darker skin, you may need 5 times longer in the sun to absorb vitamin D.
• Consult with your physician, and if you are lacking vitamin D, take up to 5,000 IU of D3 per day during the winter months. Check with your physician or naturopath to see the amount you require.
• Eat tuna, sardines, trout, herring or drink vitamin D fortified beverages, such as rice milk.

What Does Stress Have to do With All of This?

In short doses, cortisol provides our body with a quick source of glucose (sugar) as a source of energy. Afterward, our body is supposed to find its equilibrium, and all the levels of glucose are reduced. With chronic exposure to stress, there is a continued increase in our production of cortisol that can lead to health conditions such as diabetes, PCOS, weight gain, and chronic inflammation. Cortisol production is usually suppressed at night, but chronic stress disrupts this suppression. Therefore, inflammation can perpetuate ongoing aches and pains in our bodies. In addition, high levels of stress can affect the production of our sex hormones and has an impact on our hormonal balance and health.

How Can We Optimize our Cortisol Levels?

• Eat protein, healthy fats, and limit sugar consumption.
• Balance your blood sugars by consuming foods that are high in biotin (fish and liver).
• Reduce or eliminate alcohol and caffeine.
• Support the adrenal glands with fish oils, magnesium, vitamin C (red peppers, kiwis).
• To reduce the effects of stress on the body try green tea, curcumin, Omega-3’s, vitamin E and C, and CoQ10.
• Develop good sleep hygiene.
• Learn relaxation techniques to calm the stress response such as mediation, yoga, and Qi gong.

What About Food Sensitivities?

Did you know the lining of our gut is only one cell thick? Gaps in these cells can cause certain proteins, like gluten, to pass through. When this occurs, it can cause an immune reaction which is called leaky gut. Signs of leaky gut include food sensitivities, allergies, nutrient deficiencies, and chronic inflammation.

Omega-3’s

Our current Western diet comprises of a lot of processed foods with are loaded with PUFA’s (polyunsaturated fatty acids) which increase the inflammatory responses in our bodies. High PUFA fats like Crisco, soybean oil, corn oil, canola oil, vegetable oil, and margarine are highly oxidized and oxidized fats are are considered very inflammatory.  These PUFA’s are mostly Omega-6’s. We are eating way too much Omega-6’s compared to Omega-3’s, and this imbalance leads to inflammation and poor gut health. You can find more Omega-3’s to consume in most fish and seafood.

Magnesium

Our current Western diet is also very deficient in magnesium, which helps regulate muscle contractions. It acts like a calcium blocker, helping our muscles relax. When we are low in magnesium, it can cause muscle spasms or cramps. Magnesium can also help reduce constipation, pain hypersensitivity, as well as menstrual cramps (dysmenorrhea). We also need magnesium for vitamin D to metabolize in our bodies.  Our daily requirement of magnesium should be around 300-450 mg per day.

Magnesium is depleted with alcohol, consumption of sugar, heavy menses, decreased sleep, pain, and chronic stress.

Great sources of magnesium are kelp, dark leafy greens, sardines/salmon, legumes, dark chocolate, almonds, cashews, hemp seeds, sunflower seeds, and avocados.

Please contact your physician/nurse practitioner or naturopath before taking any supplements discussed above.

So, What Should We Eat?

Bahram Jam states it best in his book Pain Truth and Nothing But:

• Avoid foods that have ingredients you:
  
  • Can’t pronounce..
  • Can’t visualize (monosodium glutamate, aspartame).
• Food is likely NOT good for you if it arrives through your car window.
• Food is likely GOOD for you If it comes FROM a plant.
• If food is made IN a plant, it’s likely not good for you (a.k.a avoid processed foods).
• Avoid foods that make health claims or that are advertised on television.
• Limit food with high glycemic index. Studies have shown that high blood sugar (after eating high glycemic foods) LOWERS pain thresholds and INCREASES inflammatory reactions.
• High glycemic index foods are: pastries, candy, colas, chocolate bars, white bread, doughnuts and cake.

Keep it simple. Avoid refined sugar. Eat nutrient dense foods. Eat plants and fruits, and try to eat organic as much as you can. Eat healthy fats (flax seeds, Omega 3’s, olive oil, avocados) and sources high in good quality proteins. Cook at home and avoid processed foods that contain a lot of PUFA’s. Ultimately, you know your body best, so do what feels good for your health.

References

The role of magnesium in pain:

Na HS, Ryu JH, Do SH. The role of magnesium in pain. In: Vink R, Nechifor M, editors. Magnesium in the Central Nervous System [Internet]. Adelaide (AU): University of Adelaide Press; 2011. Available from: https://www.ncbi.nlm.nih.gov/books/NBK507245/

Magnesium for constipation:
http://www.med.umich.edu/1libr/MBCP/Magnesium.pdf
https://www.webmd.com/vitamins/ai/ingredientmono-998/magnesium

Vitamin D and pain:
https://www.painscience.com/articles/vitamin-d-deficiency-and-pain.php

Helde-Frankling M, Björkhem-Bergman L. Vitamin D in Pain Management. Int J Mol Sci. 2017;18(10):2170. Published 2017 Oct 18. doi:10.3390/ijms18102170. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5666851/

Martin KR, Reid DM. Is there role for vitamin D in the treatment of chronic pain?. Ther Adv Musculoskelet Dis. 2017;9(6):131–135. doi:10.1177/1759720X17708124 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5466150/

The pain truth and nothing but, Bahram Jam:
www.aptei.com
https://www.amazon.ca/Pain-Truth-Nothing-Book-Workbook/dp/0973537426
https://www.youtube.com/watch?v=GPjv97unQu0

Integrative Women’s Health Institute:
https://integrativewomenshealthinstitute.com

The Healing Pain Podcast with Dr. Joe Tatta:
Episode 126:  Less stress, less pain and more life
Episode 124:  Hormones, birth control and the association with chronic pain
Episode 122:  The impact of diet on widespread chronic pain
Episode 121:  Nutrition facts and fiction about pain
Episode 109:  How the microbiome affects stress, pain and the mood
Episode 108:  How to treat neuropathy and neuropathic pain using nutrition
Episode 99:  Anti-inflammatory and ketogenic nutrition