Mini: Dietary approaches and supplements to combat chronic pain

You don’t need Examine Membership to know that coping with chronic pain (CP) is rough. CP is defined as pain that lasts longer than three months. Types of CP have been classified according to the causal factor and include primary and secondary pain. Primary CP is caused by fibromyalgia or nonspecific low-back pain. Secondary pain is caused by an underlying disease, such as chronic cancer-related pain, chronic neuropathic pain, chronic abdominal pain, chronic post-traumatic and post-surgical pain, chronic headache and orofacial pain, and chronic musculoskeletal pain.

The Global Burden of Disease Study^[1] 2016 concluded that pain and pain-related diseases are the leading causes of disability worldwide. The burden of chronic pain is escalating. Chronic tension-type headaches are the most frequent cause of pain, affecting 1.9 million people annually. Low back and neck pain is also high on the top 10 list of CP classification^[2]. The social burden^[3] of CP hits vulnerable populations, such as elderly people, unemployed people, and less educated people, particularly hard.

An unhealthy diet^[4], lack of exercise, obesity, smoking, and stress negatively affect CP management. The Western diet^[5], devoid of fruits and vegetables and robust in refined flours, sugars, and processed meats, causes excess production of inflammatory^[6] mediators that can exacerbate CP. Diets that include an array of nutrients^[7], vitamins, minerals,^[8] fiber, polyphenols^[9], antioxidants^[10], and omega-3 fats play a role in reducing the inflammation related to chronic pain.

Since CP is so widespread and debilitating, the Study Deep Dives editors summarized this open-access systematic review^[11] of 38 clinical and randomized controlled trials to offer up some evidence-based dietary approaches and supplements that may help to manage this condition. If you want more information, click the link to look at the whole paper!

• Eating goat yogurt supplemented with the probiotic Bifidobacterium longum for five weeks eased pain caused by chronic constipation.
• Lactobacillus casei Shirota was found to be beneficial for alleviating pain in people with Parkinson's related constipation.
• A lactose-restricted diet improved abdominal pain in people without a definitive diagnosis of lactose intolerance.
• Supplementing with a novel galacto-oligosaccharide (RP-G28) reduced abdominal pain and improved all lactose intolerance symptoms in people with the condition.
• Resistant starch in the form of green banana biomass (whole cooked green bananas blended into a paste) alleviated pain related to chronic constipation.
• Partially hydrolyzed guar gum, a soluble fiber formula, eased irritable bowel syndrome pain and helped normalize bowel movements.

• Fasting combined with integrative medicine showed benefits for lowering general body pain due to fibromyalgia. This fasting therapy was conducted in a hospital setting for two weeks.
• A low-FODMAP diet (fermentable oligo-di-mono-saccharides and polyols) reduced gastrointestinal disorders and fibromyalgia symptoms.
• A lacto-vegetarian diet combined with stabilization and core exercises helped reduce back pain and improve body composition in women with fibromyalgia.
• Avoiding monosodium glutamate (MSG) relieved joint pain and IBS related to fibromyalgia.
• A gluten-free diet improved symptoms and pain scales in people with fibromyalgia alongside concurrent celiac disease.

• A combination of ibuprofen (400 mg daily) and a proprietary amino acid blend (Theramine®️; 710 mg twice a day) eased chronic back pain substantially.
• A bolus dose of 100,000 IU of vitamin D3 followed by a 4,000 IU daily dose of the vitamin improved back pain in people with overweight or obesity and a vitamin D deficiency.
• 60,000 IU of vitamin D3 per week for eight weeks reduced pain intensity and improved functional capacity for people with a vitamin D deficiency suffering from back pain.

• A low calorie ketogenic diet helped reduce the number of and duration of migraine attacks.
• Lowering omega-6 fat and increasing omega-3 intake reduced pain and improved quality of life for people with chronic headaches.
• Daily supplementation of 1.5 grams of omega-3s reduced the number of headache days in people with chronic migraines.
• A low fat, plant-based diet helped reduce the number and severity of migraine attacks.
• A daily multivitamin lowered the intensity of migraine pain.
• 100 mcg (4,000 IU) of vitamin D3 per day helped lessen the frequency of migraine attacks.
• Taking a daily, 250 mg natto-derived supplement containing bacillopeptidase F eased chronic headache pain caused by neck and shoulder stiffness. Bacillopeptidase F has antithrombotic, fibrinolytic, and blood viscosity-lowering effects.

• A plant-based diet of grains, fruits, vegetables, and legumes decreased pain and increased quality of life for people with chronic musculoskeletal pain.
• A personalized dietary consultation aimed at increasing nutrient-dense food intake improved pain scores and quality of life for people with general musculoskeletal pain.
• A weekly, high dose vitamin D2 supplement improved musculoskeletal symptoms and pain induced by an aromatase inhibitor used in breast cancer treatment. The dose of vitamin D2 supplement was based on the participants' baseline 25-OH vitamin D status.

• A low fat, plant-based diet with supplemental vitamin B12 improved pain levels in people with diabetic neuropathy.
• Taking either 640 mg of omega-3 three times a day or taking 300 mg of vitamin E twice a day equally reduced the incidence of chemotherapy-induced neuropathy.
• Supplementing 400 mg of vitamin E daily for 12 weeks reduced pain scores in people with diabetic neuropathy.

• A very low calorie diet to induce quick weight loss reduced knee load and knee pain in people with obesity.
• Supplementing freeze-dried blueberry powder (40 grams of freeze-dried blueberry per day for four months) reduced pain, stiffness, and difficulty in performing daily activities while improving gait performance for people with symptomatic knee osteoarthritis.

• A low fat diet (under 20 grams per day) reduced upper abdominal pain in people with nonalcoholic, mild pancreatic disease.
• Taking an antioxidant mix for three months improved pain levels in people with chronic pancreatitis. The following antioxidants were used: 600 mcg of selenium, 0.54 grams of vitamin C, 9,000 IU of beta carotene, 270 IU of vitamin E, and 2 grams of methionine.