The Role of Diet in Chronic Pain
In this blog, I usually focus on the muscle and joint pain that’s caused by our chronic muscle tension and our habitual posture and movement; that’s what Clinical Somatics is all about.
However, there’s another common cause of chronic pain that many people are not aware of: chronic systemic inflammation.
We hear about inflammation a lot these days in terms of the role it plays in many chronic disease conditions, including cancer, diabetes, and heart disease. Research and personal stories of people who have eliminated their chronic pain by reducing inflammation in their bodies is now accumulating as well, and the way that many people achieve this is by changing their diet.
In this post we’ll start with a quick lesson on inflammation and why what we eat can increase or decrease inflammation throughout the body. If you want to learn more, check out What is Chronic Inflammation, and Why Is It Killing Us? and 12 Causes of Chronic Inflammation.
Then, for each of the following painful conditions that are caused or exacerbated by inflammation, I’ll summarize and link to research and personal stories showing how changing your diet can oftentimes eliminate these conditions completely:
Localized vs. Systemic Inflammation
Localized inflammation is the type that I typically talk about in the context of Clinical Somatics. Localized inflammation occurs at the site of an injury or infection. When cells of your body are damaged or attacked, your immune system kicks in to remove the harmful stimuli and begin the healing process. Blood vessels dilate and capillaries become permeable, and the increased blood flow to the affected area makes it swollen, red, and warm. The swelling can press on nerves and cause pain. Another cause of pain is the release of inflammatory mediators; these substances activate nociceptors (pain receptors) and contribute to the pain you feel in localized inflammation.
When localized inflammation is acute (lasting for a short period of time), it’s beneficial because it facilitates the healing process. However, when localized inflammation becomes chronic—like in a joint that is constantly being put under too much strain and pressure—the physical wear-and-tear and the never-ending immune system attack will gradually destroy protective joint tissues and cause dysfunction and deformity of the joint.
If you feel pain and symptoms of inflammation in just one specific part of your body, then chronic, localized inflammation is probably the type of inflammation involved. In order to reduce or eliminate this type of inflammation, you must release your chronic muscle tension and change the habitual posture and movement patterns that are causing the damage to your body.
However, if you feel inflammatory pain throughout your body, chronic systemic inflammation is likely involved. Systemic inflammation occurs when your immune system produces the inflammatory response throughout your body rather than in just one specific area. When systemic inflammation is chronic, research shows that it can cause pain throughout the body, destruction and scarring of tissues, buildup of plaques in arteries, changes in gene expression, cancer, diabetes, dementia, depression, and other dangerous conditions.
Some proven causes of chronic systemic inflammation are viral and bacterial infections, allergies, smoking, obesity, stress, and alcohol intake. And another major cause of systemic inflammation, our diet, affects the vast majority of people in the world to some degree, whether they’re aware of it or not.
Luckily, the effects of our diet on inflammation and chronic health conditions is becoming more widely researched and recognized. It hasn’t hit the tipping point quite yet, in my opinion, but I believe it will very soon simply because so many people are suffering and desperate for a solution.
Why what we eat causes inflammation
The research on the link between diet and chronic pain conditions (and many other health conditions) is narrowing in on the consumption of animal products versus eating a plant-based diet. So, I’m going to briefly discuss why eating animal products causes systemic inflammation, and the growing movement in favor of a plant-based diet.
Meat, poultry, and fish contain substances called endotoxins. Endotoxins are lipopolysaccharides found in the outer membrane of certain bacterial cells, and they are released when the bacterial cell dies or disintegrates. These compounds are classified as “toxins” because they can cause serious health problems—like cancer—in humans, animals, and other organisms.
Endotoxins are present in meat, poultry, and fish no matter how these products are cooked or prepared. When we eat these foods, the endotoxins are absorbed into our system, triggering the immune system response of systemic inflammation. Eating meat, poultry, and fish that are high in fat increases our absorption of endotoxins.
If you want to learn more about this topic, watch this series of short (2-4 minutes each), easy-to-understand videos by Dr. Michael Greger.
Second video: The Exogenous Endotoxin Theory
Third video: Dead Meat Bacteria Endotoxemia
Meat and other animal products contain or lead to the formation of many other inflammatory substances as well, including nitrosamines, trimethylamine N-oxide (TMAO), heterocyclic amines (HCAs), N-Glycolylneuraminic acid (Neu5Gc), and polycyclic aromatic hydrocarbons (PAHs).
Meat, poultry, and fish aren’t the only inflammation-causing animal products. Eggs cause inflammation for two reasons: they contain high levels of arachidonic acid and cholesterol.
Arachidonic acid is a fatty acid involved in the inflammatory process. While we need a certain amount of arachidonic acid for essential cellular processes, our body makes all that we need; we don’t need to ingest any. The same is true for cholesterol: our body makes all that we need, and excess cholesterol in the bloodstream triggers the inflammatory process.
Just one egg yolk contains 62% of our recommended daily intake of cholesterol, and eggs are associated with increased cancer risk. And incredibly, egg consumption has similar effects on atherosclerosis and life expectancy as a regular smoking habit.
Lastly, there are several reasons why dairy products cause inflammation. Some people don’t produce the enzyme lactase, which is necessary for breaking down the lactose in dairy products. Some people are intolerant of casein and whey, the two proteins found in cow’s milk. And many dairy products contain hormones and antibiotics that are given to cows in order to stimulate their milk production and prevent infection.
Lactose, casein, whey, hormones, and antibiotics can all trigger the inflammatory response. So it’s not surprising that dairy consumption has been linked to an increased risk of cancer and other inflammatory conditions, like arthritis, asthma, acne, type 1 diabetes, and multiple sclerosis.
What is a plant-based diet?
As a result of the research that Dr. Greger discusses in his videos, as well as other research showing the negative effects of eating highly processed foods, more and more healthcare professionals are recommending a whole-food, plant-based (WFPB) diet. Basically, this diet is a slightly relaxed version of a vegan diet (in which you eat zero animal products). In addition, it emphasizes whole, minimally processed foods.
While many people are under the impression that humans are omnivores, it turns out that biologically we’re frugivorous herbivores—we evolved eating fruit, vegetables, nuts, seeds, roots, and legumes. That’s why eating a whole-food, plant-based diet resolves so many health issues; it’s how we’re meant to eat.
The great thing about adopting a WFPB diet is that it allows for the fact that we’re human and that it’s hard to avoid eating animal products and processed foods all of the time. And the reality is that eating a little bit of animal products or processed food once in a while is probably not going to kill us, so we don’t need to avoid them 100% of the time in order to reap the benefits and avoid chronic disease.
The growing movement toward a plant-based diet
At the 2017 American Medical Association (AMA) Annual Meeting, the AMA passed resolutions calling for hospitals to eliminate processed meat from their menus and to offer more plant-based meals. Hospitals including NYC Health & Hospitals, the University of Florida Health Shands Hospital, and the University of Rochester Highland Hospital have begun to offer and encourage a plant-based diet for their patients. And according to Food Revolution Network, other mainstream health organizations including Kaiser Permanente (the largest healthcare organization in the U.S.), the Dietary Guidelines Advisory Committee, and the American Institute for Cancer Research have all begun recommending a plant-based diet.
The Economist declared that “2019 will be the year veganism goes mainstream.” The article states that 25% of Americans between the ages of 25 and 34 are vegan or vegetarian.
The school district of Los Angeles, America’s second-largest, now offers vegan meals in its schools.
And yes, folks…even McDonald’s has introduced its McVegan burger in Sweden and Finland.
This Food Revolution Network article provides statistics on how veganism is growing around the world. The Chinese government has encouraged the country to reduce their meat consumption by 50%; Google is shifting toward plant-based foods in their employee cafeterias; and professional athletes including Venus Williams, Tom Brady, 11 of the Tennessee Titans, and a number of NBA players are now eating plant-based diets.
If you want to learn more about the negative health effects of eating animal products and the growing movement toward a plant-based diet, I recommend watching the engaging documentaries What the Health and Forks Over Knives (both available with a Netflix or Amazon Prime subscription, and available to rent or buy through other streaming services).
If you’re curious about athletic performance on a plant-based diet, The Game Changers is a must-see. This “revolutionary new documentary about meat, protein, and strength,” produced by James Cameron, Arnold Schwarzenegger, and Jackie Chan, is sure to change public perception of plant-based diets.
How a plant-based diet can reduce and eliminate chronic pain conditions
Following is just a taste of the research and personal stories available online showing how eating a plant-based diet can improve and eliminate some chronic pain conditions. If you have any chronic health condition, I recommend doing your own research to find out if switching to a plant-based diet might help you.
A 2014 study published in the Journal of Headache and Pain compared the efficacy of eating a plant-based diet to a placebo for the treatment of migraine headaches. The study showed significant decreases in number of headaches, headache intensity, duration of headaches, and number and percent of medicated headaches after following a plant-based diet for 8 weeks. Notably, many of the participants refused to resume their baseline diets at the end of the test period, even though the study required that they do so, because they were experiencing relief on a plant-based diet.
In this 2002 study, 24 rheumatoid arthritis (RA) patients ate a very low-fat, vegan diet. The patients experienced significant improvement in RA symptoms after just 4 weeks on the diet.
This 2001 study found that a vegan, gluten-free diet improved RA symptoms, and that the positive effects may be related to a reduction in the immune system’s response to food antigens.
This 2000 study found improvement in RA symptoms after following a raw vegan diet.
A quick search on the National Center for Biotechnology Information (NCBI, a division of the National Institutes of Health) returns a list of related research.
Theresa Dojaquez was diagnosed with rheumatoid arthritis at age 37. She refused to go on the medications that her doctor recommended, and after doing her own research, decided that eating a plant-based diet might help her. Two months later, she was free from all pain and inflammation. She went on to run her first half marathon. Six months after adopting the diet, her polycystic ovary syndrome, which she’d battled her whole life, also resolved.
Jon Hinds was an elite Ju-jitsu athlete when he was diagnosed with RA. Luckily, a colleague told him it was reversible with a plant-based diet. Two months later, he was completely pain-free.
35-year-old Emily Brandehoff resolved her rheumatoid arthritis, which involved excruciating pain and severe depression, by switching to a plant-based diet.
This 2015 study found that osteoarthritis patients eating a whole-food, plant-based diet experienced significant reduction in pain after just two weeks, as well as improvements in their energy and physical functioning.
This 2001 study tested the effects of eating a mostly raw vegetarian diet on fibromyalgia symptoms. After 2 months, 19 of 30 participants experienced improvement of all fibromyalgia symptoms. And after 7 months, these 19 participants had complete resolution of 7 out of 8 health scales measured in the study.
This 2002 study found that eating a raw vegan diet reduced pain and joint stiffness in fibromyalgia sufferers.
Dr. Michael Greger summarizes research about the effects of vegan and vegetarian diets for fibromyalgia sufferers in his video Fibromyalgia vs. Vegetarian & Raw Vegan Diets.
In addition to plant-based diets, gluten-free diets have been shown to improve fibromyalgia symptoms in people who have celiac disease or non-celiac gluten sensitivity. For these people, going on a gluten-free diet is shown to have “remarkable clinical improvement.”
Read the story of Melayna Evans, who used a plant-based diet to cure her fibromyalgia, as well as her high blood pressure, diabetes, high cholesterol, and sleep apnea.
And read Cheryl Lambert’s story of how she overcame 4 years of fibromyalgia and constant physical pain by going on a plant-based diet.
While I couldn’t find any clinical studies on the effectiveness of a plant-based diet for endometriosis symptoms, I found many personal stories:
Christine Krebs had suffered from endometriosis pain for about 20 years, debilitating back pain for 10 years, and also had recurring chronic pain in her hands, feet, legs, and neck. Within three days of going on a whole-food vegan diet, her pain was completely gone.
Katherine Lawrence was diagnosed with Stage 4 endometriosis, ovarian and uterine cysts, and advanced reproductive disease. Her doctor told her that her only option was to get a hysterectomy. But after 6 weeks on a whole-food, plant-based diet, 95% of her endometriosis was gone, her reproductive problems resolved, and the fibrotic cysts she’d had in her breasts since puberty had completely disappeared.
Jessica Murnane couldn’t get out of bed most days because of her Stage 4 endometriosis. But within weeks of going on a plant-based diet, her pain began to fade, and her depression lifted soon after.
Paula recovered from many years of endometriosis pain by going on a vegan diet. Within 8 months her pain was completely gone, and within 2 years she was able to naturally conceive after previously being told she would not be able to.
In this 2019 case study of two lupus sufferers, both experienced improvement in joint pain, kidney function, and energy level after eating a raw, whole-food, plant-based diet for 6 weeks.
Jami Heymann was diagnosed with lupus after experiencing crippling joint pain and partial seizures. Immediately after being diagnosed, she went home and researched how people had recovered from autoimmune diseases. The consistent answer was a whole-food, vegan diet, so she made the switch immediately. Jami’s pain, hair loss, and extreme fatigue gradually decreased over the next few months until they disappeared completely. She has stopped having seizures as well.
At age 16, Brooke Goldner, M.D. was diagnosed with lupus after suffering from debilitating arthritis and migraine headaches. At the same time, she found out that she had stage IV kidney failure—her immune system was destroying her kidneys. She underwent 2 years of chemotherapy in order to stabilize her condition, but had by no means recovered. Luckily, 12 years after her initial diagnosis, she met her future husband who helped her switch to a vegan diet. Dr. Goldner has now been disease-free for 10 years and has given birth to two healthy children.
Joyce Hale suffered from daily seizures and neuropathy episodes caused by lupus. Shortly after switching to a whole-food, plant-based diet, her seizures and neuropathy began to lessen. Five years later, she was able to stop all of her lupus medications completely, and she finally feels free from chronic illness.
In 1948, neurologist Roy Swank began testing the effects of a diet very low in saturated animal fats on multiple sclerosis (MS). Thirty-four years after beginning his study, 95% of the participants were without progression of the disease. His work has been called the “most effective treatment of multiple sclerosis ever reported in the peer review literature.”
Corinne Nijjer was diagnosed with fibromyalgia at age 22 and multiple sclerosis at age 24. She continued to have relapses of MS about every six months, and 4 years later, she woke up one day unable to feel anything below her waist. She had been hearing about Roy Swank’s research, and she knew at this moment that she had to make the switch to a low-fat, whole-food, plant-based diet. Corinne quickly felt improvement in her chronic pain and other symptoms. Ten years later, she is completely free from symptoms and relapses.
In 1995, Dr. Saray Stancic woke up from a brief nap during an overnight shift at the hospital to find both her legs numb and heavy. She was diagnosed with MS after an emergency MRI. By 2003 she could only walk with a cane and was dependent on nearly 12 prescription drugs. In 2003, she learned about the benefits of a whole-food, plant-based diet for MS patients, and decided to taper off her medications and make the switch to the WFPB diet. Her neurological symptoms gradually improved and she felt stronger and more energetic. In 2010, she ran a marathon. Dr. Stancic is so passionate about the WFPB diet that she left her infectious disease practice to focus solely on lifestyle medicine.
In this study, 21 patients suffering from systemic distal polyneuropathy (SDPN) with adult-onset (Type II) diabetes mellitus (AODM) were put on a low fat, high fiber, whole-food, vegetarian diet. Remarkably, 17 of the 21 patients experienced complete pain relief after just 4-16 days. Four years later, 71% of the patients had remained on the diet, and nearly all of them continued to experience relief or had further improvement.
This 2015 study also found a reduction in neuropathic pain in type 2 diabetes patients after following a low-fat, plant-based diet for 20 weeks.
Always remember: Just because you’re told that you will suffer from a condition and be on medications forever doesn’t mean it’s true. We did not evolve to inevitably get one disease or another; our bodies simply can’t deal with the toxins in our food and our environment, and the stress in our daily lives. Keep an open mind, do your research, and don’t give up hope!