Does Dietary Pattern Affect Chronic Musculoskeletal Pain?
In the past decades, talks of nutrition have been steadily increasing. Instagram, Facebook, and Snapchat are flooded with mouth-watering recipe posts, while Youtube, Netflix and Hulu are filled with cooking and talk shows related to food, nutrition or health. However, many of these shows often highlight redundant themes of aesthetic-driven goals such as weight loss, muscle gain and skin care. Other topics, namely nutrition-related diseases which include hypertension and type 2 diabetes, are left on the back burner as they are deemed boring and not as interesting. Nonetheless, such topics are equally, if not more important than those that have graced the headlines of many popular media. One emerging topic is nutritional approach to chronic musculoskeletal pain.
In general, it has been well established that nutrition plays a significant role in improving musculoskeletal health, specifically by supporting cartilage structure and immune modulation. Milk advertisements that claim their products are essential for bone health due to the high content of vitamin D and calcium show how universal nutritional approach is to maintaining musculoskeletal health. However, what is not well known is nutrition’s ability to alleviate musculoskeletal chronic pain.
The understanding of chronic pain has recently expanded from the traditional biomedical perspective to a broader scope. Lifestyle factors such as unhealthy diet and obesity/overweight are receiving more attention regarding their roles in managing chronic pain. It has been suggested that one or a combination of these factors, including poor sleep, smoking and stress “can change the neuronal organisation in the peripheral and central nervous system, leading towards increased sensitivity of the central nervous system (i.e., central sensitization) in musculoskeletal pain conditions such as non-specific chronic lower back pain (NCLBP), osteoarthritis, fibromyalgia, and chronic fatigue syndrome” (Elma). In other words, dietary intake can “enhance the function of the nervous, immune and endocrine systems, directly impacting pain experiences” (Brain). Optimal nutrition intake can also result in weight loss which reduces not only loads on joins and meta-inflammation, but also risk and severity of chronic diseases that often occur concurrently with chronic pain.
The conclusion that appropriate dietary intake can relieve chronic musculoskeletal pain is supported by several research studies that focus on studying impacts of single nutrient intake on specific conditions. For instance, chronic lower back pain has been associated with low intake of vitamin D and alkaline mineral, while rheumatoid arthritis has been correlated with low consumption of omega-3 polyunsaturated fatty acid, calcium, folate, zinc, magnesium, and vitamin B6. A study concerning therapeutic possibilities for fibromyalgia has also investigated the link between pain severity and inadequate intake of carbohydrates, proteins, lipids, vitamin A-E-K, folate, selenium, and zinc. Nonetheless, a more suggestive and clearer relationship between nutrition and chronic pain management can be seen through a recent study that suggests “endogenous pain-relieving systems in the central nervous system require essential fatty acids such as eicosapentaenoic acids, arachidonic acids, and tryptophan” (Elma). This finding is reinforced by a similar study that shows a positive correlation between pain severity and fat/sugar intake in chronic osteoarthritis pain.
Nevertheless, as we often consume combinations of nutrients rather than a single nutrient or food, it is more natural to examine overall dietary patterns instead. In this regard, there is numerous research concerning specific diets that have been proven to alleviate chronic pain. Systematic reviews and meta analyses show that vegetarian and vegan diets are effective in decreasing pain among patients with general chronic musculoskeletal pain, while weight loss and FODMAP diet are beneficial to alleviate pain severity in patients with fibromyalgia.
Available publications prove that plant-based, high protein, and limited saturated fat/sugar diets are effective to not only maintain and improve musculoskeletal health, but also alleviate painful symptoms of musculoskeletal diseases. Such a relationship can be caused by numerous factors, however, there is one reason that many studies have supported the most: optimal diets have anti-inflammatory characteristics that produce pain-relieving effects on chronic musculoskeletal pain. Even so, existing literature is still unable to explain the mechanism behind said interaction. Therefore, more clinical research concerning nutrition, inflammatory processes and chronic pain is needed to ensure that dietary patterns can be tailored to treat musculoskeletal pain.
References:
Bell, Rae Frances, et al. “Food, Pain, and Drugs: Does It Matter What Pain Patients Eat?” PAIN. Oct. 2012, journals.lww.com/pain/fulltext/2012/10000/food,_pain,_and_drugs__does_it_matter_what_pain.6.aspx?casa_token=L-Wlfqmou0cAAAAA%3AB0aVSUVNDVVkB4phRvxifdSiz8koWPJoG69DFHULzpT4i99jFlC7a-jE8-yG6tDq3UngA9Qi63ZR4noEMiNG_lvLGj4.
Bjørklund, Geir, et al. “Fibromyalgia and Nutrition: Therapeutic Possibilities?” Biomedicine & Pharmacotherapy, Elsevier Masson, 24 Apr. 2018, www.sciencedirect.com/science/article/abs/pii/S0753332218309697.
Brain, Katherine, et al. “Nutrition and Chronic Pain.” Europe Pain Federation , International Association for the Study of Pain , 2020, europeanpainfederation.eu/wp-content/uploads/2020/03/European-Year-2020-Nutrition-and-Chronic-Pain-Fact-Sheet.pdf.
Elma, Ömer, et al. “Do Nutritional Factors Interact with Chronic Musculoskeletal Pain? A Systematic Review.” Journal of Clinical Medicine, MDPI, 5 Mar. 2020, www.ncbi.nlm.nih.gov/pmc/articles/PMC7141322/#B1-jcm-09-00702.
