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Good Nutrition Can Reduce Chronic Pain

Follow two simple rules of “more” and “less.”

By J. Tobias Musser, M.D.
Staff Physiatrist, Shepherd Pain Institute

We all want to be healthier – or at least we say we do.

Chances are you’re one of millions of people each year who set out to make healthy lifestyle changes as part of their New Year’s resolutions. And, chances are you’ve already broken those resolution(s). Only about 8 percent of us are successful in maintaining resolutions beyond January.

The typical resolution revolves around the stereotyped “I’m going to eat healthier” statement, which – knowing from personal experience – is a very hard one to keep indeed. There are many reasons why we tend to fail at keeping our resolutions, but thankfully there are easy steps a person can take to increase the likelihood of making a behavioral change stick. But this topic deserves its own lengthy discussion elsewhere.

Inherently, we all know – though some of us are in denial – that our diet is highly important for our state of health and wellbeing. There is an ever-growing body of scientific evidence that nutrition can complicate and/or improve chronic disease. This is especially true for patients, such as those we see at Shepherd Pain Institute, who suffer from the “disease” of chronic pain. Although the cause of pain in chronic pain sufferers is varied, it typically involves some sort of chronic inflammation and/or chronic irritation or dysfunction of the nervous system. In either case, there is a strong link between chronic pain and nutrition.

For example, periods of dietary fasting have been linked to the temporary relief of pain among many patients. For longer term pain relief, some experts suggest a high protein, low carbohydrate diet, which has been associated with decreases in pain sensitivity and inflammation. Likewise, several studies have shown that a vegetarian/vegan diet is also beneficial to patients with chronically painful conditions. Some foods, however, can increase pain. For example, for patients with rheumatoid arthritis, just one teaspoon of sugar can increase pain and inflammation for up to a month.

For the millions of Americans who suffer from chronic pain, a sustainable dietary change can make a difference in their pain – though in some more than others. But where does a person start? Unfortunately, doctors are spending less time than ever talking to patients about nutrition because they lack time, training and even optimism that patients can make sustained lifestyle changes. It’s much easier, for both parties, to simply consider prescribing/taking a pain pill.

But there are several easy tips to help take steps towards improving pain through dietary changes. There are certain foods in our diets that can actually stop our bodies from healing and get in the way of rehabilitation for an injury. Moreover, certain foods may increase pain for days or even weeks at a time from a single exposure. There are two main rules to nutrition that can get people out of pain: MORE and LESS.

Here are some suggestions of specific nutrients that will augment healing and/or more quickly reduce pain.

MORE Anti-Inflammatory Foods:

1. NUTS, especially almonds, are a good source of anti-inflammatory omega fatty acids.

2. DARKS (dark, leafy veggies), especially kale and red cabbage.

3. SPICES, especially turmeric and ginger. Both are potent anti-inflammatory spices.

4. REDS, especially tart cherry juice/extract, red beets/juice. Both are especially good for improving muscle and joint inflammation and fatigue.

5. CORES: Pineapple cores, a good source of bromelain, can fight joint inflammation and pain, as in osteoarthritis.

6. OILS: Fish/krill oil has been found to improve joint pain and swelling, especially in people with rheumatoid arthritis. These oils also improve mood, memory and metabolic syndrome. Evening primrose oil is a potent anti-inflammatory.

7. ALLIUMS: Garlic and onion. Garlic has been shown to work similarly to NSAID pain medications (such as ibuprofen). Onions contain similar anti-inflammatory chemicals.

LESS Pro-Inflammatory “Foods”:

1. SUGAR (but this does not mean you should use artificial sweeteners). Sugar leads to more inflammation, weight gain and insomnia, and it reduces the effectiveness of opioids.

2. MARGARINE and other HYDROGENATED OILS. These are very pro-inflammatory and can degrade nerve transmission.

3. GLUTEN is one of the top reasons for inflammatory processes in the body, and thus pain. Most pain patients would be candidates for trying a gluten-free diet for one to two months to see if it improves their pain. Some may feel better within a few days, while in others, it can take up to two months for the immune system to recover and experience a noticeable difference in pain. If, after two months, there is no obvious difference in pain, the patient should plan a day to eat large amounts of gluten all day and then observe the body for two to three days to see how they feel.


J. TOBIAS MUSSER, M.D., is a physical medicine and rehabilitation physician in the Shepherd Pain Institute. He completed his residency at Emory University Hospital, including eight months of training at Shepherd Center. Dr. Musser spent an additional year of training as Shepherd Center’s first Fellow in the Shepherd Pain Institute to build and further refine his skills in interventional and chronic pain management. With an interest in holistic, mind-body medicine, Dr. Musser chose physiatry because it interlaces all of those specialties into one. Read more about Dr. Musser by clicking here.

About Shepherd Center

Shepherd Center, located in Atlanta, Georgia, is a private, not-for-profit hospital specializing in medical treatment, research and rehabilitation for people with spinal cord injury, brain injury, multiple sclerosis, spine and chronic pain, and other neuromuscular conditions. Founded in 1975, Shepherd Center is ranked by U.S. News & World Report among the top 10 rehabilitation hospitals in the nation. In its more than four decades, Shepherd Center has grown from a six-bed rehabilitation unit to a world-renowned, 152-bed hospital that treats more than 900 inpatients, 575 day program patients and more than 7,100 outpatients each year.