Chronic Pain – does diet hold the key?

Chronic pain is a debilitating condition that affects millions of individuals worldwide, significantly impacting their quality of life. Unlike acute pain, which is typically short-lived and serves as a warning signal for injury or illness, chronic pain persists for extended periods, sometimes even for years. Understanding the root causes of chronic pain is crucial for effective pain management. One key factor often overlooked is the role of nutrition in exacerbating or alleviating chronic pain.

The Role of Chronic Inflammation

Chronic pain often arises from a state of chronic inflammation within the body. This persistent inflammation can exert pressure on nerve endings, transmitting pain signals to the brain. Autoimmune conditions like rheumatoid arthritis and inflammatory bowel disease can contribute to this chronic inflammation, further compromising an individual’s quality of life.

The Impact of Diet on Chronic Pain

Diet plays a vital role in either exacerbating or mitigating chronic pain. Some foods can promote inflammation by increasing the production of inflammatory chemicals such as interleukins and cytokines. While these foods are not the root cause of chronic pain, they can intensify pain and inflammation in an already sensitive body.

Conversely, specific foods can support chronic pain management by dampening the inflammatory response and exerting an anti-inflammatory effect. These foods work through various mechanisms, including the presence of plant phytonutrients, omega-3 fatty acids, beneficial enzymes, and more.

  • Plant Phytonutrients: Many plant compounds, known as phytonutrients, possess anti-inflammatory properties that can reduce the levels of inflammatory cytokines and prostaglandins in the body. Examples include curcumin from turmeric, gingerol from ginger, and quercetin from onions.
  • Omega-3 Fatty Acids: Omega-3 fatty acids, particularly EPA and DHA found in oily fish like salmon and sardines, compete with omega-6 fatty acids to reduce the production of inflammatory prostaglandins. Balancing these fatty acids is essential for pain management.
  • Enzymes: Some foods contain enzymes with anti-inflammatory properties, such as bromelain in pineapples and papain in papaya. These enzymes can be beneficial when incorporated into a broader nutrition and lifestyle modification plan.
  • Food Allergy/Intolerance: Identifying and eliminating foods to which an individual is allergic or intolerant can help reduce the release of inflammatory chemicals triggered by an immune response. This can alleviate inflammation not only in the gut but also in joints, skin, and muscles.
  • Nutrient Deficiencies: Certain nutrient deficiencies, including vitamin D, B vitamins (B12 and B6), and magnesium, have been linked to pain conditions. Addressing these deficiencies can be a critical step in pain management.
  • Gut Microbiome: The gut microbiome, composed of various bacteria and microorganisms, can influence inflammation and pain levels. A diet rich in dietary fibre promotes beneficial bacteria and the production of anti-inflammatory substances like Short Chain Fatty Acids (SCFA).
  • Visceral Fat/Adiposity: Excess central adiposity can contribute to inflammation and chronic pain, emphasising the importance of weight management.

Common Dietary Factors That Exacerbate Chronic Pain

Certain dietary factors can contribute to or exacerbate chronic pain conditions:

  • A standard Western diet, low in vegetables, fruits, and fibre, and high in refined carbohydrates, sugars, processed foods, fizzy drinks, and alcohol can promote inflammation.
  • Unstable blood sugar levels caused by frequent sugar consumption and snacking throughout the day can lead to insulin resistance and worsen inflammation.
  • Processed and ultra-processed foods, rich in saturated fats and quick-release carbohydrates, can disrupt blood sugar balance and promote inflammation.
  • Fried foods cooked in unhealthy vegetable oils can contribute to inflammation.
  • Wheat and dairy allergies or intolerances are common and should be ruled out if suspected.
  • Excessive alcohol consumption can trigger inflammation, particularly in autoimmune conditions.
  • A high intake of processed red meat products may exacerbate inflammation.
  • Omega-6 rich vegetable oils remain a topic of debate; extra virgin olive oil is recommended for its anti-inflammatory properties.

Recommendations for Individuals with Chronic Pain

Managing chronic pain through nutrition involves adopting specific dietary patterns.

My Renew Reset Recharge® Programme is a science-led, no-nonsense eating plan that is easy to follow, helps people lose weight and includes many of the anti-inflammatory foods necessary for their health. I have seen clients regularly experience less pain while following this programme.

I usually help people to transition onto a lower carbohydrate Mediterranean eating plan which includes some degree of intermittent fasting. This does not have to be extreme and may just be leaving a gap of 4-5 hours between meals or aiming for a 12 hour fast between the evening meal and breakfast.

I recommend the following:

  • Food that looks like nature intended! Choose fresh food wherever possible.
  • Fresh vegetables – these should form the basis of every meal. The more colourful, the better when it comes to inflammation. Include onions, garlic, leeks as well as dark green leafy vegetables. It is fine to use frozen vegetables. Aim for 250g colourful vegetables at each meal.
  • Colourful fruits, such as low sugar berries as well as apples, pears and pineapple. Frozen berries can be more economical.
  • Lean proteins such as poultry, fish and shellfish as well as fresh eggs and dairy. Aim for free-range, sustainable fish or organic versions if you can. With fish think SMASH – the best fish for chronic pain are the high omega 3 fish:
    • Sardines
    • Mackerel
    • Anchovies
    • Salmon
    • Herring

If you cannot eat fish, include plenty of flax and chia seeds into your diet and consider taking a vegan Omega 3 from algae.

  • Plenty of plant proteins such as tofu, edamame beans, white beans, chickpeas, lentils as well as seeds and nuts. These are free from saturated fats and can really top up our protein levels when added to meals.
  • Healthy whole food carbohydrates such as sourdough, oats, quinoa, brown rice, oat cakes as well as Root vegetables, such as parsnips, beetroots, pumpkin and squashes.
  • Cooked beans and lentils including chickpeas to increase fibre and protein.
  • Healthy oils such as olive oil (extra virgin olive oil), flaxseed oil, hemp oil, walnut oil, pumpkin seed oil, sesame oil.

I also recommend that you stop eating at least 3 hours before going to bed to allow the stomach and small intestine to clear of food before you fall asleep.

Nutritional Supplements for Chronic Pain Management

Certain supplements can be beneficial for individuals with chronic pain:

  • Curcumin Supplements: High-quality curcumin supplements like Nutri-Advanced Curcumin Megasorb can provide anti-inflammatory benefits over the long term.
  • Omega-3 Fish Oil: Omega-3 supplements can be beneficial but their use should be monitored, especially if the individual is taking other medications.
  • Specialized Pro-resolving Mediators (SPMs): Products like Optiresol, enriched with SPMs, support the resolution of inflammation and can be particularly helpful for chronic inflammation.

Understanding the connection between nutrition and chronic pain is a crucial step toward improving pain management and overall well-being. While some foods can exacerbate chronic pain by promoting inflammation, others can alleviate symptoms by dampening the inflammatory response. Tailoring one’s diet to include anti-inflammatory foods and addressing potential dietary triggers can be a valuable strategy in managing chronic pain and improving the quality of life for those affected by this challenging condition.

About the Author, Dominique Ludwig, Nutritionist MSc and Nutritional Therapist mBANT

Dominique Ludwig is an accomplished Nutritionist MSc., and Nutritional Therapist who is also BANT, CNHC and AFMCP accredited. Dominique works in numerous health conditions using a personalised nutrition approach.She specialises in her signature group programmes Renew Reset Recharge® programme and The Triple 30 Plan and runs a busy clinic in the heart of the South Downs where she works with her private clients as a Nutritional Therapy Practitioner, offering personalised Renew Reset Recharge® appointments.Dominique is also a double award-winning nutritionist. Dominique has over 30 years’ experience as a King’s College, London qualified Nutritionist and almost 20 years as a registered Nutritional Therapist.

Dominique works with many high-profile and A-list clients, known and respected for her discretion, expertise, and trustworthiness. Dominique works out of her own busy practice, Dominique Ludwig Nutrition Limited, in Hampshire as well as Meyer Clinic in Chichester. Dominique has helped over a thousand clients, globally, live healthier lives. She is a regular contributor to The Times, The Sunday Times and Times 2, Sheerluxe, Top Sante and many other magazines and podcasts.


Features published by Dominique Ludwig are not intended to treat, diagnose, cure or prevent any disease. Always seek the advice of your GP or another qualified healthcare provider for any questions you have regarding a medical condition, and before undertaking any diet, exercise or other health-related programme. Please refer to our Terms and Conditions and Medical Disclaimer for more information as well as our Webiste Terms and Conditions.

Dominique Ludwig

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