Nutrition’s Role in Chronic Non-Cancer Pain

Chronic non-cancer pain (CNCP), defined as pain persisting for more than three months, affects approximately 20% of adults worldwide, with a higher prevalence among vulnerable populations such as the elderly and those from diverse cultural backgrounds. The economic burden of CNCP is substantial, exceeding that of heart disease, diabetes, and cancer in countries like the United States. Beyond the financial implications, CNCP significantly impacts individuals' quality of life, leading to absenteeism, loss of productivity, and increased healthcare utilization.

Traditionally, CNCP management has focused on pharmacological interventions and physical therapies. However, emerging evidence underscores the importance of a holistic, person-centered approach that addresses various lifestyle factors, including nutrition. Healthy eating patterns are associated with reduced systemic inflammation, as well as lower risk and severity of chronic non-cancer pain and associated comorbidities.

Persisting low-grade systemic inflammation is associated with CNCP and multiple comorbid chronic health conditions. Diet plays a complex role in modulating systemic inflammation. Knowledge is expanding rapidly in this area and multiple links between diet and inflammation have been identified. Metabolic mechanisms associated with postprandial hyperglycemia and frequent and prolonged rises in plasma insulin levels, influenced by dietary intake, can produce systemic inflammation.

Nutritional Strategies for Pain Management
Evidence from a number of recent systematic reviews shows that optimizing diet quality and incorporating foods containing anti-inflammatory nutrients such as fruits, vegetables, long-chain and monounsaturated fats, antioxidants, and fiber leads to a reduction in pain severity and interference.

Non-nutritive bioactive compounds such as polyphenols mitigate oxidative stress and inflammation, as well as modulate pain experiences. One such mechanism operates through the inhibition of COX-2 in neuromodulating pathways. Polyphenols are found in a range of foods such as fruits, vegetables, whole grains, cocoa, tea, coffee, and red wine.

Incorporating anti-inflammatory foods into one's diet can be a practical approach to managing CNCP. Emphasizing the consumption of fruits, vegetables, whole grains, and healthy fats, while reducing the intake of processed foods and sugars, can help modulate inflammation and alleviate pain. Additionally, maintaining a balanced diet supports overall health, which is crucial for individuals dealing with chronic pain.

Adopting a healthy, anti-inflammatory diet can reduce systemic inflammation and alleviate pain severity, contributing to improved quality of life for individuals with CNCP. As research in this field continues to evolve, healthcare providers should consider incorporating nutritional strategies into comprehensive, person-centered pain management plans.

To learn more about essential digestion concepts, nourishment strategies, and the interconnected nature of physical and emotional health across the lifespan join Megan Prybil in her upcoming course, Nutrition Perspectives for the Pelvic Rehab Therapist on February 23-24, 2025. Whether at the beginning of your journey or well on your way down the path of integrative care, this continually updated and relevant course is a unique, not-to-be-missed opportunity. 

Resources:

1. Brain K, Burrows TL, Bruggink L, Malfliet A, Hayes C, Hodson FJ, Collins CE. Diet and Chronic Non-Cancer Pain: The State of the Art and Future Directions. J Clin Med. 2021 Nov 8;10(21):5203. doi: 10.3390/jcm10215203. PMID: 34768723; PMCID: PMC8584994.
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4. Lahousse A, Roose E, Leysen L, Yilmaz ST, Mostaqim K, Reis F, Rheel E, Beckwée D, Nijs J. Lifestyle and Pain following Cancer: State-of-the-Art and Future Directions. J Clin Med. 2021 Dec 30;11(1):195. doi: 10.3390/jcm11010195. PMID: 35011937; PMCID: PMC8745758.
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