"The Best Diet for Fibromyalgia and Other Chronic Pain Relief"
Fibromyalgia is a common disorder
whose cardinal manifestation is chronic, widespread pain.
Well, not so common, affecting 2 to 4% of the population
though probably more like 2%, and especially women.
For decades, some medical professionals dismissed fibromyalgia
as all in people’s heads, but this outdated view has been refuted
by more recent research characterizing it as a disorder
of pain regulation and sensitization.
Brain imaging studies have shown several perturbations of pain
processing and regulation that amplify pain
in people with the condition.
Twin studies have shown that about half of fibromyalgia is genetic,
but the other half we can do something about.
There are lots of drugs with lots of side effects to help
with some of the symptoms, but what about lifestyle approaches?
Engagement in regular physical activity is considered
imperative for effective management of ﬁbromyalgia.
A systematic review and meta-analysis
of randomized clinical trials on the
effectiveness of therapeutic exercise in fibromyalgia
found that both aerobic and resistance exercises
are effective ways of reducing pain
and improving global well-being in people with fibromyalgia.
Patients may worry and perceive that exercise
will worsen their pain and fatigue,
and so you have to start slow and work your way up as tolerated,
with the goal of eventually achieving 30 to 60 minutes
of moderate intensity aerobic exercise in addition to
muscle strengthening exercises (1 to 3 sets of 8–11 exercises,
8–10 repetitions with a load of about 7 pounds
or 45% of the max you can lift.
But what about dietary interventions in terms of
dialing down the pain sensitivity?
Well, what causes it in the first place? Inflammation.
During the inﬂammatory response, pain receptors are activated,
and chronic inflammation, can cause chronic activation,
which may cause chronic pain, due to this prolonged
hypersensitization of pain pathways.
No wonder, then, that a pro-inﬂammatory diet
was found to be associated with pain hypersensitivity
in patients with fibromyalgia syndrome.
Exactly which foods are pro-inflammatory
and which foods are anti-inflammatory?
Check out those twin videos, but broadly speaking
components of processed foods and animal products,
such as saturated fat, trans fat, and cholesterol,
were found to be pro-inflammatory,
while constituents of whole plant foods,
such as fiber and phytonutrients, were strongly anti-inflammatory.
The intake of dietary fiber, found concentrated in
only one place— whole plant foods—
is fundamental to reducing not only the risk of abdominal pain
but also muscle and joint pain,
we think because of these short chain fatty acids
that our good gut bugs produce when we eat fiber.
These short chain fatty acids are important mediators of pain,
fundamentally because they modulate inﬂammation.
So having a lot of fiber-feeding bugs in your colon is like
carrying around your own anti- inflammatory compound factory.
But to cultivate them you actually
have to eat the foods that feed them.
And in terms of phytonutrients, plant-derived polyphenols
are widely acknowledged to also act as anti-inﬂammatory substances.
Here’s some foods packed with anti-pain pathway nutrients:
berries, greens, citrus, nuts,
spices like turmeric and ginger, edamame, and green tea.
That’s why you can do randomized, double-blind crossover trials
showing that about three cups worth of strawberries a day
can significantly improve pain and inflammation.
If that’s what a single plant can do,
what about a diet chock full of plant foods?
Put people on a strictly plant-based diet rich in
fresh fruits and vegetables, whole grains and various legumes,
which are beans, split peas, chickpeas, and lentils,
as well as nuts and seeds, and you can drop
C-reactive protein levels 33% in 3 weeks,
which is a leading blood marker of systemic inflammation.
But does that translate into less pain?
And the answer is yes, when it comes to migraine headaches.
Yes when it comes to painful periods.
A signiﬁcant reduction in menstrual pain, duration of pain, intensity
in addition to premenstrual symptoms.
In fact even just a single plant, cinnamon,
about a third of a teaspoon three times a day during your period
can help, though it doesn’t work as well as ibuprofen.
Ginger powder, on the other hand—
ground ginger – has been found
to be comparable to ibuprofen in relieving pain
in women with painful cramps.
You can learn more in my video on the topic.
Whole-food plant-based diets also alleviate
the symptoms of osteoarthritis.
Several studies have shown improvements in rheumatoid arthritis
symptoms with diets excluding animal products,
though it may be just as much a function of
increasing the quantity of healthy plant foods.
But it’s not just because plant- based diets are so effective
in causing weight loss, even at the same weight
there’s an improvement in rheumatoid arthritis
from more plant-based diets.
And plant-based diets can also alleviate fibromyalgia symptoms.
This is the latest study, which enrolled anyone
with chronic musculoskeletal pain, fibromyalgia or not.
Yes, diets high in animal proteins and fats have been linked to
chronic pain and inﬂammation, while plant-based diets
produce anti-inﬂammatory responses.
So, did it actually work when put to the test for pain?
Yes.
Consumption of a plant-based diet produced
positive improvements in chronic pain and function.
How much?
Well, a minimally clinically important diﬀerence in
chronic musculoskeletal pain is 1 point on the
Numeric Pain Rating Scale, which is just a scale of 1 to 10,
on how much pain you’re feeling.
And on the plant-based diet
perceived pain decreased an average of
three points on a 10-point scale,
from an average of 5 or 6 out of 10 down to 2.
Now, unlike most of prior studies there was no control group,
but what’s the downside of giving healthier eating a try?
In fact, those with chronic pain are more likely to be overweight
and have nutrition-related maladies such as high blood pressure,
diabetes, and heart disease all of which can be prevented,
arrested, and in some cases even reversed
with a healthy-enough plant-based diet.
So, any pain benefit is just icing on the cake of health.
Uh...scratch that.
How about...
the dollop of guacamole on your bean burrito.