Nutrition and Pain

Food, diets, and eating get more attention in popular culture today than just about any topic imaginable. Bookstores and magazine racks are crowded with publications hawking “magical” foods that can make us look and feel better. Diets, eating plans, and weight-loss strategies abound, but which ones really work? Atkins? South Beach? Why French Women Don’t Get Fat? Skinny Bitch? And what about eating to ease chronic pain? Is such a thing even possible?

No foods have been proven to directly relieve specific pains, just as there are no foods that cure diseases. But remember: A major focus of this website is to help you become healthier overall, which is key to helping you manage your pain. Experience has taught me that the healthier you become, the less your pain will limit you. A lot of what I discuss on this site doesn’t directly alleviate pain, but it can get you to the point—the healthy point—where your pain is ultimately better controlled.

Proper nutrition is one of the most important building blocks of good health. If your nutritional habits are not rock solid, you cannot be 100 percent healthy, no matter what else you do. Working out in the gym four hours every day is great, but if you go home and scarf down a big bag of potato chips and a six-pack of beer, you’re undermining your overall health.

That’s not to say that there are no links between food and your pain. For example, the stress response and inflammation associated with chronic pain is harmful and painful. An anti-inflammatory diet can help counteract some of these harmful changes and protect the brain and body. Good nutrition helps re-balance the stress-damaged body. And some new research suggests that fish oils containing omega-3 fatty acids and vitamin D have some pain-relieving effects that can be helpful in reducing musculoskeletal pain, the pain of fibromyalgia, and other types of pain problems.

This section is about healthful eating in general, for good nutrition is a necessary step in building a healthier you.

The Link Between Chronic Pain and Diet

What and how much you eat can affect your pain levels. That’s because pain triggers a stress response that produces inflammation, which sets the stage for health problems like heart disease, diabetes, Alzheimer’s disease, and in some cases, cancer. (I’m not just talking about the type of inflammation you can see, like a swollen, sprained ankle, but also the silent type that afflicts your heart, brain, and nerves.) Many of these inflammation-driven diseases can increase your pain levels. What you eat can make matters worse, because some foods actually promote the inflammation response, increasing both your pain levels and your chances of developing chronic, debilitating diseases.

Another factor in the food–chronic pain equation is obesity. Obesity is a known risk factor for cardiovascular disease, hypertension, arthritis, certain cancers, diabetes, and other chronic diseases.

About one-third of the adult population is obese, while another third is overweight and at risk of becoming obese. One of the “by-products” of pain is inactivity, and in my practice I have found a strong association between obesity and chronic pain. The most obvious link is that excess weight puts pressure on the joints, muscles, and organs and makes it difficult (if not painful) to move the body. This can create a vicious cycle: Pain promotes inactivity, which leads to weight gain, which increases pain. A less obvious problem is the fact that white adipose tissue—the kind that accumulates in the abdomen—produces substances called adipokines, which create inflammation. This is one of the reasons why abdominal fat is considered more dangerous than fat that accumulates elsewhere on the body. For these reasons, keeping body weight down to a moderate level is crucial to controlling or preventing chronic pain.

Luckily there are other foods that do just the opposite and quell inflammation. Not only does food have an impact on how you respond to pain and stress, it can be a deciding factor in the kinds of chronic diseases you develop—or don’t develop—along the way.

Let’s Go Grocery Shopping

Because poor nutrition can accentuate the inflammation that’s already present in injured areas and simultaneously pose added health dangers, it’s critical that you carefully choose what you eat. The easiest way to think about the foods that can build and maintain your health and help keep chronic pain levels at a minimum is to visualize the way a grocery store is organized. Typically the fresher and healthier foods are arranged along the store perimeter. That’s where food still looks like food: fruits and vegetables, poultry, fish, meat, and dairy products. In general the more processed and less nutritious foods (like Captain Crunch and Doritos) are found in the middle aisles, so be careful when strolling through them!

Pigment Paradise

One of the safest places to choose foods is in the produce section, where the food is unprocessed (it’s either pulled out of the soil or plucked off a plant) and contains most of its original nutrients and fiber. Fruits and vegetables are typically high in fiber, low in calories, and chock-full of vitamins and minerals. Which ones are best? Think “rainbow foods”—the more colorful the better. For example, dark green vegetables like spinach, broccoli, and kale are rich in folic acid, beta carotene, and vitamins C, E, and K. Yellow orange and orange vegetables like squash, carrots, and pumpkin are very high in beta carotene, which has been linked with lower risks of certain cancers and heart disease. Red foods such as tomatoes and watermelon have large amounts of lycopene, which can lower inflammation and dramatically reduce the risk of developing prostate cancer. Blueberries and other purple blue foods contain anthocyanins, which help fight inflammation, strengthen the walls of blood vessels, boost brain function, slow aging, and improve circulation.

All of these rainbow foods are rich in antioxidants, which can help clean up the free radicals thought to be a major cause of disease and aging. They may also help slow the progression of chronic diseases, including those associated with inflammation.

Naturally grown fruits and vegetables have other benefits too: They have a high fiber content, are relatively low in calories compared to other foods, and help balance blood sugars. High-fiber diets help lower cholesterol and lipid levels and keep glucose levels more stable in the blood, but you won’t find much fiber in processed, packaged foods. Here are just a few examples of rainbow foods for your shopping list. Pick what you enjoy most, keep an open mind, and don’t be afraid to try new things:

  • Apples
  • Apricots
  • Bean sprouts
  • Berries (especially blueberries)
  • Broccoli
  • Brussels sprouts
  • Cabbage
  • Cantaloupe
  • Carrots
  • Cauliflower
  • Cherries
  • Citrus fruits
  • Cranberries
  • Kale
  • Kiwi
  • Peaches
  • Peppers, green
  • Peppers, red
  • Pomegranates
  • Green vegetables, like spinach
  • Tomatoes
  • Watermelon
  • Winter squash

I prefer fresh foods because they usually taste better, can be eaten raw, and tend to have more nutrients than pre-cooked foods or frozen foods that have to be cooked in order to be eaten. However, frozen foods are reasonable alternatives when fresh foods are not available.

Herbs and spices are also worth mentioning, because many of them—oregano, basil, bay leaves, dill, mint, thyme, parsley, and rosemary—are loaded with nutrients and antioxidants. More exotic choices like cumin, fenugreek, coriander, cinnamon, ginger, and turmeric have been used medicinally in Asian and Indian cultures for centuries. Turmeric, one of the strongest antioxidants in existence, has long been used in India for gastrointestinal ailments, and modern scientists have discovered that it has the potential to reduce inflammation, lower the risk of cancer, improve liver detoxification, protect circulation, and boost brain function in the elderly. Ginger helps treat nausea, improve digestion, lower blood pressure, and reduce plaque build-up in the coronary arteries. It also reduces swelling and inflammation and has a compound that can reduce pain.

Good Fat, Bad Fat

Let’s leave produce and move over to the butcher section. The good news is that there is a lot of protein in this section, which is important for building strong muscles and other important body functions. This good news is tempered a bit, however, by the fact that some of the butcher’s items also contain a lot of fat, which means you should select wisely to get the best results. I took inventory in a chain grocery store near my house. It seemed that anything that came in a package in the meat section, whether it was hot dogs, bacon, or turkey, contained the preservative sodium nitrite. If you consume large quantities of processed meats and poultry, be aware that sodium nitrite can be a carcinogenic, and the government regulates its use in foods.

There are some important things to know about dietary fat. First of all, not all fat is bad. In fact eating the right fats, including essential fatty acids, is a requirement for great health. Essential fatty acids are fats the body and mind need for optimum health but cannot be made by the body; we must get them through food. Nuts and avocados are examples of good sources of essential fatty acids, which are typically unsaturated fats. These fats contain antioxidants and help improve brain and nerve function, strengthen circulation, and fight cancer and heart disease. Eating the right fats actually decreases inflammation and reduces the risk of having a heart attack.

The unhealthy fats are the saturated fats and trans fats. These fats are pro-inflammatory, and will increase cholesterol and promote heart disease. Saturated fats are usually found in fatty animal products like red meats and bacon. Trans fats, which are now considered to be one of the most harmful products in the American diet, are usually found in the processed foods that line those middle aisles of the grocery store. Trans fats may be hydrogenated or partially hydrogenated to give them a more solid consistency, as in margarine. If you read labels, you will find hydrogenated fats in most processed and baked products sold in your local market.

A great source of healthy fat is salmon, as it has an abundance of omega-3 fatty acids. Other fish, including sardines and tuna, also offer high amounts of omega-3 fatty acids, but salmon is best. Be aware of where the salmon you buy comes from, however. Wild salmon is preferable to farm-raised salmon, as it tends to have more omega-3 fatty acids. Fish raised on farms are often fed food that leaves them without the plentiful supplies of omega-3 found in wild fish. What’s more, you need to be careful not to eat too much farm- raised fish, as well as too much canned tuna, which may be high in toxins like mercury. Keep in mind, however, that organically-farmed salmon may be a reasonable alternative to wild salmon. If you aren’t a fan of fish, flaxseed can be an alternative source of omega-3 fatty acids. Nuts, including almonds, walnuts, pecans, and hazelnuts, are also sources of omega-3 fatty acids.

Olive oil is the best all around oil to use for cooking and seasoning. It has a great track record going back thousands of years and is a key ingredient in the healthy Mediterranean diet, where its consumption is credited with lower rates of cardiovascular disease. Olive oil is a monounsaturated fat with lots of healthy oleic acid, which is an omega-9 fatty acid. Be aware, however, that some manufacturers of olive oil are now mixing in other oils, like peanut oil, to lower costs. Be sure you only buy pure olive oil. Canola oil, also a monounsaturated fat, is an alternative oil to consider.

Not everything in the butcher section is high in saturated fat. Even different cuts of red meat can vary widely in their fat content. Chicken and turkey breasts, sirloin steak, filet mignon, and lamb are some of the butcher items that are relatively low in saturated fat. On the other hand, prime rib, New York strips, rib eyes, and pork chops have some of the highest quantities of saturated fat and so should be eaten in moderation. For example, a sirloin steak has about eighteen grams of fat, with only nine grams of that being saturated fat; a similar size piece of rib eye has double the amount of total fat and saturated fat, plus an extra two hundred calories. As for prime rib, I would save it for really special occasions, as a sixteen-ounce piece packs a whopping ninety-four grams of fat—over half of it saturated fat—and thirteen hundred calories!

Since we’re talking about fats, let’s head over to the dairy section. Cheese has now become the leading source of saturated fat in the American diet. Cheeses, just like meats, vary quite a bit in their fat content, so read labels. The amount of fat they contain is based on the type of milk used to make them: whole, reduced, nonfat, or cream. For example, because it is made from cream, cream cheese is high in fat. Cheeses made from whole milk include Brie, Swiss, and cheddar; a one-ounce serving of cheddar cheese contains fourteen grams of total fat, compared to half a gram of fat in a four-ounce serving of nonfat cottage cheese. Reduced-fat dairy products also contain lower levels of saturated fats. On the positive side, cheese is typically well stocked with healthier essential fatty acids like conjugated linoleic acid. Low-fat cheeses and unsweetened yogurts can be good sources of protein. Butter is high in saturated fat, but margarine has trans fats, which makes it a poor alternative.

If you like extra flavor in your yogurt, I suggest you add it yourself. All the flavored and sweetened yogurts that I looked at in the market contained something called high fructose corn syrup. Before I explain why you want to avoid that, let me just say that every time I looked at the ingredients of packaged items, they most assuredly had either sodium nitrites, hydrogenated fats, high fructose corn syrup, or some combination of the three.

Avoid the Sweet Spot

Let’s move on to the bakery section of the grocery store to learn more about sugars and starches—and high fructose corn syrup. First you need to understand the concept of the glycemic index, which measures how quickly certain foods cause a spike in blood sugar (glucose) after they are eaten. This is important, because spikes in blood sugar mimic the body’s stress response, which leads to increased inflammation. If the sugar spikes on an ongoing basis, insulin resistance and diabetes can develop, which is like putting the body into a state of chronic stress. And excess glucose in the circulation can build up in the cartilage, leaving the joints stiffer and more painful to move.

Foods that rate high on the glycemic index break down into sugar quickly and overwhelm the body’s ability to keep blood sugar levels in balance. Foods that rate lower on the index, such as whole-grain starches and most fruits and vegetables, are digested slower in the intestines, because they have more fiber. This means there isn’t a surge of glucose flooding the bloodstream. Comprehensive glycemic index lists can be found in many diet and nutrition books. Be aware of the following commonly eaten foods, which score high:

  • White bread and bagels
  • White rice and pasta
  • Potatoes
  • Dried fruit
  • Watermelon, corn, and bananas

Because processed and polished starches found in foods like white bread, white rice, and pasta score high on the glycemic index, you want to seek out alternatives that contain whole grains whenever possible, or just eat fewer starchy foods. Substituting fruits, vegetables, nuts, and meats for starchy foods will likely lower stressful sugar spikes in your blood and decrease your daily caloric intake, which will also reduce body fat. Other great starch alternatives that also have bountiful supplies of antioxidants include buckwheat, lentils, barley, and beans. There are times, however, when high glycemic index foods are appropriate to eat. The best time to consume them is around periods of intense physical activity, when exhausted muscles are looking to replenish their sugar supplies.

The glycemic problem runs deeper than just white flour, though. High fructose corn syrup has become the sweetener of choice for most pre-made foods and soft drinks. Once you head into the middle aisles of the grocery store, where a lot of processed foods like cookies, cereals, and crackers are sold, you will find high fructose corn syrup listed on most of the labels. High fructose corn syrup is corn syrup that is processed to increase its fructose content. A large percentage of this country’s calories now comes from this sweetener. The U.S. Department of Agriculture estimates that the average American consumes over sixty-three pounds of it each year. Nutritionists have been concerned for years about the correlation between the jump in use of high fructose corn syrup and the concurrent increase in the incidence of diabetes and obesity. High fructose corn syrup contains a combination of fructose and glucose, as does table sugar, but it has become such a prevalent sweetener in processed foods because it is cheaper and easier to cook with than table sugar. Unfortunately, foods containing high fructose corn syrup are usually high in calories and carry a high glycemic index.

I almost made the mistake of assuming that my grocery store’s in-house bakery would offer healthier alternatives to the items offered in the pre-packaged baked goods aisle, but just to be sure, I read through the ingredients of things like sandwich rolls, buns, and pastries. To my surprise, not only was everything baked with high-glycemic refined starches, but partially hydrogenated trans fats and high fructose corn syrup repeatedly popped up on the labels! I could feel my coronary arteries get stiff just sniffing this stuff.

Drink Up

Fluid intake is also a critical part of good nutrition. Our bodies are, after all, mostly water. Decreases in the hydration, or water level, of certain body tissues is associated with certain pain problems and aging. For example, the intervertebral disks in our backs and necks dry up, or desiccate, as you get older. This can lead to degenerative disk disease and spinal stenosis, which can cause back pain and neck pain or sciatica. Well-hydrated disks receive good circulation and look fuller and healthier, just as skin looks younger and more supple when it is well hydrated.

How many glasses of water should you drink each day? Is it eight, as some suggest? It depends on the individual person and what activities he or she does on any particular day. For example, if you go for a strenuous hike or walk one day, you need to drink more water than on a day when you just sit at your desk. A great way to gauge how much water you need is to look at your urine. The darker it is, the more dehydrated you probably are. The clearer it is, the more hydrated your tissues are likely to be. Tap water in certain areas across the country may contain too many toxins, however, so I recommend using a water purifier.

The next great beverage debate concerns coffee. Ever since the Boston Tea Party, America has been infatuated with the coffee bean. Unfortunately caffeine is a potent diuretic, and too much of it can cause the dehydration that interferes with having a healthy spine and joints and beautiful skin. Caffeine also causes a surge in stress-activated mediators and therefore has pro-inflammatory properties. Then there are those folks who are addicted to those large, supersized “caffeine cocktails” from places like Starbucks, which are also high in sugar and calories. Many feel obliged to drink coffee throughout the day to “keep going,” but I consider that a recipe for burnout.

The body’s stress hormones, such as cortisol, naturally rise in the early morning; that is thought to be the reason why heart attacks are more common in the morning. Adding a heaping dose of caffeine causes cortisol levels to spike to even higher levels, but many people do it anyway because otherwise they feel too sluggish to attack the day. About three hours after consuming the caffeine, though, their energy starts to wane and they feel taxed again. This can create a vicious cycle that lasts the entire day, forcing them to repeatedly ingest coffee, energy drinks, sodas, or candy for spurts of energy. The resulting highs and lows exhaust the body’s circuits, making it even more difficult to get restful sleep. On the flip side, coffee contains its own antioxidants, and some argue that there is some health benefit to a cup of joe.

Green and white teas are another story. I have found these beverages to be vastly superior alternatives to coffee. They are much richer in healthful antioxidants, contain much less caffeine, and have chemicals believed to decrease body fat and improve glucose balance. Darker teas, like black tea, have more caffeine and less antioxidants than green and white tea do. Consider replacing most of your coffee with a few cups of green or white tea per day. My guess is you will feel better as a result. One of the really cool things about drinking tea is that there is a vast variety of flavors to choose from. Even though I started drinking tea about five years ago, I am not even close to running out of new flavors to enjoy.

If you are a big coffee drinker and try to stop, expect to have some frontal headaches for a few days. Rebound headaches from caffeine withdrawal are common. Hang in there, though, because they will eventually go away.

Another beverage often tied to reported health benefits is wine. It is now known that drinking one to two glasses of wine a day is generally associated with good cardiovascular health. Wine is rich in antioxidants, but remember, it is also contains sugar and calories, so too much will offset its benefits. If you enjoy wine, I recommend drinking it with or after a meal; drinking it on an empty stomach is more likely to cause a spike in blood sugar.

Soft drinks, on the other hand, offer no value to your health. They come loaded with sugar, score high on the glycemic index, and add unneeded salt to the diet. Diet drinks may introduce nerve-toxic chemicals like aspartame into your body and boost levels of the amino acids glutamate and aspartate around brain cells with heavy use. Pain, stress, and possibly artificial sweeteners can cause excess levels of glutamate and aspartate to float around the brain, and this imbalance can destroy neurons. Recent research shows that drinking diet sodas is actually associated with weight gain, even though they contain almost no calories. One hypothesis is that diet drinks stimulate a hunger for other high-caloric or very sweet foods. I recommend you eliminate soft drinks of all types, and hydrate with purified water and green teas instead.

Kefir, a cultured-milk drink that originated in the Caucus region of Eastern Europe, is considered good for immune system function because it is probiotic, or helps increase the levels of beneficial bacteria in the intestines. It differs from yogurt, which is also probiotic, because of the type of bacteria used for the culture. Kefir is high in protein, vitamin D, and calcium and low in saturated fat. While most fruit drinks are too high in sugar to be recommended, mixing a juice rich in antioxidants, like pomegranate juice, with kefir can make a great snack.

Timing is Everything

Speaking of snacks, many folks equate snacking with poor nutrition and obesity, but it doesn’t have to be that way. In fact eating six small meals per day is associated with less overall caloric intake and better blood sugar balance. For example, having a small snack in the middle of the morning keeps the blood sugar from dipping too low, which allows the body to run more smoothly. Once lunchtime hits, you won’t be as hungry so you are less likely to overeat. Frequent smaller meals also lower the strain on the pancreas, which manufactures and releases insulin to control blood sugar levels. If you eat more frequent but small meals, your pancreas won’t have to work as hard to keep your sugars in balance.

I recommend you plan your snacks ahead of time and don’t leave them up to chance. Avoid the office donuts in favor of foods with a low glycemic index and no trans fats. Something as simple as a handful of almonds offers a great supply of protein and essential fatty acids, with a minimal amount of sugar.

I believe the old adage about breakfast being the most important meal of the day to be true. The time between bedtime and breakfast is the longest period our bodies go without food each day; therefore breakfast is crucial to refueling the body for a productive and efficient day. Studies have shown that folks who regularly eat a substantial breakfast are actually thinner than those who skip breakfast. A hearty morning meal will do a much better job than multiple cups of coffee at keeping your engines humming smoothly, keeping your sugar and cholesterol in balance, and maintaining a slim waist.

The folks on the island of Sardinia, which lies about 120 miles off the Italian peninsula, are considered quite healthy and live longer than people in most other cultures. It turns out that their diets contain high levels of some of the things discussed here. The locally netted sardines are rich in omega-3 fatty acids, and their locally produced wine and sheep’s milk cheese are particularly high in antioxidants. They also eat lots of fresh produce, and Italians seem to be quite good at living a low-stress lifestyle.

Eat Mindfully

Now that we have made a round through the grocery store, what do we do with all this information? For recipes and cooking tips, I suggest you consult with some of the famous cookbooks of our time, especially those that have healthful recipes. I would also like you to think about more than just the ingredients you put into your stomach and intestines when you eat. Eating is an experience. Running into the kitchen, throwing a few items into a microwave, then ingesting them while standing up is not what I mean when I talk about an experience. Neither is driving through a fast-food window, grabbing some greasy food, and eating it while driving.

Preparing food for a meal should be much more than a simple, mundane task; it is actually an act of love. Even if you will be the only person eating what you make, you can honor your body and soul by making something special to nourish and please it. The same can be said for others, if the meal is to be shared with friends or family. The meal you create reflects your kindness, generosity, and grace. Take a moment to experience the fragrances and colors of the food. How does it feel when you hold it or taste it? Does the meal you have created bring people together for sharing and laughter? Because meals can be churned out so quickly in our fast-paced world, we run the risk of missing these valuable experiences, which leaves our senses dull.

Let’s use our knowledge of nutrition to nourish our body and soul, as well as help prevent the progression of pain and the development of some of our society’s most debilitating chronic diseases.

The foods we eat directly impact the weight we place on our joints and spines, the strength of our muscles, the amount of inflammation in our bodies, and the health of the blood that travels through the vital organs like our hearts, brains, and livers. Food should never be an afterthought! Instead it should be an ongoing opportunity to cleanse your systems of harmful toxins and inflammation, while taking in plenty of the right nutrients.

These simple steps create an anti-inflammatory diet:

  • Eliminate the white menace—sugar and foods made of white flour that are quickly converted into sugar. Read labels and watch out for high fructose corn syrup.
  • Avoid excessive salt. Pre-made meals and fast foods are usually pretty salty, so if you avoid them, your salt intake will automatically subside.
  • Throw out processed foods. This will help you stay away from trans fats, high fructose corn syrup, and other sources of empty calories.
  • Reduce your dependence on caffeine for optimum mental and physical performance.
  • Drink clean water.
  • Consider switching to organic foods.
  • Make foods rich in antioxidants, such as the rainbow foods, the staple of all your meals.
  • Eat foods rich in omega-3 fatty acids in place of foods high in saturated fats.
  • Don’t eat more calories a day than you burn in a day. You can use the Mayo Clinic’s Calorie Calculator to get a rough idea of the number of calories you need to burn daily. It’s on their Web site at http://mayoclinic.com/health/calorie-calculator/NU00598.
  • Don’t crash diet! This can cause you to lose important muscle mass and slow down your metabolism. Eat well but smart, and the fat will gradually burn off without destroying the muscles you need to protect your joints and spine.
  • Never skip breakfast, and eat about six small meals per day.
  • Have some protein with each meal.
  • Add the right supplements to your diet to optimize your results.

Supplements

The average American diet has an abundance of calories but is sadly lacking in nutrients. In fact current estimates hold that 70 percent of Americans are overweight, while 80 percent are malnourished. Besides poor food choices, one reason for this epidemic of malnutrition may be overeating itself. When we overeat, the extra calories add to the workload placed on our mitochondria, the energy generators of the cells. The mitochondria must then work harder to clear the free radicals, toxins, and wastes that are produced from the metabolism of excess calories. Thus chronic overeating overtaxes the system and burns out the mitochondria. Anti-aging experts believe that the longer the mitochondria can carry on without burning out, the longer the lifespan. So you may literally be eating yourself into an early grave!

One way to help fight the rampant malnutrition that affects just about everybody is to take supplements. You can think of the typical American body as a car that is burning a lot of gas. It needs additional oil to keep it running smoothly, or the sludge will start to build up and the engine will break down. The “oil” comes in the form of vitamins, minerals, and other supplements.

New research is showing that vitamin D holds promise as a supplement that combats some aches and pains. A deficiency of vitamin D has been linked to chronic pain, including generalized bone and muscle aches. Even though our bodies use sunlight to manufacture vitamin D, deficiency still seems to be widespread. Supplementation of at least 2,000 IU has recently been shown to reduce chronic pain symptoms from problems like arthritis, low back pain, and fibromyalgia. Dairy products and seafood are also good sources of vitamin D.

The following supplements may help optimize your health and reduce the effects of pain and stress:

  • B vitamins: Critical to fighting cardiovascular disease and atherosclerosis, they also support nerve and brain function and help repair damaged nerves.
  • Carnosine: This antioxidant supports healing and nerve and immune function. It may also protect against Alzheimer’s disease.
  • Alpha lipoic acid: This potent antioxidant can boost mitochondrial efficiency and improve glucose tolerance.
  • Acetyl-L-carnitine, L-carnitine, and chromium: These three supplements seem to improve lipid balance, body weight, and brain function.
  • Omega-3 fatty acids: These aid brain function, decrease inflammation, and improve cardiovascular health. Fish oil, which contains omega-3 fatty acids, may be a safer alternative to anti-inflammatory medications for problems like arthritis, back pain, and neck pain.
  • Vitamins A, C, and E: These antioxidants support immunity and fight inflammation.
  • Calcium and Magnesium: These minerals are vital to nerve, brain, and bone health.
  • Other antioxidants: CoQ10, DMAE, and the mineral manganese are potent antioxidants that may help fight stress-related inflammation.

A standard multivitamin contains most of these nutrients, but you will probably have to purchase extra supplements to get alpha lipoic acid, L-carnitine, omega-3 fatty acids, and possibly a few other items. Consult with your doctor and/or pharmacist before starting any new supplements. Check the label of your multivitamin carefully to see what it contains. Unfortunately not all supplements are created equal or can be trusted. Watch out for those made with artificial coloring, flavoring, trans fats, sugars, heavy metals, and other toxins. Brands that have the USP (United States Pharmacopeia) mark are more likely to be of higher quality. USP sets standards for the quality, purity, strength, and consistency of these products. Always check labels or consult with your pharmacist if you are unsure about what you are reading.

Herbs for Chronic Pain

There are thriving cultures today that continue to take advantage of centuries-old remedies to manage health and wellness. For example, millions of people around the world rely on traditional Chinese medicine or ayurvedic medicine from India. Most of the natural tonics used are valued for their abilities to boost overall health, as opposed to being considered disease specific or targeting a certain problem. While they aren’t expected to directly reduce pain, integrative medicine specialists like Andrew Weil, MD, recommend them as tools to address some of the secondary effects of chronic pain, like low energy and diminished libido. However, herbal supplements cannot and should not be expected to take the place of good nutrition. Taking fish oil or astragalus isn’t going to bail you out if you continue to eat loads of trans fats and high-glycemic foods. With that in mind, here are a few examples of such remedies:

  • Arctic root: Originating in the arctic areas of Scandinavia, Siberia, and China, arctic root has antioxidant properties and has been used as a treatment for chronic diseases and infertility and to boost strength.
  • Ashwagandha: Also known as ayurvedic ginseng, ashwagandha has been used in ayurvedic medicine for over four thousand years to treat inflammatory diseases and tumors and boost male potency.
  • Ginseng: In traditional Chinese medicine, ginseng root is used to strengthen the immune system, increase vitality, boost resistance to stress-related illnesses, and treat chronic diseases. Its active ingredients, the ginsenosides, have been shown to have anti-inflammatory and antioxidant properties.
  • Astragalus: A premier herb used in traditional Chinese medicine since the first century B.C., astragalus is used to boost the immune system, fight viral infections, and keep malignant cancer cells from spreading.
  • Cordyceps: Also known as “winter worm, summer grass,” cordyceps begins as a fungus that grows on the backs of caterpillars and then becomes a tiny mushroom that grows in fields. It has long been used in China and Tibet as a general wellness tonic that increases energy and stimulates the immune system. In recent years it’s been claimed that cordyceps can also improve athletic performance.
  • Dong quai: A member of the carrot family, this Chinese herb contains compounds that exert a mild estrogenic effect, which is why it’s used to relieve menstrual cramps and PMS. Dong quai may also help strengthen the actions of the liver and endocrine system and exert a calming effect on the nervous system.
  • Eleuthro: Commonly known as Siberian ginseng, the root of the eleuthro plant contains steroidal-like compounds called eleutherosides that calm the early stages of the body’s stress response. Eleuthro is also used to increase physical performance and help the body adapt more easily to environmental and physiological changes.
  • Maitake: A Japanese mushroom, maitake is used to boost immunity. Research has shown that substances in the maitake mushroom can activate immune system components called T-cells, shrink certain kinds of tumors, and, in the case of HIV, protect the immune system cells from destruction.
  • Milk thistle: Found in Europe, milk thistle enhances liver function and the production of new liver cells thanks to its active ingredient, silymarin. It also increases blood levels of glutathione, a powerful antioxidant; quells inflammation; and controls the oxidation that can damage body cells and tissues.
  • Reishi: This mushroom, which grows on trees and decaying stumps in China, is sometimes used as an immune stimulant by people with HIV or cancer. It appears to prolong the activity of immune system “soldiers” called macrophages. It may also help relieve the fatigue associated with chronic illnesses.

These and other herbal remedies and supplements may be of benefit to some people. However, just because they are “natural” doesn’t mean they’re safe. Use the same care when taking herbal supplements that you would when taking prescription medications. For safety’s sake have your physician review a list of all the supplements that you’re currently taking, as supplements can produce dangerous interactions when combined with prescription medications. And always consult with your physician before taking anything new.

A Few Last Words

Chronic pain, like other chronic health problems, can disrupt the body’s internal operating systems, including hormone balance, neurologic function, and vascular integrity. In other words, it throws the body out of whack. Fortify your body with fresh, whole foods and plenty of water; use supplements judiciously with your physician’s supervision; and cut back or eliminate antinutrients—white flour, white sugar, trans fats, caffeine, and sodium. By following the recommendations outlined in the anti-inflammatory diet, you can restore equilibrium and bring your body back to a healthier, more efficient state. By feeding yourself with care, you can do much to decrease inflammation, ease your pain, and counteract the changes created by pain.

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