Inflammation is at the heart of chronic joint pain
Have you ever noticed that your chronic joint pain gets worse after eating certain foods? Maybe after eating wheat products, your back or knee pain flares up, and you’re wondering why this happens. At the center of the issue is inflammation, a catch-all term that means our immune system is attacking something in our body. Sometimes the immune system attacks the very food we eat!
Inflammation causes collateral damage such as joint pain and degeneration (1). In this article, we’ll focus on the basics of how macronutrients (protein, carbs, and fat) play a role in chronic pain, steps you can take to reduce pain levels through dietary change, and what nutrients can help slow the aging of your precious joints.
Protein, carbs, and pain: The big picture
Protein: Foreign Invaders
When our immune system reacts to food, our white blood cells attack proteins that are seen as a foreign threat (wheat gluten is a prime example). And unlike our immune system dealing with a virus, this results in chronic inflammation with no end. We are left with chronic joint pain and gradual damage to our joints. Here’s a list of some common offenders and their proteins:
- Wheat (specifically gluten, to hear more about why it’s so problematic, check out footnote 2 at the end)
- Dairy (casein to the larger degree, but also whey for some individuals)
- Peanuts and peanut products (also a significant source of inflammatory fats, arachidonic acid)
- Eggs (albumin)
Carbohydrates + Insulin = Pain
When we eat carbohydrates, whether whole grain organic heirloom bread or a Twinkie, our body breaks it down to single molecules of sugar called glucose. Then our pancreas secretes a hormone called insulin that allows glucose to enter muscle and fat cells. Unfortunately, insulin also causes the genes involved in an immune response (and consequently inflammation) to be much more highly expressed.
In short, more carbs = more insulin = more inflammation = more pain.
I haven’t discussed all offending foods here. Food sensitivity tests are one way to get an accurate picture of what foods are problematic for you. You can experiment with removing possible offenders one at a time (each for a period of 30 days) in order to see if your chronic pain is relieved to any degree.
Foods and nutrients that promote pain relief!
Now for the good news. I am a fan of adding good things to your life rather than removing bad things (let’s be real…bread can be oh so delicious, despite the widespread sensitivity to gluten). So I’m going to mention specific foods and nutrients that can help to lower overall inflammation, and may even contribute to healing some of the wear and tear that our bodies accumulate over time.
One of my all time favorite foods are berries. Blueberries in particular contain high amounts of antioxidants, as do raspberries, blackberries, our local marionberries, and elderberries. These compounds not only offer the benefit of lowering systemic inflammation, they also promote the synthesis of cartilage and collagen (3), the main components of our tendons and ligaments.
Due to their high antioxidant levels, berries neutralize free radical damage that results from inflammation. They are also low in sugar so they satisfy sugar cravings while keeping blood sugar and insulin low. Also note that the more deeply colorful a plant food is – like kale, spinach, and other leafy greens – the higher amounts of inflammation-reducing compounds. So, eat as colorful of a menu that you can!
Culinary herbs and spices
Ginger and turmeric are regarded as perhaps the most healthful culinary spices in common use and are all-stars at lowering inflammation. They work like aspirin and ibuprofen (without the nasty side effects) by decreasing enzymes that produce inflammatory compounds. They also promote an immune response that is more tolerant of potential food offenders, improve our ability to digest food, and even afford us a bit of protection against cancer.
There are many other wonderfully healthful herbs and spices like rosemary, thyme, sage, fennel…the list goes on.
Healthy and essential fats
Omega-3 fats – the kind found in oily fish, flax & hemp seeds, and walnuts – are lacking in the standard american diet, and this may be contributing to our chronic pain epidemic (4). In addition to providing our bodies with the raw materials necessary for a balanced inflammatory response, new research shows that omega-3 fats may also reduce nerve excitability in cases of peripheral and central pain sensitization pain patterns.
Bone broth and Collagen peptides
One last food product that I’ll mention today (there are many more to discuss, but let’s make those a topic for office visit conversation), which has grown in popularity over the last few years is collagen and bone broth. Our joints are made of cartilage, tendons and ligaments, and the profile of collagen reflects almost exactly the natural makeup of our joints, and this allows for these structures to be strong and flexible. By providing our joints with the raw materials necessary for resilience and longevity, it is possible to slow down and heal some degeneration, especially when combined with plant and herbal compounds that promote joint health.
Bone broth powder and collagen peptides are easily mixable in just about every beverage, and they are also a quick and convenient way to consume high-quality supplemental protein. One thing to note, especially for individuals who choose to avoid animal products, is that bone broth and collagen are derived from animals, typically cattle. Seek out brands that are derived from grass fed and/or organically raised livestock.
Let’s chat in-depth about pain and your diet
What we eat can have a substantial impact on how our bodies feel, and I hope that I’ve expanded your understanding of chronic joint pain. I’m passionate about providing you with as many tools as I can to help you live a more pain free, active, enjoyable life, and I’m happy to have a more in depth conversation about how we can use diet as a therapy for chronic joint pain. We can also tailor a plan to your preferences, and I can provide you with more examples of healthful foods in addition to those that I mentioned earlier. With every meal that we eat, we have an opportunity to become a healthier person, and at the same time we can explore the wide, delicious diversity of flavors that nature has to offer. Now, go forth and eat something delicious and anti-inflammatory.
Dr. Grady Nesbitt is a naturopathic physician at Heart Spring Health in Portland, Oregon whose mission is to provide same day pain relief so that you can fully enjoy all that life has to offer. Using a diversity of modalities such as acupuncture, spinal adjustments, and physiotherapy devices, combined with naturopathic staples such as herbal medicine, homeopathy, and nutritional counseling, Dr. Nesbitt provides solutions for sports injuries, all types of chronic and acute pain, and degenerative conditions such as osteoarthritis and osteoporosis. His skills were acquired over nine years of medical training and orthopedic focused preceptorships at both the prestigious National University of Natural Medicine (NUNM) and Bastyr University, as well as decades of athletic pursuit. Click here to learn more about Dr. Nesbitt.
- In case you haven’t yet read my previous article about pain patterns, here’s an overview of how inflammation causes pain. Central to inflammation are your white blood cells (a major component of our immune system), who when combatting foes such as viruses or wheat gluten release chemicals called cytokines. Think of cytokines as a microscopic form of firepower that has the nasty consequence of agitating our nerves, causes our blood vessels to dilate bringing more blood and fluid to the area, and recruits more white blood cells to the task of microscopic warfare. As more blood and fluid are shunted to a damaged structure or an area of infection, tissue will often swell (which presses mechanically on nerves causing an unpleasant sensation of swelling) and feel sometimes uncomfortably hot. These painful consequences are ultimately a necessary part of a process whereby pathogens like viruses can be kept at bay, and injured structures can be healed. For most of human history, pathogens and injuries were the only activators of our immune system, however nowadays it is often the food that we eat on a daily basis that causes some degree of inflammation to occur throughout our bodies.
- Gluten is perhaps the most widely recognized problem protein. It causes many a sad tummy, an aching back, and even worse health problems. Wheat is a staple of the standard American diet, however this modern wheat has been genetically engineered to a huge extent, to feature orders of magnitude more gluten than ancient heirloom varieties of wheat, which is why ancient and heirloom wheat relatives are often much better tolerated.
- A. Basu et al.: Dietary fruits and arthritis. Food Funct. 9, 70 (2018)
- Omega-3 fats are “essential” as are Omega-6 fats, meaning that our bodies cannot produce them, rather they must be obtained through our diets.The compounds associated with managing inflammation (which are suppressed by aspirin and ibuprofen, for example) are derived from fats, specifically Omega 3s and Omega 6s. Omega 6 fats however serve to produce compounds that promote inflammation, while Omega 3 are integral to making anti-inflammatory compounds. Ideally, our diets would provide us a healthful balance of the two, however in today’s world with our modern dietary habits, we’ve seen a tremendous shift towards Omega 6 consumption.