Nutrition and Chronic Pain

Many physical therapists (PTs) treat patients with chronic pain. Chronic pain can come in many forms. From autoimmune diseases like rheumatoid arthritis (RA) or fibromyalgia, to centralized pain phenomenons like allodynia and hyperalgesia, chronic pain can cause marked disability, loss of functioning, and lacking participation in life.

Integrative Pain Management

Physical therapy (PT) can offer significant benefits to many patients with chronic pain using traditional PT methods. Exercise, stretching, manual therapy, stress reduction, pain science, mindfulness, and activity modifications are all mainstay PT treatments for people with chronic pain. PTs are now starting to see the evidence for how nutrition can also help patients with chronic pain; and as more physios include nutrition in their practices, their outcomes are improving quite dramatically.

Nutrition can help reduce the chronic pain in patients with fibromyalgia. In well-done Finnish study looking at a raw vegan diet versus a omnivorous diet where both groups of patients reported having quite a lot of pain at rest in the beginning of the study. After the study completed there was a significant decrease in pain and symptoms in the raw vegan group compared to the controls. Interestingly when the raw vegan dieters shifted back to eating an omnivorous diet the pain healing effects disappeared. They also found other significant changes (several related to PT), such as improvements in quality of sleep, reduction of morning stiffness, and measures of general health. You can watch this great NutritionFacts video to learn more about this study and others. So, while you are providing your manual PT and graded exercise, why not offer nutrition guidance to enhance your outcomes?

Copious studies have highlighted how a plant-based diet can help other autoimmune diseases like RA. In this review article researchers highlight how a low-fat, vegan diet can boost antioxidant intakes as well as reduce systemic inflammation. Other researchers have pointed to how eating a plant-based diet reduces the intake of saturated fats, lipopolysaccharides (endotoxins) from meat, and salt from processed foods. Reducing these factors on a plant-based diet will reduce inflammatory markers and enzymes that yield higher immune response. In fact, the vegan diet has been a mainstay recommendation for patients with RA by many physios in the UK. PTs in the US and other countries need to get on board and start incorporating nutrition guidance and education within their physical therapy treatments.

Some chronic pain occurs due to diabetes. Diabetes is a common condition seen in PT practice, and a condition that has major ties to nutrition. Physical therapists are great at educating patients with diabetes on protecting their feet, using physical activity, and strengthening. But why not also address a patient's diet, which could help them reduce any diabetic nerve pain they have? As diabetes progresses it can cause balance issues and chronic burning nerve pain. In a randomized controlled trial of 35 type 2 diabetes patients with painful neuropathy, half followed a vegan diet and took a vitamin B12 supplement for 20 weeks, while the other half only took the supplement. The diet group showed greater improvements in some pain measures and body weight, as compared with the control group. This study demonstrates the promise of a dietary approaches to healing diabetic nerve pain and other microvascular complications. The source for this RCT came from Physicians Committee for Responsible Medicine. 

Another generator of chronic pain can come from arthritis, also known as osteoarthritis (OA). Physical therapists offer patients with OA copious manual therapies, resisted exercises, and various modalities to help these patients. Nutrition can also greatly help reduce chronic joint pain. Consider this 2015 study where patients saw a 3 point drop in the numeric pain rating scale (NPRS) and improvement in the Short-Form 36 scale specific to their activity, functioning, and physical feeling scales. Take a look at the data on pain, patients saw responses in as quick as 2-3 weeks:

Now, just consider that these patients were not offered any physical therapy treatments. Imagine the outcomes if they had been!

Physical Therapy and Nutrition Courses

So, are you ready to learn more about nutrition to help your many patients with chronic pain? While many PTs take physical therapy courses from Medbridge, Cheapceus, or the APTA, many of these groups have their mainstay courses focused on traditional PT interventions and not nutrition. Our board-approved, online physical therapy continuing education courses are specific to nutrition and physical therapy. Our PT courses will help you use integrative pain techniques, pain science, and pain healing through nutritional changes. Take all 3 of our courses and earn the Certified Nutritional Physical Therapy (CNPT) credential, which may give you credentialing to offer nutritional counseling in your State or area. Enroll today!

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Learn about the Top 5 Functional Foods to Fight Inflammation and Pain in Physical Therapy. 

 Keywords: physical therapy, cheapceu, medbridge, nutrition, continuing education, chronic pain, pain science, CEH, CEU

Disclaimer: The above article is written as opinion piece and does not convey specific legal and/or practice act advice. 

Image reference: Xu Chong by CC 2.0 by ND