Pain Management
Joseph E Stapleton, MD RD LDN

With obese patients, weight loss should be an important element of pain rehabilitation. Chronic pain can have many sources: arthritis, a lingering bone or joint injury, fibromyalgia, chronic fatigue syndrome, etc. However, one common thread throughout chronic pain patients is inadequate nutrient intake. Coupled with a higher rate of chronic pain amongst obese individuals, it becomes clear that nutrition plays a large role in both combating and limiting chronic pain. This is where CoreLife can help. While our primary concern is weight loss, that in and of itself can have overarching effects. When BMI is lowered, stress on joints is lifted, reducing pain, or alleviating it altogether. 

Inflammation and Chronic Pain

Inflammation is an important factor in chronic pain. In many cases (such as osteoarthritis) it is a major player in causing pain; in other scenarios it acts as a multiplier to it. Thus, it is important to consume foods that are known to be anti-inflammatory while limiting intake of foods suspected to cause inflammation.  Nutritionally, foods that are inflammatory tend to be foods that CoreLife already encourages patients to limit, with anti-inflammatory foods lining up well with our general recommendations.

How CoreLife Works with Chronic Pain and Inflammation

Regular exercise can reduce inflammation and chronic pain. Many individuals with chronic pain avoid exercising in the area where their pain originates or avoid exercise altogether, when safe, guided exercise can actually alleviate pain. If a specific joint gives an individual trouble, then strengthening the muscles around that joint takes strain off it, reducing the pain. The best way to do that is by working with a therapeutically minded personal trainer within the activity guidelines provided by your primary care physician or specialist for your chronic pain. The act of losing weight itself will also help to ease the strain on chronically hurting joints and bones, simply by lowering the load that they must bear daily.   Similarly, the reduction in blood pressure expected as hypertensive obese patients lose weight can have a large effect on chronic inflammation and patients that suffer from migraines.

Supplementation can be helpful in reducing inflammation related pain, as research works to confirm many hypothesized mechanisms of action.  B vitamins play a role, so we would recommend that chronic pain patients utilize our CoreVite injections. Glucosamine has been shown to have an effect with joint and bone related pain, but do not recommend to those with shellfish allergies or to diabetics taking insulin, as it can limit their medication’s effects. Fish oil is another supplement that can be beneficial to patients, along with standard protein supplementation for those that cannot meet their elevated protein goals from whole foods alone..

Lastly, if part of a patient’s chronic pain management plan from their doctor includes opioid medications, then we need to address their some of their most common side effects. Sedation/lethargy can hinder patients getting physical activity into their day, along with potentially masking important pain signals during bouts of exercise. Its is recommended that patients schedule workouts with a trainer and that they schedule them so they take their dose of pain medication after their workout rather than before. Constipation is very common, so proper fiber and water intake must be reinforced. Nausea can lead to improper intake, especially limited protein intake, so effective strategies unique to the patient need to be developed to ensure proper intake.

References

Nutrition and Pain Management. Ahmed, Shan. http://www.nysoms.org/library/event-media/Nutrition%20and%20Pain%20Management_Ahmed.pdf

Nutrition and Supplements for Pain Management. Sulindro-Ma, Maria et al. https://link.springer.com/chapter/10.1007/978-1-59745-344-8_19

Diet and Nutrition For Patients With Pain—The Time Is Here. Tennant, Forrest. https://www.practicalpainmanagement.com/treatments/nutraceutical/diet-nutrition-patients-pain-time-here

Nutrition and Pain. Mayo Clinic, 2015. https://www.mayoclinic.org/nutrition-and-pain/art-20208638

Nutrition for Chronic Pain Management. Tick, Heather, 2016. http://heathertickmd.com/nutrition-chronic-pain-management-painweek-2016/

The Role of Nutrition in Modulating Chronic Pain. Chaverneff, Florence, 2016. http://www.clinicalpainadvisor.com/painweek-2016/role-of-nutrition-in-modulating-chronic-pain/article/521163/

The association between chronic pain and obesity. Okifuji, Akiko and Hare, Bradford D, 2015.  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4508090/