If you live with chronic pain, you will likely have had people tell you that a healthy diet can cure it. This can be frustrating and patronising. However the truth is, that while a healthy diet isn’t going to magically cure your pain, it can make a significant positive difference to your pain levels and improve your pain management.
Benefits of a healthy diet for chronic pain patients
Having a healthy diet is important for everybody in life, whether you live with chronic pain or not. What we eat is the fuel we’re giving our bodies to function. However, when you live with extra health challenges like chronic pain, a healthy diet takes on a new level of importance. Let’s take a look at the benefits of a healthy diet:
- Giving your body the energy it needs to function
Living with chronic pain puts extra strain on your body and mind. It can be really draining emotionally and physically to cope with chronic pain symptoms on a day to day basis. Stress and pain go hand in hand. One causes the other and it becomes a cycle which is tough to break. When your body is stuck in a prolonged state of stress it can wear your body and mind out. Just like with chronic pain, our bodies are not designed to withstand chronic stress.
Fatigue is often one of the most debilitating symptoms of chronic pain. I certainly find fatigue one of the toughest symptoms to function through. Often we struggle to sleep which contributes to a lack of energy. Even if we do sleep well, our sleep is often non-restorative. This means that we don’t feel refreshed or re-energised in the morning as a healthy person would. Therefore it’s even more vital for us to give our body as much energy as possible.
- Keeping your immune system strong
Many chronic pain conditions are associated with a weakened immune system. Similarly, our immune systems can play a role in causing and perpetuating some chronic illnesses. This in depth study explains that, “It is well known that the immune system plays a critical role in the development and maintenance of many chronic pain conditions.” Therefore, it becomes even more vital that we give our body the nutrients it needs to maintain a strong immune system.
- Facilitating growth and repair within the body
Eating the right diet provides our body with what it needs to create new cells and to repair damage.
- Promoting optimum cognitive functioning
Chronic pain patients often struggle with cognitive functioning. Many chronic pain conditions, such as fibromyalgia in my case, have symptoms of cognitive dysfunction. I struggle with ‘fibro fog’, which makes it hard to focus, to remember things and to think clearly. Chronic pain affects your mood and memory significantly, often causing problems with cognitive processing. A healthy diet can help your brain to function properly and helps to tackle cognitive issues.
- Helping to maintain a healthy weight
Being overweight can be detrimental to health in general. When it comes to chronic pain, especially in conditions like arthritis, having extra weight on the joints can increase pain and make mobility more difficult. Eating a healthy diet can help you to maintain a healthy weight.
- Fighting inflammation
Inflammation can cause and perpetuate chronic pain, and unfortunately is a common problem in those with chronic pain. Eating the right foods can help to reduce inflammation within the body, therefore reducing pain levels.
- Keeping your heart healthy
The prolonged stress we mentioned earlier can have a detrimental effect on your heart, because it’s under too much strain which it is not designed to cope with. Eating a heart healthy diet can help to increase the health of your heart, to try to counteract these negative effects.
- Maintaining strong bones and teeth
Some chronic conditions, such as rheumatoid arthritis, increase the risk of osteoporosis. Osteoporosis is a condition which weakens bones, making them more likely to fracture or break. Some factors which come along with chronic pain (such as inflammation) can result in lower bone density. Often medications which are prescribed for chronic pain, for example glucocorticoids and anticonvulsants, can be detrimental to bone strength. These factors all make it so important for those of us with chronic pain to eat a healthy diet to keep our bones strong.
- Reducing the risk of other health conditions
Chronic pain can increase the risk of other health conditions. Minimizing this risk is vital. Eating a healthy diet can reduce the risk of heart disease, diabetes, high blood pressure and more.
Reasons chronic pain patients may specifically need a healthy diet
On top of the benefits we’ve discussed, there are some specific reasons pain patients may need a healthy diet:
- Altered glucose levels
The hormone levels released during periods of high stress can lead to glucose levels becoming unbalanced, as explained here. This can result in hypoglycemia (low blood sugar) or hyperglycaemia (high blood sugar). Both of these altered glucose levels can have a negative impact on health and can even be dangerous.
- Adrenal exhaustion
If chronic stress and chronic pain are left untreated for a long period of time, the stress hormones released can lead to adrenal exhaustion. This simply means the adrenal glands are overworked. This can lead to loss of appetite, weight loss, and cravings for salt among other symptoms.
- Increasing endorphins
Endorphins are the body’s natural painkillers. They help to provide relief from pain by interacting with the same receptors as opioids, except without the side effects. They also help us to maintain a positive mood. Our nervous systems need amino acids from our diet in order to ‘build’ and distribute neurotransmitters like endorphins and serotonin (which also helps to maintain our mood).
- Vitamin deficiencies can cause pain
If our bodies don’t have enough of certain vitamins it can cause problems, including causing pain! This article explains that a lack of B12 can cause peripheral polyneuropathy (nerve pain), while a lack of vitamin D and C can contribute to musculoskeletal pain.
- Opioid side effects
Among many side effects, taking opioids in the long term can cause weight gain, a change in diet preference (to more fatty/sugary foods), unstable blood sugar levels and even changes in metabolism.
What should a healthy diet consist of?
The guidelines for a healthy daily diet in general include:
- Eating 5 portions of fruit and vegetables a day
- Some diary (or dairy alternatives)
- High fibre foods (whole wheat pasta, brown rice and wholegrain bread)
- Some protein including beans and pulses, fish, eggs and meat
- Healthy fats (unsaturated fats like vegetable or sunflower o
- 6-8 glasses of fluid per day
- Minimum ‘junk food’ (processed food, sweets, desserts, fast food, etc)
A woman should consume on average 2000 calories per day, while a man should consume 2500 calories. You can find out more from the Eatwell Guide.
For those of us with chronic pain, the following aspects should be taken into account for a healthy diet:
- A balance between Omega 3 and Omega 6
The ratio of omega 3 to omega 6 should be 1:1, as this article states. Omega 6 has been linked to inflammation, which is something our bodies need to heal properly. However, when this inflammation becomes excessive it can cause pain among other problems, as we discussed earlier.
Omega 3 has anti-inflammatory properties, which balances out the inflammatory properties of omega 6 and allows your body to gain the other benefits without causing problems. The article referenced above explains that omega 3 has been proven to reduce, “joint pain, morning stiffness, number of painful joints and consumption of non-steroidal anti-inflammatory drugs in patients with rheumatoid arthritis.” Omega 6 can be found in poultry and vegetable oils. Omega 3 can be found in cold water oily fish like mackerel and salmon.
Antioxidants have anti-inflammatory effects which can help to reduce pain. You can find antioxidants in fresh fruit and vegetables, such as in the skin of red grapes, in the skin of cherries and the skin of blueberries for example.
- Vitamin B12
Ensuring you have enough B12 in your diet sets your body up for success. You can find B12 in fish, egg yolks, cheese, beef and lamb.
- Vitamin D
We generate vitamin D from sunlight, so in the winter it can be a good idea to talk to your doctor about a supplement. Vitamin D can tackle musculoskeletal conditions.
- Vitamin C
Like vitamin D, vitamin C helps to tackle musculoskeletal pain. It’s an antioxidant and has anti-inflammatory effects, so it’s a vital part of your diet. You can find vitamin C in fruits and vegetables.
- Foods to limit
There are foods which can increase inflammation and pain. This doesn’t mean you should avoid them completely, but simply that you should have them in small amounts. These foods include:
- Oranges and orange juice: These contain polyamines. Polyamines are a compound which is used in cell growth, but research has found that, “Polyamines upregulate activity in a receptor in the nervous system which is involved in amplifying pain”.
- Caffeine: High levels of caffeine can cause problems with sleep among other negative effects. Caffeine has even been linked to increased chronic headaches and increased risk of osteoporosis.
- Processed foods/ junk food: Foods with high sugar and fat content and processed foods are not required in our diet. In excess, they can contribute to health issues and obesity.
Practical tips to implement a healthy diet despite chronic pain
You might think that this all sounds very well and good, but it can be hard enough just to get through the day, never mind think about a healthy diet when you live with chronic pain. When you’re in pain, often struggling with fatigue and your functioning is reduced. It can be tough to get the motivation to eat well, to go shopping and to cook for example. It can be all too easy to grab easy quick meals which don’t require too much effort, but these are not always healthy!
There are practical, simple ways that you can get started with a healthier diet:
- Don’t put too much pressure on yourself
You don’t have to change every aspect of your diet right away. Putting too much pressure on yourself will only add to stress. Be kind to yourself. You can start off with small simple steps and gradually build up to implementing a healthier diet. It’s important that this is a long-term lifestyle change rather than a fad diet.
- Shopping online
Doing your shopping online and getting it delivered to your door saves so much energy. You can shop from your sofa or bed, taking your time to figure out what you want to buy and how much you want to spend. This reduces the risk of you grabbing something while in the shop which doesn’t fit in with your healthy diet, perhaps because your fatigue has kicked in and you just want to get home (I speak from personal experience)! The delivery driver will bring the food straight to your door. You can even ask them to bring it into your kitchen. That way, you can save your energy for planning and cooking meals.
- Use frozen / tinned / pre-prepared vegetables and fruit
Frozen or tinned vegetables and fruit are just as good as fresh ones and they don’t go off as quickly. This means that you can have them ready when you want them, and if you forget to eat them or have an off day, they aren’t wasted. Prepared vegetables and fruit can save a lot of energy! You can buy them in packets within which they have already been peeled and chopped, so they’re just ready to cook or eat.
- Make things easier for yourself where you can
Making things as easy as possible for yourself does not make your diet any less healthy and does not make the effort you are putting in any less valid. Just as with the fruit and vegetables, if there are things you can buy that are pre-prepared to save you time and energy, don’t be afraid to make use of these. For example, some meats will already be seasoned and even chopped, ready for you just to cook them.
- Make easy simple swaps
Swapping small things in your diet for a healthier option can be a great way to gradually introduce healthy eating without it feeling overwhelming. For example, you could swap mayonnaise for a low-fat version, or white bread for wholegrain bread.
- Have healthy snacks ready
When you’re not feeling well, you might not feel like making or eating a full meal. It can be all too easy to grab something you can just eat out of the packet, like crisps or chocolate. I know that this is something I struggle with! Having healthy snacks ready means you can grab a healthy alternative. You can buy healthy snacks ready prepared, such as protein bars or healthy versions of crisps. You could also prepare them yourself, for example having baby carrots with a dip ready to snack on.
- Food preparation
Something that I’ve found extremely useful over the last year is doing food prep. On a day when I have more energy and don’t have as many other things to be done, I will use that time to cook healthy meals in batches. I’ll then divide them up into microwave ready containers, so that during the week healthy meals are ready to just be quickly heated up and eaten.
- Use a slow cooker
A slow cooker can be a fantastic tool to save time and energy! In the morning you can throw all your ingredients into the slow cooker together, with very little preparation time (especially if you bought pre-prepared ingredients). You put the slow cooker on and leave it, occasionally stirring it during the day. When you’re ready to eat that night, you have a warm healthy meal ready to go. I even use the slow cooker as part of my food prep, cooking big batches to freeze for another time or to reheat later in the week.
- Ask for help
If you’re struggling to eat a healthy diet, ask your loved ones for help. They may be able to help you to plan or prepare meals for you to heat up later. They might even offer to start eating a healthier diet with you. Having somebody else involved can often motivate you. You can even encourage one another to keep going and make it a bit more fun!
- Allow yourself a treat
Remember that eating a healthy diet doesn’t mean you can’t have treats and desserts. It’s about eating them in moderation. Life is short and it’s hard enough when you live with chronic illness. Allow yourself to have a piece of cake now and then, and don’t feel guilty about it!
- Eat smaller portions
Gradually reducing your portion size at meal time (within reason) can help you to control how much you are eating. Something that really helps is using a smaller plate or bowl, so that it doesn’t look like your portion is smaller. That might sound silly, but it is something that can really help. This is more important when you are eating less healthy foods.
- Keep a food diary
Some people may find that certain foods make their symptoms flare. Keeping a diary of what you are eating can help you to pinpoint any foods that may be increasing your symptoms, so you can then limit or eliminate them.
- Chat to your doctor
It’s always a good idea to chat to your doctor about a healthy diet if you have any concerns. Some chronic conditions may have specific dietary requirements. If you’re really struggling, your doctor might be able to signpost you to services that could help. You may be able to see a nutritionist or dietitian who can help to guide you. They may recommend local groups you can join to get more guidance and encouragement.
If you are struggling to get into that motivated mindset, your doctor may suggest psychological therapy to help you to reduce your chronic pain and get a better handle on self-management. There are a wide range of options available such as Cognitive Behavioural Therapy (CBT) or Acceptance and Commitment Therapy (ACT). You can even access these therapies online, through a natural pain relief app like ours (update Aug 2023: Pathways is now a web app! Start our program here) .
Eating a healthy diet is a vital part of self-managing your chronic pain. It’s a way to give your body and mind the best chance possible to function properly.
- Totsch, S. K., & Sorge, R. E. (2017). “Immune System Involvement in Specific Pain Conditions.” Molecular pain, 13, 1744806917724559.
- E. Michael Lewiecki, MD, FACP, (2012), “Chronic Pain, Osteoporosis, and Bone Density Testing”. Practical Pain Management, Volume 4, Issue 6
- Forest Tennant, MD, DrPH, (2012), “A Diet for Patients With Chronic Pain”. Practical Pain Management, Volume 11, Issue 6
- Rae Frances Bell, (2019), “Diet and Pain.” Pain Concern.
- NHS, (2019), “The Eatwell Guide”.
Please note: This article is made available for educational purposes only, not to provide personal medical advice.