When he was about 30, Dan Schwartz, a teacher, started getting flare-ups of pain in his wrists and ankles. He would have moderate pain attacks that lasted four or five days. Then they began to get worse. “I couldn’t walk on an inflamed ankle, couldn’t turn a door knob with a hand that was flaring,” Schwartz remembers. Walking the hallways of his school became a challenge. Eventually, he was diagnosed with psoriatic arthritis, an immune condition treated with steroids and non-steroidal anti-inflammatory drugs. The medications didn’t help much. “The attacks became more frequent until I was getting them about once a month,” he says. “Then another teacher told me that eating wheat might be causing my pain. A doctor did allergy skin tests that were positive for allergies to grains. So I stopped eating grains and the pain went away.” Stories like his are not uncommon, but their usefulness is limited. Just as each person’s pain is unique, so are his or her reactions to certain foods. Books about treating pain with diet may agree on some things, but they all give different prescriptions for what to eat. One says stop eating grains; another says to avoid meat. Some say citrus fruits are dangerous; others that they are healthy. This article explores the food pain connection and offers expert recommendations to avoid pain triggers.
The food pain connection: Heal your inflammation with diet
It’s easy to give up and decide food doesn’t matter. That’s what most doctors say anyway. When you think about it, though, your pain has to come from somewhere. Chronic pain is mostly a result of inflammation. Foods can cause inflammation the same way you get rashes when you eat something to which you’re allergic.
Science has proven that foods can cause pain and diet change can heal it. Neal Barnard, M.D., author of Foods That Fight Pain (Harmony, 1999), says studies have shown that “in people with arthritis, avoiding certain foods reduces inflammation. Often the culprits were as seemingly innocent as a glass of milk, a tomato, wheat bread, or eggs. By avoiding specific foods, patients improved dramatically. Pain diminished or went away. The same benefit has been seen for migraines.”
People often find that eating the foods that are right for them heals their pain. “Foods can work against pain in four ways,” Barnard says. “They can reduce damage at the site of injury, cool your body’s inflammatory response, provide analgesia on pain nerves themselves, and even work within the brain to reduce sensitivity.”
Several books recommend a three-step plan to treat pain with food
- Find out what foods make your pain worse and stop eating them.
- Start eating foods that make your pain better.
- If needed, take supplements of vitamins, minerals, or herbs.
These steps are easier said than done, but the results are worth the effort.
Expert recommendations for avoiding the pitfalls of the Western diet
The Academy of Integrative Pain Management (formerly the American Academy of Pain Management) indicated that it expects to release targeted dietary recommendations for pain patients, probably in 2017. Robert Bonakdar, M.D., director of pain management at the Scripps Center for Integrative Medicine in La Jolla, California, and an assistant clinical professor at the University of California, San Diego, recently described how nutrition affects pain.
A large part of the problem, he said, is the western diet’s highly processed foods and overall lack of fresh fruits, vegetables, and fiber. For example, a poor diet can lead to elevated levels of C-reactive protein, which increases the risk of low-back pain. Below are a few ingredients that help people avoid pain, according to Bonakdar.
- Magnesium. About 70 percent of the population has a magnesium deficiency, and when we don’t have enough of the mineral, our chances of developing migraines rise 35-fold. Foods high in the nutrient include spinach, chard, pumpkin seeds, almonds, black beans, avocado, figs, and bananas.
- Vitamin D. Its many benefits include a reduced risk of diabetes, heart attacks, rheumatoid arthritis, and multiple sclerosis. You can take vitamin D in pill or liquid form, or you can consume it in salmon and other fish, orange juice, milk, cheese, and egg yolks.
- Curcumin. Studies show this substance in turmeric eases the pain and inflammation of osteoarthritis and rheumatoid arthritis. Read more about turmeric and find recipes containing it.
Tips for avoiding pain triggers
Have you ever noticed that you hurt more after eating than you did before? The effect may take an hour or a day to be noticeable. Jessie Morris, a 68-year-old San Francisco resident who lives with rheumatoid arthritis and fibromyalgia, had an instructive experience with tortilla soup. “I found a recipe that included tomatoes, and it sounded delicious,” she says. “I made a big pot of soup, and it tasted so good that I drank big bowls of it two days in a row. Then I noticed my knee pain was severe. It throbbed for three days. I’m sure it was the tomatoes.”
With the exception of green vegetables and sweet potatoes, nearly any food can trigger pain in sensitive individuals. The following list of food groups describes how they can trigger inflammation or flare-ups, but it’s important to note that not all of them need to be cut from your diet. (If you did, you might be wondering what’s left to eat!) You have to experiment to determine which ones affect you.
Think about which of the following food groups tend to make your pain worse and monitor your progress
- Grains and gluten. Common pain triggers are grains such as wheat and corn, which are a staple of most people’s diet. “Chronic exposure to gluten and other proteins in grains contributes to acute and delayed inflammation as well as leaky gut and digestive distress,” says Peter Osborne, author of No Grain, No Pain (Touchstone, 2016).Gluten, a protein in wheat, barley, and rye, is problematic for people with celiac disease, a condition in which people have trouble absorbing nutrients. Osborne claims that people with chronic pain and many other conditions respond well to going on a grain-free diet. If you want to stop eating grains, know that a large percentage of packaged foods contain gluten and other corn and wheat products. Even soy sauce often contains wheat, not soy.
- Meats, dairy, and eggs. Barnard cites research that nearly all animal products can provoke inflammation and pain. He recommends a vegan diet as a major step against pain and for health.
- Citrus fruits. Barnard and others have found that citrus fruits, apples, and many other fruits can be problems for some people.
- Bad fats. The Arthritis Foundation says saturated fats like those found in cheeses and fatty meats are arthritis triggers. So are trans fats, usually labeled “partially hydrogenated oils,” created in factories and found in many fast foods, snacks, packaged foods, and margarine.
- Sugars. Found in desserts, candies, sodas, fruit juices, and many packaged foods.
- Omega-6 fatty acids. They’re in oils such as corn, safflower, sunflower, grapeseed, soy, peanut oil, mayonnaise, and many salad dressings. You need some omega-6s, but we usually get way too much and not enough of the healthier omega-3s.
- Peanuts and tree nuts. They can cause allergies and pain.
- Nightshades. Tomatoes, white potatoes, eggplants, tobacco, and peppers are members of the plant family Solanaceae or “nightshades.” These plants have been blamed for muscle pain, stiffness and tightness, arthritis, insomnia, and gall bladder problems.
- Additives. Preservatives, texture agents, and chemical flavors such as the diet sweetener aspartame and the “meat flavor” seasoning monosodium glutamate (MSG) cause pain in many people.
How can you determine what your pain-triggering foods are?
How do you decide which foods are hurting you? There are several ways. Most of them involve paying more attention to your body and to what you eat.
Keeping a log of your food and your pain gives you crucial information. Without a written or electronic log, it’s hard to notice and remember the food eaten and the pain experienced later.
To explore your individual food pain connection, you should try recording two things with Pain-Free Living’s food-pain log:
1. Record your pain level at various times and what you eat.
2. Write down everything you eat and the time and date you ate it. Record your pain levels several times a day.
Look for connections. With or without a log, you might notice that certain foods tend to make your pain worse. For example, you might decide to try stopping grains, nightshades, or dairy. Or you might suspect a particular food and stop eating it for a few weeks. Note the results so you don’t forget.
Elimination diets: Challenging, yet effective
A more challenging but possibly more effective way to find your triggers is with an elimination diet. Such a diet is intended to be short-term. Matt Rogers, a 37-year-old forest ranger, describes the diet he went on for the pain of irritable bowel syndrome.
“You basically stop eating everything that anyone’s ever been allergic to,” he says. “All I could eat were vegetables, a few exotic grains like quinoa, a few fruits like pears and berries, and some oils. I was told to keep that up for 21 days.”
There are other versions. Barnard says to start by eliminating everything except brown rice, cooked or dried cherries, cranberries, pears or prunes, and cooked green, yellow, and orange vegetables. The website Mind Body Green suggests a slightly less severe starting point: no gluten, dairy, eggs, soy, fast food, or alcohol for 23 days.
For flavoring, you can have salt, maple syrup, or vanilla. For fluids, drink water. In practice, this diet often means eating a lot of sweet potatoes. If food is partly causing your pain, you should notice a major improvement in your symptoms as this cleansing diet continues.
After 23 days, start adding foods back
“Reintroduce the eliminated foods one at a time, every two days, to see if your symptoms return,” Barnard advises. “Have a generous amount of each new food, so you will know whether or not it causes symptoms. If you see no problem, you can keep it in your diet. Anything that causes pain should be eliminated again.”
Elimination diets aren’t fast because some foods may create an immediate reaction, but other reactions may take longer to show up. Don’t rush. If you re-introduce several foods at once, you won’t know which caused the problem, and you’ll have to start again.
The diets are hard. “You have to plan everything way in advance,” says Schwartz. “You can’t give in to your cravings. You can’t go to a restaurant or a party. It’s even hard to eat with your family at the beginning. You get really hungry after a hard day, and you’re supposed to go home and eat mashed sweet potatoes.”
Staying away from trigger foods after you identify them requires creativity
When Schwartz was not eating grains, he and his wife learned to bake with flour made from fava and garbanzo beans. They learned to avoid packaged food, which nearly always contains grains and additives.
Rogers advises getting help with your diet. “You’ll need somebody to talk to about it for support. If you feel you’re doing it by yourself, at some point, you’ll find yourself scarfing down fast food.”
The earned reward is that you will gradually build up a list of foods you can safely eat. If there’s a food you like that causes pain symptoms, you can retest it after a while, because effects do sometimes wear off as you heal. Schwartz has periodically retested himself on grains for years. He still can’t eat wheat, but he can now eat small amounts of other grains.
You might also lose significant weight on an elimination diet.
Learn the difference between food allergies and food sensitivities
If an elimination diet seems too demanding, you might ask your doctor for blood tests or skin tests for allergies. These are much simpler but have a few limitations.
Food allergies and food sensitivities are different. A food might cause pain for you even though you’re not allergic to it, and vice versa. False positive results might tell you to stop foods that are really OK. False negatives could miss the foods that you need to stop.
Allergy testing costs money. The patient advice website Choosing Wisely says you should always work with a doctor in exploring food allergies to help you understand the results.
Find foods that heal pain, supplements to support them
We should all want to stop eating the foods that hurt us, and everyone can benefit from eating foods that heal. Omega-3 fatty acids, for example, are anti-inflammatory. The Foundation for Peripheral Neuropathy advises eating ground flaxseed, fatty fish such as salmon, mackerel, and tuna, and walnuts several times a week. To add more fiber, which has many health benefits, eat more fruits, vegetables, nuts, and beans.
Other foods and spices that have been found to reduce inflammation are ginger, olive oil, red grapes, coffee, and thyme.
Supplements to consider include vitamins B, C, D, and E, magnesium, and oils high in alpha-linoleic acid
In addition, alpha-lipoic acid helps reduce neuropathy pain. The supplements glucosamine and chondroitin and SAM-E relieve pain for many people. Herbs used to reduce pain include capsicum, comfrey, and devil’s claw.
For many people, learning what to eat and what not to eat has reduced their pain tremendously. Schwartz is now leading bicycle tours, Rogers is climbing rocks with less abdominal pain, and Morris is sleeping and feeling better. You might find it worth the effort to find what foods trigger your pain.
Other online resources for healing pain with food