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Nutritionist Advice

Rx for Pain

Can a menu change provide relief?

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Q: I have chronic arthritis and a bad back, and am worried about the side effects of pain medications. Are there any natural pain remedies?

A: Absolutely. Surprising as it may sound, the answer to many kinds of pain— from sore joints and back pain to headaches and stomachaches— may be in the kitchen, rather than the medicine cabinet.

Foods fight pain in three main ways: First, certain foods can cool inflammation. Natural plant oils (flax, evening primrose, borage, and others) have an anti-inflammatory effect that may help relieve sore joints.

Even more importantly, some foods trigger pain, and a quick menu change is often all you need for relief. Among the common pain triggers are dairy products, eggs, citrus fruits, meat, and wheat, and they can play major roles in migraines, sore joints, and some digestive problems, such as Crohn’s disease. Eliminating a food from your diet for about two weeks and then reintroducing it may help you identify sensitivities.

Second, a diet change can improve circulation. When Dean Ornish, MD, used a vegetarian diet, along with exercise and stress management, to improve circulation in heart patients, many of his research participants had been on medications for years without relief. But with simple diet and lifestyle changes, their arteries began to open up again, and their chest pain melted away.

Amazingly enough, poor circulation may also be a key contributor to back pain. In the same way that a meaty diet and smoking can constrict the arteries to the heart, they also limit blood flow to the spine. Without a good blood supply, the leathery discs that act like cushions between the vertebrae become fragile. If a disc breaks open, it is like a pillow losing its stuffing. Its soft core squeezes out and can pinch a nerve, causing pain. A research team in Finland used a special scanning technique to measure the arteries to the lower back of 51 people with chronic back pain. They found constricted arteries much more often in back-pain sufferers, compared with the average person.

Later, a Japanese team showed that surgically restoring circulation to the back improves back pain. These studies show that back pain is not necessarily caused by heavy lifting or a lumpy mattress. Often, it is caused by poor circulation.

Third, a menu change can rebalance hormones. This makes all the difference for menstrual cramps. Several years ago, a young woman called my office complaining of excruciating menstrual pain. She could barely get out of bed. I prescribed painkillers to ease her immediate symptoms; I also suggested that she try a diet change to see if she could head off pain the following month. That meant eliminating animal products and emphasizing vegetables, fruits, whole grains, and beans. Indeed, this rather simple diet change virtually eliminated her pain.

To put this diet to the test in larger numbers, we invited women with painful menstrual cramps to try a low-fat vegan diet for two months. The menu change reduced pain severity and duration and also improved PMS symptoms. Why would a change in diet help? Because it can affect the hormones that contribute to pain. Here’s how: Every month, estrogens— — female sex hormones— — thicken the lining of the uterus in anticipation of pregnancy. At the end of the monthly cycle, as menstrual flow begins, the disintegrating uterine lining releases prostaglandins, a group of chemicals that cause cramps. Our theory is that if fewer estrogen particles were flowing through your bloodstream, there should be less uterine thickening, less prostaglandin release, and less pain.

It turns out that a diet change can help eliminate excess estrogens.

Every minute of the day, your liver filters your blood, removing estrogens and sending them into the intestinal tract, so they can leave with the wastes. In order to work, this system depends on fiber. If there is plenty of fiber in the intestinal tract, estrogen binds to the fiber and promptly exits your body. If you don’t eat enough fiber, your liver still removes estrogens from the blood and sends them into the intestine, but with no fiber to adhere to, these estrogens pass from the intestinal tract back into the bloodstream. A high-fiber, plant-based diet helps get your hormones into balance, helping to prevent menstrual pain. It may be that the same hormone-control method can help with endometriosis and some types of cancer pain, but this has not yet been tested.

There are many other ways that foods can fight pain. Capsaicin, which gives chiles their spice, is an active ingredient in some joint-pain creams; as the tingle kicks in, the joint pain subsides. Ginger also appears to ease joint pain. Vegan diets have been shown to ease the nerve pain of diabetes; they may also help prevent painful kidney stones. So, while painkilling drugs have their place, for many common aches and pains, a menu change can be just what the doctor ordered.