ANTA Member Article Summer 2023
Ananda Mahony
ANTA Naturopathy Branch Chair BHSc (Naturopathy) Graduate Certificate (Human Nutrition) Master of Medicine (Pain Management)
Dietary Interventions in Musculoskeletal Pain
Persistent pain is a leading cause of disability worldwide with a huge personal and economic cost. It is associated with increased risks of co-morbid health conditions, increased body mass and poorer diet quality and patterns. As a modifiable risk factor, dietary intake and nutritional interventions have the potential to positively influence individual experiences of pain and improve quality of life. Further, such approaches may provide valid solutions to help resolve chronic pain. Unfortunately, the relationship between chronic pain and dietary influences is not clear cut. Poor nutrition is known to contribute to system inflammation and oxidative stress, both of which can play a role in pain persistence. While most studies examining diet and musculoskeletal pain focus on interventions that promote weight loss or reduce inflammation and oxidative stress there is still much that remains unexamined. It is currently unclear whether individual dietary components are causal, increase risk or are sustaining factors in persistent pain. In addition, many of the studies investigating the effect of targeted dietary interventions have limitations. From a clinical practice perspective uncertainty about best practice approaches for clients in persistent pain even within subpopulations with the same pain condition persists. In addition, lack of clinical certainty can lead to unnecessary dietary
restriction, lack of effect and even risk of nutritional insufficiency. This article examines different dietary patterns and targeted dietary interventions for chronic musculoskeletal pain. Recent research is explored and dietary interventions that have the potential to reduce pain severity, improve quality of life and minimise the risk of co-morbid conditions are discussed. It is clear in the literature that a western dietary pattern (WDP) is associated with advancement of osteoarthritis and other musculoskeletal pain. Abundant in saturated fat, the WDP promotes expansion of white adipose tissue and dysfunctional adipose cellular responses. It is also high in energy and refined carbohydrate intake, which promotes inflammatory signalling and gene expression and increased systemic inflammation overall. Poor nutrition and unhealthy dietary patterns associated with the WDP contribute to oxidative stress, which along with inflammation plays a role in pain persistence1,2. The WDP is also associated with greater Dietary Inflammatory Index (DII) scores which correlate with increased weight gain, obesity risk, greater pain severity and osteoarthritis prevalence3. The
THE NATURAL THERAPIST VOL 38 NO. 2 | SUMMER 2023 | PAGE 35
