Chronic Pain—Natural Solutions
Chronic pain affects a large percentage of the general population on a daily or otherwise regular basis. It includes a variety of different conditions, such as osteoarthritis (“wear and tear” arthritis), rheumatoid arthritis, migraine, fibromyalgia, low-back pain, and even repetitive strain conditions such as various types of tendonitis and other injuries that do not heal properly. Approximately 18.9% of Canadians over 18 years of age are estimated to suffer from chronic pain. Many people depend on pain-killers and other medications in order to function normally on a day-to-day basis. There are a variety of natural therapies that offer relief from chronic pain. This series will discuss some of these lesser-known therapies.
Many conditions characterized by chronic pain involve inflammation due to activation of the immune system. This is true for most autoimmune conditions — such as rheumatoid arthritis (RA), psoriatic arthritis, ankylosing spondylitis (AS), lupus (SLE), and other arthrides, as well as for migraines, and even fibromyalgia, although this latter is less well-known. Autoimmunity refers to various conditions where the immune system attacks its own body, producing antibodies against proteins present on the body’s own cells, activating T cells to react against these proteins, or producing various proinflammatory chemicals called cytokines.
Alterations in digestive function have been identified in some of these conditions. In fibromyalgia, for instance, there is an association with the presence of “leaky gut”. “Leaky gut” is a term that describes a situation where there is deterioration in the barrier function of the gut lining, allowing larger food particles to enter the bloodstream and trigger an immunological reaction. In a study of 40 patients with fibromyalgia, 17 patients with chronic regional pain syndrome, and 57 normal controls, patients with chronic pain had significantly higher rates of increased intestinal permeability compared with normal controls. The presence of increased intestinal permeability, or “leaky gut,” has also been demonstrated in patients with juvenile arthrides. Another study found elevated intestinal permeability in a group of patients with lupus, ankylosing spondylitis (AS), and another condition called Behcet’s.
Naturopathic doctors recognize that certain foods can act as triggers for the development of leaky gut, which can lead to immune activation when the implicated food proteins enter the circulation. Consumption of these foods can lead to hyperactivation of the immune system, similar to what can happen with allergies. The term “food sensitivity” is used to describe this phenomenon. Although the role of food sensitivity on chronic pain is yet underrecognized, there are a number of studies that suggest an overlap between some of these conditions, in particular fibromyalgia, with celiac disease (gluten intolerance). Another study of rheumatoid arthritis found that these patients have increased levels of food-specific antibodies present in their intestinal fluid, compared to normal subjects. The involved foods included proteins from cow’s milk (alpha-lactalbumin, beta-lactoglobulin, casein), cereals, hen’s egg (ovalbumin), cod fish, and pork meat. Similar results have been shown by an older study of proteins from wheat and milk.
Identification and elimination of food sensitivities may pose an effective strategy to the management of chronic pain. We encourage readers to seek the guidance of a naturopathic doctor in undertaking such an approach.