CHRONIC pain is widespread in the UK, causing misery to millions.
While many find out the cause of their pain, such as arthritis, injury or illness, others can go years without any answers – but a new study might help give clues.
Millions of people live with chronic pain – that which lasts more than 12 weeks – every day[/caption]
Published in the journal Pain Practices by the University of Arizona Health Science it found that lower levels of certain vitamins and minerals could be associated with chronic pain.
These vital compounds are like ‘spark plugs’ for the body, igniting chemical reactions that keep the body running optimally.
Vitamins and minerals are needed for everything from making red blood cells to supporting the immune system and bone health, protecting cells from damage that lead to disease and releasing energy we need from food.
The research team examined the status of vitamins in people without pain, people with mild-to-moderate chronic pain and people with severe chronic pain.
“Our study across various chronic pain conditions in a large, diverse population found that certain vitamins and mineral deficiencies are more frequent in people with chronic pain, and particularly in some in specific racial and ethnic groups,” said the study’s co-author Deborah Morris, PhD, a research laboratory manager in the Department of Neurosurgery.
Chronic pain is sometimes defined as that which lasts for more than 12 weeks.
Approximately 8 million adults have chronic pain that is moderate to severely disabling, according to the Faculty of Pain Medicine.
And up to 50 per cent of GP consultations are related to pain, according to the NHS drug regulator Nice.
So it’s a severe but often overlooked issue that is widespread in the UK.
Doctors hope to try and manage chronic pain using more than just medicine and instead, use all-round holistic approaches, such as psychological therapy or exercise.
So could the diet be one way of improving your pain, whether it be in the knees, back or neck?
Aimee Benbow, head nutritionist at Viridian Nutrition adds: “The study acknowledges that it is unclear whether there is a casual effect (so whether the pain or the nutrient deficiency comes first).
“However, what was found was that low serum levels of specific micronutrients was associated with increased pain.”
Aimee adds that long-term micronutrient deficiencies can cause all sorts of health problems.
“Taking supplements can be an effective way to help address specific nutrient deficiencies and shortfalls,” adds Aimee.
If you’re dealing with pain, you might want to consider upping your intake of these nutrients…
Vitamin D
Who’s at risk? Anyone who avoids the sun or wears clothes outdoors that cover most of the skin
Best sources: The sun, oily fish, eggs and supplements
Vitamin D is an essential nutrient that helps the body form and maintain healthy bones, muscle and teeth.
“There is also evidence to show that this vital nutrient plays a role in immunity, mood and heart health as well,” adds Aimee.
“In the journal Endocrine Practice, a deficiency in vitamin D was linked to pain, in particular fibromyalgia and musculoskeletal issues, which encompasses the body’s supporting structures such as joints, muscles and ligaments leading to pain, stiffness and reduced mobility.”
Barbecued salmon, fried potatoes and vegetables on wooden background[/caption]
Research in the journal Medical Principles and Practice also associated lower vitamin D levels with the intensity in which teenagers experience ‘growing pains’.
“Supplementation with vitamin D resulted in a significant reduction in pain intensity in those who were low or deficient,” adds Aimee.
Our main source of vitamin D is exposing our skin to the sun.
So while this is easy in the spring and summer, from October to March, the UK government advises that everyone over four years old takes a supplement containing at least 10 micrograms (μg) of vitamin D.
“Vitamin D deficiency has increased, particularly in the UK,” says Aimee.
If you don’t go outside much, wear clothes that cover most of your skin outdoors or live in an institution such as a care home, then it’s advised to take a supplement all year.
“Foods such as oily fish and eggs can help to boost vitamin D levels,” says Joanna Lyall, nutritional therapist and head of nutrition at thebettermenopause.com.
Joanna recommends a supplement with magnesium.
“Vitamin D also needs magnesium and vitamin K2 to work properly.”
Try: Viridian Vitamin D3 2000IU, (60 capsules, £16.40), or Longevity Vitamin D3, K2 & Magnesium, (125 capsules, £25)
Magnesium
Who’s at risk? Postmenopausal women, people with digestive issues, those with a junk food diet
Best sources: Leafy greens, wholegrains, nuts and seeds
The mineral magnesium is involved in over 300 processes within the body.
“The body contains on average 25g of magnesium and 60 per cent of this is primarily found in bones,” says Aimee.
Magnesium is found in nuts and seeds[/caption]
Aimee says that magnesium deficiency has been linked to health issues “including cardiovascular disease, hypertension, cognitive disorders, anxiety, depression and chronic fatigue”.
Low levels of magnesium have been associated with increased headaches and migraines too, according to the journal Nutrients.
People with stressful lifestyles may be more at risk too, as are those with digestive issues
Joanna
A study in the International Clinical Psychopharmacology journal found that people with low blood magnesium were 35 times more likely to have migraine attacks compared to healthy individuals.
Aimee adds: “Supplementing with magnesium has shown to help those who suffer with restless leg syndrome which can significantly impact quality of sleep.”
A deficiency in magnesium has been linked to osteoporosis in postmenopausal women, because magnesium is important for maintaining bone density.
Joanna adds: “People with stressful lifestyles may be more at risk too, as are those with digestive issues.”
The foods high in magnesium are not typical of a modern, Western diet, which is increasing the risk of deficiency.
Foods that contain magnesium include spinach, wholegrains, nuts, dark chocolate and avocado.
When should I see the doctor for pain?
Everyone experiences pain now and again, whether due to illness, injury or out of the blue.
When should you bother seeing your doctor about it?
If you’ve been experiencing pain for more than three months, it’s considered chronic.
This type of pain is complex and often requires a professional evaluation to identify the cause and create a management plan.
Here are some reasons to make a doctor appointment:
Persistent pain
When pain that lasts longer than a few weeks or doesn’t improve with self-treatment measures like over-the-counter pain relievers, rest, and heat or ice.
Pain that interferes with daily life
If the pain is severe enough to disrupt your sleep, work, or other daily activities, it’s time to see a doctor.
Pain that gets worse
If your pain is steadily increasing in intensity or you’ve developed new symptoms.
Pain with other symptoms
If your pain is accompanied by signs of infection, such as redness, swelling, or warmth around a joint or muscle, or a fever.
Pain from a known condition
If you have a chronic condition like arthritis, and your pain is worsening or not responding to your usual treatments.
When to seek emergency help:
- Sudden, severe pain: Any pain that comes on suddenly and is excruciating.
- Chest or upper abdomen pain or pressure: Especially if it lasts for more than a few minutes or is accompanied by other symptoms like shortness of breath, sweating, dizziness, or pain radiating to your arm, jaw, or neck. This could be a sign of a heart attack.
- Pain with loss of function: If you experience pain that causes a sudden loss of muscle power or an inability to use a joint.
- Pain with neurological symptoms: Severe headaches, numbness, tingling, or weakness in your arms, legs, or face; trouble speaking or seeing; or confusion. These could be signs of a stroke or other serious neurological issue.
- Back pain with loss of bladder or bowel control: This can indicate a serious spinal problem.
- Pain following a severe injury: Such as a car accident, a fall, or a large wound.
- Severe abdominal pain: Particularly if it’s accompanied by fever, bloody stools, or persistent nausea and vomiting.
Aimee says: “Poor soil quality with reduced mineral levels due to widespread use of artificial fertilisers and over farming, is also leading to a reduced mineral content of vegetables.”
A supplement can help to make sure you’re getting enough magnesium.
Avoid taking more than 400 mg of magnesium as it can cause diarrhoea and consider the various types of magnesium.
Joanna says: “Magnesium glycinate is good for pain and relaxation, magnesium malate is useful when fatigue and low energy (such as in fibromyalgia) are present.”
Try: Viridian Ionic Magnesium Liquid (£24.70 for 100ml)
Vitamin B12
Who’s at risk? Vegetarians, vegans, older adults
Best sources: Meat, dairy, eggs, fish, fortified foods
Vitamin B12 “plays a critical role in improving mood, energy levels, cognitive function and nerve health,” says Aimee.
A lack of vitamin B12 can sometimes cause neurological problems, which affect your nervous system, according to the NHS.
Sardines are a good source of vitamin 12. The NHS says if you eat meat, fish or dairy foods, you should be able to get enough vitamin B12 from your diet[/caption]
These problems include vision problems, memory loss, pins and needles, a loss of physical co-ordination and damage to parts of the nervous system, particularly in the legs.
When it comes to pain, a research review in the journal Brain Nerve concluded that B12 helps reduce pain by protecting and repairing nerves, calming overactive nerve signals and balancing brain chemicals.
Older adults and people with digestive issues (such as IBS, coeliac or low stomach acid) can be at risk of vitamin B12 deficiency
Joanna
Research in the European Review for Medical and Pharmacological Sciences, which involved 60 patients aged between 18 and 65 with back pain, found that vitamin B12 injections significantly reduced pain.
As a water soluble vitamin, we need to get enough vitamin B12 every day as it isn’t stored in our bodies.
“It’s obtained through the diet in animal food sources such as meat, dairy, eggs and fish,” says Aimee.
If you follow a vegan or mostly plant-based diet, you might want to consider a supplement.
“Older adults and people with digestive issues (such as IBS, coeliac or low stomach acid) can be at risk too,” says Joanna.
Joanna explains that vitamin B12 is complex because genetics can affect how well we absorb and use it.
She says: “A blood test showing high B12 doesn’t always mean the vitamin is being used properly in the cells.
“For a more accurate picture, doctors sometimes test homocysteine and methylmalonic acid, which give a better insight into how well B12 is working in the body.
“This is especially important for people with chronic pain, as nutrient activity inside the cells matters more than blood levels alone.”
If you’re concerned, book an appointment with your GP who may be able to arrange blood tests.
TRY: Holland & Barrett High Strength Vitamin B12 (120 tablets, £17.49)
Vitamin C
Who’s at risk? Anyone with a highly processed diet, smokers, chronically ill
Best sources: Citrus fruits, kiwi, peppers, tomatoes, leafy greens
You might dose up on vitamin C when you catch a cold or feel yourself becoming ill. But vitamin C is more than just an immune support.
Aimee says: “It plays a role in skin structure and healing.
“Deficiency can lead to poor gum health, reduced wound healing and an impaired immune system.”
A study published in The Journal of Bone and Joint Surgery found that people suffering with wrist fractures who supplemented with 500mg of vitamin C reduced the risk of regional pain syndrome one year post-fracture compared to placebo.
Spinach and kale are sources of vitamin C, as well as citrus fruits like oranges[/caption]
Deficiency in vitamin C has also been strongly linked to periodontal disease, according to research in the International Journal of Environmental Research and Public Health.
Aimee says: “Evidence suggests that those with lower dietary intake of vitamin C show greater progression of periodontal [gum] disease than those with sufficient intakes.”
Joanna adds: “Vitamin C supports the production of the feel-good hormone dopamine too, which can affect how we perceive pain.”
Oranges and citrus fruits are great sources of vitamin C, as are tomatoes, kiwis, peppers and green leaves such as spinach and kale.
“However, significant losses of this nutrient occur through wilting, chopping, and cooking,” says Aimee.
“Smokers and those with poor diets or chronic illness can be affected by low vitamin C,” says Joanna.
TRY: Vitabiotics Ultra Vitamin C (120 tablets, £10.85)
Folate
Who’s at risk? Pregnant women, poor diet, alcohol dependents
Best sources: Oranges, lentils, leafy greens and beans
Also known as vitamin B9, Joanna explains: “Low folate can raise homocysteine levels, which promotes inflammation.”
Inflammation can cause pain.
Research in the journal BMC Musculoskeletal Disorders found that folate intake was linked to reduced knee pain and stiffness as well as reduced foot and lower back pain in patients with osteoarthritis.
Legumes like lentils will give you a folate boost[/caption]
The study, which took place over two years and involved 413 participants, found that those who had higher folate intake had reduced inflammation and, therefore, reduced pain.
Joanna says: “Pregnant women or childbearing age, alcohol dependents or those with poor diets are most at risk of low folate.”
Leafy greens, beans, lentils, avocados and citrus fruits can help increase your levels of folate.
If you’re taking a supplement, choose natural folate supplements over folic acid.
Joanna says: “Many supplements use folic acid, the synthetic form, but this isn’t well absorbed by everyone, especially those with certain genetic variations.
“Natural folate is often a better option, as blood tests can sometimes show adequate folic acid levels even when the body isn’t using it properly.”
Try: Solgar Folate (60 tablets, £24)
Zinc
Who’s at risk? Vegetarians, vegans, anyone dealing with high stress
Best sources: Seafood, meat, pumpkin seeds
A mini but mighty mineral, zinc is essential for healing, nerve health and immunity, according to Joanna.
A research review in the journal Nutrients found that zinc can even help to reduce menstrual cramps.
Doses as low as 7 mg per day offered significant relief compared to a placebo. The effects of zinc were greater when taken over eight weeks or more.
Joanna says: “Low zinc can be linked to anxiety and depression, which often accompany chronic pain.
“Stress, including the stress of pain itself, rapidly depletes zinc.
“Signs of deficiency can include poor wound healing, brittle nails, low immunity and changes in taste or smell.”
Vegetarians and vegans or people coping with high stress may be at risk of zinc deficiency.
Including foods like seafood – especially oysters – lean meats and pumpkin seeds can be helpful, as can a supplement.
Try Wild Nutrition Food-Grown Zinc Plus (30 capsules, £15.50)