Insights on Nutrients as Analgesics in Chronic Pain

Effects of Dietary Interventions in Patients With Migraine: A Systematic Review

CONTEXT

Migraine is a disabling neurological disorder. Diet may be a factor to consider because measures of diet quality have been linked to both frequency and severity of attacks.

OBJECTIVES

To investigate the effects of dietary interventions on the clinical symptoms of migraine, quality of life, and body composition of patients with migraine.

DATA SOURCES

The MEDLINE, Embase, and Web of Sciences databases were searched since database inception to February 13, 2024. We included articles on randomized clinical trials that assessed the effect dietary interventions on clinical symptoms of migraines and the quality of life and body composition of individuals with migraine.

DATA EXTRACTION

Data from the included articles were independently extracted by 2 researchers; another independent reviewer further verified the extractions. The Cochrane risk-of-bias tool was used to evaluate the risk of bias of selected studies, and the Physiotherapy Evidence Database scale was used to assess the methodological quality.

RESULTS

Eight articles were included in this review. Of these, 3 reported on studies that assessed the ketogenic diet (KD), 2 reported on the Dietary Approaches to Stop Hypertension (DASH), and 3 reported on studies of other dietary strategies. Strong evidence exists regarding the effectiveness of the KD and DASH in reducing the frequency of migraine attacks, whereas their efficacy in improving patients' quality of life was supported only by limited evidence. There also is strong evidence regarding the effectiveness of DASH in reducing migraine's severity and patients' body weight. Insufficient evidence was found regarding the effectiveness of the other dietary interventions on all variables.

CONCLUSIONS

The DASH and KD may help reduce migraine frequency and severity. However, more high-quality studies are needed to confirm their effectiveness.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO No. CRD42024516161.

The Impact of Nutrition on Pain: A Narrative Review of Recent Literature

PURPOSE OF REVIEW

Pain is a complex phenomenon that affects millions of individuals worldwide and poses a significant burden on public health. While pain management typically focuses on pharmacological and physical interventions, emerging research suggests that nutrition plays a crucial role in pain modulation. This narrative review aims to explore the relationship between nutrition and pain, providing a comprehensive overview of recent literature. The review covers various dietary factors, including macronutrients, micronutrients, dietary patterns, and specific dietary interventions. Additionally, the potential mechanisms underlying the impact of nutrition on pain are discussed. The findings highlight the potential for dietary interventions to complement traditional pain management approaches and provide valuable insights for future research and clinical practice.

RECENT FINDINGS

Literature suggested the impact of healthy nutrition on improvement in pain and that certain types of food may increase and worsen different pain conditions. Nutrition plays an important role in modulating pain. It is important to counsel patients in pain on best diet for their pain condition to alleviate pain. Our article summarizes very well the issue of nutrition and pain and provides a guide to all practitioners caring for patients with chronic pain.

The Critical Role of Nutrition Care to Improve Pain Management: A Global Call to Action for Physical Therapist Practice

Physical therapists have unique education in the comprehensive biopsychosocial assessment and treatment of chronic pain and its mechanisms. Recently, physical therapists have raised awareness regarding the impact of nutrition on promoting health and managing noncommunicable diseases. Robust evidence supports the implementation of nutrition in physical therapist education and practice. Of particular interest for the physical therapist are investigations that use dietary interventions for the treatment of chronic pain. Yet physical therapists have received little guidance regarding their role in nutrition care for pain management and may pass on opportunities to counsel their patients on the connection between nutrition and pain. Therefore, a clinical paradigm shift and unified voice within the profession is called on to encourage physical therapists to develop tailored multimodal lifestyle interventions that include nutrition care for the management of chronic pain. This Perspective describes evidence supporting the implementation of nutrition care in physical therapist practice, supports the role of nutritional pain management for physical therapists, and encourages the use of nutrition care for primary, secondary, tertiary, prevention, health promotion, and wellness related to chronic pain. To achieve these aims, this Perspective offers suggestions for how physical therapists can (1) enhance clinical decision making; (2) expand professional, jurisdictional, and personal scope of practice; (3) evolve entry-level education; and (4) stimulate new investigations in nutrition care and pain science research. In doing so, physical therapists can assert their role throughout the pain management continuum, champion innovative research initiatives, and enhance public health by reducing the impact of chronic pain.

IMPACT

The nutrition care process for pain management is defined as the basic duty to provide adequate and appropriate nutrition education and counseling to people living with pain. Including the nutrition care process as part of a multimodal approach to pain management provides an opportunity for physical therapists to assert their role throughout the pain management continuum. This includes championing innovative research initiatives and enhancing public health by reducing the impact of chronic pain for over 50 million Americans.

Dietary Patterns and Interventions to Alleviate Chronic Pain

Pain is one of the main problems for modern society and medicine, being the most common symptom described by almost all patients. When pain becomes chronic, the life of the patients is dramatically affected, being associated with significant emotional distress and/or functional disability. A complex biopsychosocial evaluation is necessary to better understand chronic pain, where good results can be obtained through interconnected biological, psychological, and social factors. The aim of this study was to find the most relevant articles existent in the PubMed database, one of the most comprehensive databases for medical literature, comprising dietary patterns to alleviate chronic pain. Through a combined search using the keywords "chronic pain" and "diet" limited to the last 10 years we obtained 272 results containing the types of diets used for chronic pain published in the PubMed database. Besides classical and alternative methods of treatment described in literature, it was observed that different diets are also a valid solution, due to many components with antioxidant and anti-inflammatory qualities capable to influence chronic pain and to improve the quality of life. Thirty-eight clinical studies and randomized controlled trials are analyzed, in an attempt to characterize present-day dietary patterns and interventions to alleviate chronic pain.