The Importance of Nutrition as a Lifestyle Factor in Chronic Pain Management: A Narrative Review

Abstract

In everyday clinical practice, healthcare professionals often meet chronic pain patients with a poor nutritional status. A poor nutritional status such as malnutrition, unhealthy dietary behaviors, and a suboptimal dietary intake can play a significant role in the occurrence, development, and prognosis of chronic pain. The relationship between nutrition and chronic pain is complex and may involve many underlying mechanisms such as oxidative stress, inflammation, and glucose metabolism. As such, pain management requires a comprehensive and interdisciplinary approach that includes nutrition. Nutrition is the top modifiable lifestyle factor for chronic non-communicable diseases including chronic pain. Optimizing one’s dietary intake and behavior needs to be considered in pain management. Thus, this narrative review reports and summarizes the existing evidence regarding (1) the nutrition-related health of people experiencing pain (2) the underlying potential mechanisms that explain the interaction between nutrition and chronic pain, and (3) the role of nutrition screening, assessment and evaluation for people experiencing pain and the scope of nutrition practice in pain management. Future directions in the nutrition and chronic pain field are also discussed.

Eating habits and the desire to eat healthier among patients with chronic pain: a registry-based study

“…Lifestyle factors have key roles in the development of chronic pain 5 . In addition to physical activity and sleep disorders which are already well addressed in pain management 51 , 52 , attention to nutrition support is needed 7 , 11 . However, there are several challenges that may prevent lifestyle change.…”

“…The authors postulate that poor adherence may explain this outcome. Tailored and person-centered approaches in nutrition support are essential to overcome this barrier 11 , 12 . It is also important to identify which lifestyle factors patients want to change to optimize their motivation and help clinicians to improve future tailored IPRP targeting these patients.…”

Exploring the terminological validity of ‘chronic pain’ nursing diagnosis: A retrospective descriptive study using nursing diaries

“…Another important causal factor, although only detected in eight cases, is the ‘repeated handling of heavy loads’ (RF), as demonstrated in a study of agricultural workers in California (Xiao et al, 2013). Data on ‘malnutrition’ (RF) and a ‘body mass index above normal ranges for age and gender’ (RF) were low, respectively 2.4% and .4% of cases, but studies affirm that inadequate nutritional statuses, such as malnutrition, wrong eating behaviours, and insufficient dietary intake, plays a significant role in the onset, development, and prognosis of chronic pain (Elma et al, 2022). On the other hand, a BMI tending towards obesity, and a high‐calorie diet rich in simple sugars, fats, salt, and caffeine (Elma et al, 2020) also contribute.…”

Food insecurity is associated with chronic pain and high-impact chronic pain in the USA

“…Among these, food insecurity contributes to poor quality diets and maladaptive eating patterns that compromise nutritional status (27)(28)(29) . Thereby, food insecurity potentially exacerbates proposed mechanisms underlying the impact of nutrition on chronic pain, including malnutrition, obesity, inflammation, metabolic dysfunction and nervous system sensitisation, among others (30,31) . Notably, food insecurity has been associated with markers of systemic inflammation (32) , as well as diets with higher inflammatory potential (33) , which in turn have been associated with incidence of pain in middle-aged and older adults (34,35) .…”