What is Chronic Pain? Lifestyle Approaches and Natural Supplements for Pain

According to the Centers for Disease Control and Prevention, approximately 50 million (or 15% of) adults reported suffering from chronic pain in the United States in 2018. (6) Managing chronic pain commonly requires an integrative approach that may include pain medications, physical therapy, lifestyle interventions, dietary modifications, and pain-relieving supplements.

Continue reading to learn about lifestyle approaches and dietary supplements for pain, including curcumin, evening primrose oil, omega-3 fatty acids, vitamin D, collagen, and topical capsaicin.

What is pain?

Physical pain is a signal sent from an affected body part to the brain via the nervous system. This signal is intended to notify you that something is wrong, such as an injury or infection. (22) Pain can generally be divided into acute pain, which is short-lived, and chronic pain, which persists beyond the normal healing time. (24)

Chronic pain includes neck, back, joint, bone, muscle, and nerve pain.

Chronic pain

Chronic pain is characterized by pain that persists beyond twelve weeks. The pain may range in intensity from mild to severe (9) and may be classified into three main types, which refers to the pathways in the body that contribute to the experience of pain.

The three types of pain include:

• Nociceptive, which is a response to real or potential harm detected by pain receptors
• Inflammatory, which refers to tissue damage due to inflammation
• Neuropathic, which is typically localized to one area and is caused by damage or disease to the nervous system (24)

While chronic pain itself is a symptom, the term chronic pain syndrome refers to a health condition in which chronic pain is commonly seen, such as fibromyalgia, irritable bowel syndrome (IBS), migraine, dysmenorrhea (menstrual cramps), and rheumatic conditions. (1)

Lifestyle approaches to chronic pain

Modifiable risk factors associated with chronic pain include alcohol intake, smoking, poor diet, and physical inactivity. (9) Addressing chronic pain effectively may involve certain lifestyle interventions, such as psychological interventions, physical therapy, dietary modifications, acupuncture, exercise, and supplementation.

Psychological interventions

There are various psychological and psychosocial approaches to managing pain. One review study examined the effects of cognitive-behavioral therapy (CBT), operant behavioral therapy (OBT), and self-hypnosis training in individuals with chronic pain. The study suggests that CBT and OBT, which address the factors that maintain or worsen pain, are effective and should be included in the multidisciplinary treatment of chronic pain. Self-hypnosis was found to provide lasting pain relief to a minority of individuals, while the majority only experienced temporary pain relief. (15)

Physical therapy

The goal of physical therapy, also referred to as physiotherapy, in addressing chronic pain is to increase tolerance to movement and reduce pain, resulting in reduced suffering and disability. (7) Physical therapy may be effective in preventing the progression of acute pain to chronic pain. One study of individuals with low back pain examined various outcomes of physical therapy treatment at the first point of care, at any point, or not at all. The researchers concluded that seeing a physical therapist at the first point of care was associated with lower opioid use and lower use of medical services, such as emergency department visits and advanced imaging services. (8)

Physical therapy may help reduce the need for medical services for chronic pain.

Dietary modifications

Published in the journal Nutrition Research Reviews, a group of researchers has proposed a food pyramid for individuals with chronic pain. The food pyramid focuses on increasing anti-inflammatory and anti-oxidant foods in the diet. This anti-inflammatory diet encourages the consumption of low-glycemic carbohydrates, vegetables, fruit, yogurt, red wine, and extra-virgin olive oil. The food pyramid also allows for a moderate intake of legumes and animal proteins including fish, white meat, eggs, fresh cheese, and red meat, as well as the occasional consumption of sweets. (19)

Acupuncture

A recent meta-analysis compiled clinical trials examining the effects of acupuncture in the management of chronic pain. The study found that acupuncture was associated with chronic pain reduction when compared to the control groups, sham acupuncture, and no acupuncture treatment. Various government guidelines recommend acupuncture for different types of pain, including headache, migraine, and back pain. (23)

Exercise for pain

Review studies have assessed the effects of various types of exercise in individuals with chronic pain, such as balance training, core training, yoga, pilates, and tai chi, as well as aerobic, strength, and flexibility exercises. The research suggests that exercise may improve several factors related to chronic pain, including severity and physical function. (16)

Supplements for inflammation and pain

While the best natural supplements for chronic pain will vary depending on an individual’s health condition and the root cause of the pain, we’ve highlighted some of the top evidence-based supplements for pain.

Curcumin

Supplementation with curcumin, the bright yellow pigment found in the medicinal herb turmeric, has been shown to reduce pain in individuals with inflammatory conditions, such as IBS (5) and osteoarthritis. (20) Curcumin may exert its anti-inflammatory effects by inhibiting certain enzymes that mediate inflammatory processes. (13)

Evening primrose oil

Evening primrose oil (EPO) is derived from the seeds of the evening primrose plant (Oenothera biennis). EPO provides linoleic acid (LA) and gamma-linolenic acid (GLA), two omega-6 fatty acids that have been associated with the beneficial effects of the oil. (3) In individuals with multiple sclerosis, a chronic inflammatory condition, EPO supplementation was associated with reduced pain and fatigue compared to placebo. (12)

Omega-3 fatty acids

Known for their anti-inflammatory effects, omega-3 fatty acids are found in dietary sources including fatty fish, flaxseed, hemp seeds, and walnuts, as well as dietary supplements. Meta-analyses have examined the effects of omega-3 supplementation in various conditions. In one, researchers found that omega-3 supplementation may improve chronic pain in conditions such as dysmenorrhea (menstrual cramps). (18) Another meta-analysis of studies in patients with rheumatoid arthritis (RA) found that omega-3 supplementation for over three months was associated with reduced use of nonsteroidal anti-inflammatory drugs (NSAID), a medication commonly used to manage pain. (11)

Vitamin D

Vitamin D, a fat-soluble vitamin, is produced in the skin with sun exposure and provided in small amounts from certain dietary sources, such as cod liver oil, egg yolks, and cheese. Vitamin D deficiency commonly occurs in individuals with limited sun exposure and those with issues absorbing or converting the vitamin to its active form. (17) Research has found that low levels of vitamin D are associated with high levels of reported pain. (14) Studies that have assessed the effect of vitamin D supplementation in individuals with chronic widespread pain, such as individuals with fibromyalgia, have found that supplementation may decrease pain scores. (25)

Joint pain relief supplements and products include capsaicin, an extract from hot peppers that is used in topical pain relief creams and gels.

Natural supplements for joint pain

In addition to the nutrients and herbs listed above, certain natural products have also been shown to relieve joint pain specifically such as collagen and topical capsaicin.

Collagen

Collagen is a structural component found in certain body tissues, including bones, cartilage, ligaments, and tendons. (21) As a supplement, collagen is produced from a variety of sources including beef, fish, pork, and eggshell membranes. In individuals with knee osteoarthritis, collagen supplementation has been demonstrated to reduce pain and stiffness. (4) Similarly, in individuals with rheumatoid arthritis, beef collagen was found to reduce symptoms and levels of tumor necrosis factor-alpha (TNF-alpha), an inflammatory marker. (2)

Capsaicin

Naturally found in hot peppers such as cayenne, capsaicin is an ingredient used in topical (applied on the skin) pain relief products. Researchers have found that capsaicin gel or cream has an analgesic and anti-inflammatory effect when used repeatedly. Topical capsaicin may benefit individuals with joint pain conditions, such as osteoarthritis and rheumatoid arthritis. (10) Note that capsaicin can have a caustic, or burning, effect if used to excess. Consult your integrative healthcare provider for guidance on how to properly administer topical capsaicin.

The bottom line

Chronic pain is a symptom that negatively affects an individual’s physical function and quality of life. A multidisciplinary approach to chronic pain management may involve lifestyle modifications and dietary supplements. Working with an integrative practitioner or integrative healthcare team is recommended in order to develop an individualized approach to treatment.