Nutrition and nutraceutics in pain therapy
The role of nutrition in treating pain is receiving special attention in the field of pain management. Currently, it is thought that people with chronic pain should receive tailored nutritional advice from the start of their treatment with the aim of improving their quality of life.
As well as the severity of the underlying condition, interindividual variability in chronic pain depends on many factors, including sociocultural context, genetic and psychological factors and pathophysiology, which can be modulated by altering nutritional habits. The first meeting on pain therapy and lifestyle (held in April 2016 in Rome) focussed on the association between nutrition and neutraceutics and the development and perception of pain, appropriate nutrition for cancer patients, the role of obesity in producing chronic pain, the microbiome involved in pain, the specific role of omega-3 fatty acids, soy, curcumin and polyphenols in painful inflammatory and degenerative processes and tolerance to opioids.
Many diseases have an inflammatory component. The long-chain omega-3 polyunsaturated fatty acids (omega-3 LC-PUFA) eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) have a modulating effect on inflammation. Numerous of in vivo studies have shown that omega-3 fatty acids prevent inflammatory symptoms associated with obesity; they also play a role in cardiovascular diseases. Longitudinal studies have shown negative correlations between fish consumption and cognitive deterioration, Alzheimer’s disease and dementia. DHA is the precursor to neuroprotectin D1, which reduces neuroinflammation and protects neuron cells.
The beneficial effect of omega-3 fatty acids on pain is currently being studied, with promising results. These are some examples:
- Pain is the main symptom of osteoarthritis and current analgesics either fail to mitigate it adequately or are associated with major secondary effects; the analgesic effect of activating the D-series resolvin pathways on osteoarthritic pain has been demonstrated in animal models.
- DHA supplementation was successful in reducing administration of buprenorphine to newborns who had undergone surgery.
- In the treatment of chronic or long-term pain, joint administration of opioids and omega-3 fatty acids could help reduce the appearance of adverse effects.
- EPA y DHA have therapeutic potential in nociceptive and neuropathic pain.
- De Gregori M, Muscoli C, Schatman ME et al. Combining pain therapy with lifestyle: the role of personalized nutrition and nutritional supplements according to the SIMPAR Feed Your Destiny approach. J Pain Res. 2016; 9: 1179-1189. Published online 2016 Dec 8. doi: 10.2147/JPR.S115068
- Bernabé-García M, López-Alarcón M, Salgado-Sosa A et al. Enteral Docosahexaenoic Acid Reduces Analgesic Administration in Neonates Undergoing Cardiovascular Surgery. Ann Nutr Metab. 2016;69(2):150-160.
- Huang J, Burston JJ, Li L et al. Targeting the D-series resolvin receptor system for the treatment of osteoarthritic pain. Arthritis Rheumatol. 2016 Nov 16. doi: 10.1002/art.40001. [Epub ahead of print]