Chronic Pain – Treat the brain to treat the pain

Chronic Pain

Persisting and debilitating pain is not where you think it is. Compelling research evidence now points to this pain emanating from the brain after injury.  Acute pain from an injury to any part of the body should heal and eventually cease. However, pain signals from the damaged area can lead to areas of the brain that are sensitised and amplified where you don’t need painful (nociceptive) signals going to the brain (Bottom-Up), you can have all of the pain generated within the brain (Top Down) that leads to persistent and relentless pain.

This central (brain) sensitization is driven by inflammatory processes that recruit the brain’s own immune cells the microglial cells and astrocytes that keep the inflammatory process alive resulting in painful signals being continuously transmitted^{281, 282}.

The key to stopping or attenuating chronic pain syndromes is to deal with brain inflammation through the provision of all the nutrient resources needed to dampen this inflammatory process not drugs that target only specific metabolic pathways. It has to be a big picture approach that ensures an optimal intake of various forms of Magnesium including Magnesium Threonate known to penetrate the Blood Brain Barrier (BBB), Omega-3’s (EPA, DHA), Specialised Pro-resolving Mediators (SPMs derived from EPA and DHA) and a rich supply of plant chemicals called polyphenols that have a dampening effect on brain inflammation.

The Activ8Health approach is to provide all the micronutrients needed by cells for repair and resolution of inflammatory processes.

Chronic Pain: Key Points

• Inflammation is the driver from the very start of a painful stimulus, whether caused by trauma (injury) or bacterial infection. Tissue injury from any cause sets into motion an inflammatory cascade from the outset. This early inflammation is productive but should be resolved once healing occurs. Healing occurs through many immune cell released factors but these are created from critical factors derived from your diet. However, in overfed yet undernourished individuals in Western populations, dietary acquired inflammation-resolving factors are often lacking. These factors include phytochemicals from fruit and vegetables, Specialised Proresolving Mediators (SPMs) from Omega-3s or Magnesium that you get in abundance from dark-green leafy vegetables.
• Having inadequate nutritional resources for healing or dampening inflammation means that both the damaged peripheral tissues will keep on  sending pain signals to a brain that is as equally deficient in dietary derived inflammation fighting factors leading to brain sensitization and amplification of pain signals.
• In my mind, as a medically trained clinical nutritionist, it is folly to think that diet has nothing to do with pain processing. From abnormal Omega-6 to Omega-3 levels fuelling inflammation to gut microbiomes damaged by diet also driving inflammation in the brain through cytokines or inadequate short-chain fatty acid production (SCFAs) or gut-brain Vagus Nerve signals ²⁸².
• The Western diet is riddled with inadequacies, and dietetic advice is often given to go and consume the mythical optimal diet. Such advice is given to Western people where 60% of the population are overweight or obese, and 99% of individuals don’t consume even near an adequate intake of fruit and vegetables to provide the antioxidants, minerals and polyphenols (plant chemicals) that can dampen the brain’s inflammatory processes ²⁸¹. Chronic pain sensitisation and amplification thus occurs in the context of deficient nutrient resource, creating fertile ground for persistent pain syndromes.
• The MIND Smoothie or MIND dietary approach is research-based and can provide a rich source of phytochemicals including anthocyanins and polyphenols, fibre and magnesium. Discuss this with an Activ8Health Dietitian who can provide in-depth dietary analysis that includes nutrient intakes, nutrigenomic analysis (genetic analysis) and arrange a check on your Omega-3 levels.