Therapists frequently deal with clients after an injury, diligently working to ease the client's pain, reduce inflammation and promote the process of healing. As a trusted source of healing touch to your client's complaints of pain, you can also be a valuable resource for nutrition information that can aid in their pain relief. According to a recent Massage Today poll, information about nutrition and health is of great interest to massage therapists. (See March 2009 poll results in poll archives.) Massage clients are also interested in overall health, specifically natural alternatives to traditional medicine. Common fruits and vegetables, herbs, and vitamins can play a vital role in the healing and prevention of an injury, while other foods can contribute to pain, slow the process of healing, and even produce inflammation. In the following article, Dr. David Seaman, clinical nutritionist, provides valuable information for your client's path to wellness by explaining the common pitfalls of painful diet choices as well as alternatives to pain-relieving drugs.

Americans take an inordinate amount of medication to reduce pain and inflammation, most notably acetaminophen, aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen. In fact, it is estimated that each year, Americans purchase literally billions of over-the-counter (OTC) anti-inflammatory drugs. How do these medications work? By inhibiting the enzymes that normally convert dietary fatty acids into inflammation-producing chemicals that can cause pain.

Dietary choices directly contribute to inflammation, pain and suffering; common medications only serve as a short-term "fix." The source of the problem is poor diet; making changes in your food choices is the sensible solution. By the way, the side effects from these medications range from intestinal ulcers to reduced bone health, stroke and heart attack. Clearly, it is a good idea to use these medications sparingly.

Painful Diet Choices

The modern diet consists largely of nutrient-free calories: approximately 20 percent from refined sugar, 20 percent from refined flour and 20 percent from refined oils derived from corn, safflower seeds, sunflower seeds, cottonseeds, peanuts and soy. Oh, and don't forget another 10 percent to 20 percent from overweight or obese animals. That means for too many people, 80 percent of the calories they consume promote inflammation and thus pain, and lack any appreciable nutrient quality at all.

It is highly unlikely that taking NSAIDs or supplements will reduce pain and suffering for those individuals who subsist largely on these types of foods. That means the first order of business is to reduce the consumption of foods that cause inflammation and pain. Refined oils and fatty meat are known to contain an excessive amount of omega-6 fatty acids, which are generally inflammatory compared to omega-3 fatty acids. Oily potato and corn chips are excellent examples of foods with calories derived largely from the oils mentioned above (which contain only omega-6 fatty acids). In contrast, omega-3s are found in green vegetables, certain seeds (flax, chia and hemp), fish, and wild game or grass-fed animals, from which less than 10 percent of the average American's calories are derived.

Alternatives to 
Pain-Relieving Drugs

Most of our calories should come from vegetables, fruit, fish, lean meats and nuts. These foods reduce heart disease because of their anti-inflammatory nature. In 1991, this type of diet was used in a study with patients suffering from rheumatoid arthritis, a debilitating, painful disease, resulting in a substantial reduction in pain.

When considering supplements to help reduce pain, it is important to realize that pain expression is based on physical, psychological,and biochemical factors. From a biochemical perspective, it is important to remember that the chemicals which cause inflammation are the same ones that cause pain. Therefore, our goal with supplementation should be to help reduce inflammation.

Fish oil is one of the more popular supplements on the market today and can be taken by almost anyone who is not taking blood-thinning medications such as warfarin (Coumadin). Studies have shown that supplemental fish oil is helpful for patients with neck pain and back pain, as well as joint pain associated with rheumatoid arthritis, psoriasis, and ulcerative colitis. The common supplemental recommendation is 1-3 grams of EPA/DHA, which are the omega-3 fatty acids found in fish oil. This typically means 2-5 capsules daily if a concentrated fish oil is used for supplementa-tion.

Vitamin D has emerged in recent years as a vitamin that has anti-inflammatory and anti-pain benefits. Autoim-mune diseases, such matory in nature and associated with vitamin D deficiency. Low back pain and widespread pain that can be confused with fibromyalgia are also known to be associated with vitamin D deficiency. We get vitamin D from the sun, but its production is reduced 95 percent when a sunscreen with a sun-protective factor (SPF) of 8 or greater is applied to the skin. No food contains adequate amounts of vitamin D, so we must either get it from the sun or from supplements.

Magnesium: Ever since I can remember, we have been bombarded with information about calcium, while magnesium is rarely emphasized. Yet more than 300 enzymes require magnesium, so it is involved in an inordinate amount of metabolic reactions. From a clinical perspective, the average American's intake of magnesium is well below the recommended daily allowance (RDA) and this has been associated with the expression of numerous conditions including heart disease, hyper-tension, diabetes, osteoporosis, headache, chronic inflammation, and an increase in nervous system excitability. Approxi-mately 400 mg of supplemental magnesium per day is thought to be adequate for most individuals. (Note: The most common side-effect associated with magnesium supplementation is diarrhea. However, I take 1,000 mg of magnesium daily and have normal bowel function, while others take 400 mg and get diarrhea. The average person is able to tolerate 400 mg. As always, have your clients talk to their doctor before taking any supplement for the first time.)

Probiotics: Research is emerging that implicates poor digestive function with musculoskeletal pain expression. This speaks to the need to drastically reduce our consumption of sugar, flour products and refined oils that are devoid of fiber and known to compromise healthy gut bacteria. Supplementation with healthy bacteria called "probiotics" (Lactobacillus aci-dophilus and Bifidobacteria) are known to reduce intestinal inflammation, and for many this translates into less musculoskele-tal pain as well.

Ginger and Turmeric: Most herbs that we use to spice our meals are known to have anti-inflammatory functions. The most well-studied in the context of inflammation and pain are ginger and turmeric. Each has been shown to reduce musculoskeletal pain. The most economical way to take ginger and turmeric is with meals as an added spice. However, supplements are available and widely utilized. (I personally spice my meals and take a ginger/turmeric supplement.)

B Vitamins: The creation of cellular energy requires most B-complex vitamins. While B vitamins are not traditionally viewed as anti-inflammatory or analgesic, human and animal research suggests that B-vitamin supplementation may offer pain-reducing benefits.

The next time you discuss pain relief with your client, inform them of these simple dietary and supplement strategies, which have brought substantial relief to many individuals. Encourage them to discuss drugless solutions with their doctor

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Foods That Promote Inflammation

• High-fat meats (especially red meat)
• Processed meats
• Sugary snacks, sodas and cereals
• Refined grains
• Candy and other junk food

Foods That Discourage Inflammation

• Salmon and other oily fish
• Flax/pumpkin seeds
• Olive oil
• Whole grains
• Brightly colored fruits and vegetables