Chronic pain is defined as pain that persists for at least 3 months. It is a public health problem that affects millions of people worldwide. It is estimated that more than 1 in 5 adults in the USA suffer from chronic pain [1]. Chronic pain can be caused by a variety of underlying conditions, including arthritis, nerve damage, and fibromyalgia. It can impact every aspect of a person’s life, from physical function to emotional wellbeing. While medical procedures, medication and other medical treatments can be helpful in managing chronic pain, lifestyle changes also play a significant role in helping people cope with their symptoms. We will explore some lifestyle changes that can help manage chronic pain.

Make sure you are eating a healthy diet.

The first and most important lifestyle change for managing chronic pain is a healthy diet. Although there exist different categories of chronic pain and each type of chronic pain may have multiple causes, most chronic pain conditions are related to inflammation. Inflammation is the body’s response to injury, aggression, or damage. A diet that is rich in fruits, vegetables, whole grains, and legumes can help reduce inflammation and improve overall health. In addition, some foods have been shown to have anti-inflammatory properties, including omega-3 fatty acids, found in chia seeds and nuts, and turmeric, found in curry powder. Avoiding processed foods that are high in added sugar and fat can also help reduce inflammation. Therefore, you should steer clear of calorie rich and processed (CRAP) foods and drinks. I like to tell my patients to “cut the crap”. You should also avoid meat. Consumption of meat is associated with enhanced inflammation increasing the chance to develop chronic pain conditions [2]. If you cannot abolish meat from your diet, try to eat white meat no more than 2 times a week and red meat no more than once a week [3]. A healthy diet will also help with weight loss which has been proven to help relieve back, knee and hip pain.

Stop smoking.

Stop smoking is the second most important change to help relieve chronic pain. Smoking can have a significant impact on chronic pain, as it can exacerbate pain symptoms and make them more difficult to manage. Smoking also worsens inflammation in the body, which leads to increased pain. There is also evidence to suggest that smoking can lead to structural changes in the brain that can worsen chronic pain. Specifically, smoking has been shown to reduce the gray matter in certain areas of the brain that are involved in pain processing. This can make it more difficult for individuals with chronic pain to manage their symptoms and may contribute to the development of chronic pain disorders [4]. Therefore, individuals with chronic pain who smoke should seriously consider quitting to improve their pain condition.

Exercise regularly.

Another lifestyle change that can be helpful in managing chronic pain is regular exercise. Exercise has been shown to be an effective way to reduce pain and improve physical function in people with chronic pain [5]. Exercise can also help reduce inflammation, increase blood flow to the painful area, and release endorphins, which are the body’s natural painkillers. Exercise also helps to strengthen muscles, which can help support and stabilize joints and reduce pain. The Centers for Disease Control and Prevention (CDC) recommends 150 minutes of exercise per week and 2 days of muscle strengthening activity. Some people with chronic pain cannot achieve this goal because of the intensity of their pain. In these cases, in the absence of other medical contraindications, I recommend moving as much as possible to preserve muscle mass.

Exercise can also help reduce inflammation, increase blood flow to the painful area, and release endorphins, which are the body’s natural painkillers.

Make sure you get enough sleep.

Getting enough sleep is also crucial for managing chronic pain. Chronic pain can disrupt sleep, and lack of sleep can worsen pain symptoms. Establishing a regular sleep routine, avoiding caffeine and alcohol before bedtime, and creating a comfortable sleep environment can all help promote restful sleep. It is also important to treat sleep problems such as obstructive sleep apnea and insomnia because these conditions are associated with worsening pain [6].

Use strategies to deal with stress.

Stress reduction is another important lifestyle change for managing chronic pain. Chronic pain can be stressful, and stress can exacerbate pain symptoms [7]. The release of the stress hormone cortisol becomes dysregulated when stress is prolonged which predisposes our body to disease including the development of chronic pain. It is not possible to avoid all stress in our lives, but there are skills to help manage it in a positive way. Techniques such as meditation, deep breathing, and progressive muscle relaxation can help reduce stress and promote relaxation. Mind-body therapies, such as yoga and tai chi, can also be effective in reducing stress and promoting relaxation.

In conclusion, managing chronic pain is a complex and challenging process that often requires a combination of medical treatments and lifestyle changes. Regular exercise, a healthy diet, stress management, getting enough sleep, and smoking cessation are all important lifestyle changes that can help reduce pain symptoms and improve overall health and wellbeing. While lifestyle changes may not eliminate chronic pain completely, they can significantly improve a person’s quality of life and their ability to cope with their symptoms.

References

1. Yong, R.J.; Mullins, P.M.; Bhattacharyya, N. Prevalence of chronic pain among adults in the United States. Pain 2022, 163, e328-e332, doi:10.1097/j.pain.0000000000002291.
2. Seaman, D.R. The diet-induced proinflammatory state: a cause of chronic pain and other degenerative diseases? J Manipulative Physiol Ther 2002, 25, 168-179, doi:10.1067/mmt.2002.122324.
3. Rondanelli, M.; Faliva, M.A.; Miccono, A.; Naso, M.; Nichetti, M.; Riva, A.; Guerriero, F.; De Gregori, M.; Peroni, G.; Perna, S. Food pyramid for subjects with chronic pain: foods and dietary constituents as anti-inflammatory and antioxidant agents. Nutr Res Rev 2018, 31, 131-151, doi:10.1017/S0954422417000270.
4. Sutherland, M.T.; Riedel, M.C.; Flannery, J.S.; Yanes, J.A.; Fox, P.T.; Stein, E.A.; Laird, A.R. Chronic cigarette smoking is linked with structural alterations in brain regions showing acute nicotinic drug-induced functional modulations. Behav Brain Funct 2016, 12, 16, doi:10.1186/s12993-016-0100-5.
5. Borisovskaya, A.; Chmelik, E.; Karnik, A. Exercise and Chronic Pain. Adv Exp Med Biol 2020, 1228, 233-253, doi:10.1007/978-981-15-1792-1_16.
6. Rhon, D.I.; Snodgrass, S.J.; Cleland, J.A.; Cook, C.E. Comorbid Insomnia and Sleep Apnea are Associated with Greater Downstream Health Care Utilization and Chronic Opioid Use after Arthroscopic Hip Surgery. Pain Physician 2019, 22, E351-E360.
7. Timmers, I.; Quaedflieg, C.; Hsu, C.; Heathcote, L.C.; Rovnaghi, C.R.; Simons, L.E. The interaction between stress and chronic pain through the lens of threat learning. Neurosci Biobehav Rev 2019, 107, 641-655, doi:10.1016/j.neubiorev.2019.10.007.