The following article by Pamina Barkow was first published in the Reflex Sympathetic Dystrophy Syndrome Association Review. *Click here to download the pdf of the Article! (PDF)*
As a clinical nutritionist in a pain management clinic, I see people suffering in varying degrees of pain. Few cases have touched me on a personal level like those with advanced complex regional pain syndrome (CRPS). Perhaps that’s because the more the medical field learns about CRPS the more we realize there are variables and unknowns and that often there are more questions than answers. Luckily, there are many indicators that show that changing dietary habits, specifically following an anti-inflammatory diet, can have a significant positive effect on people with CRPS.
What is inflammation?
Inflammation, from the Latin meaning “I ignite,” describes the body’s biological defense response to remove harmful or irritating events to our bodies and to begin the healing process. Inflammation is initially a positive and necessary response that can manifest as pain, heat, redness, swelling and loss of function. For example, if you fall and hit your knee and then it swells, inflammation is telling your body that your knee needs rest in order to heal.
Chronic inflammation has drastic effects on the body. Moreover, it becomes a self-feeding cycle that prevents the body from working optimally. Chronic inflammation has ties to cancer, diabetes, depression, heart disease, strokes, Alzheimer’s, muscle loss, and many other conditions including pain, nerve damage, and CRPS.
CRPS is often described as injury to a nerve or soft tissue that does not follow the normal healing path. Many physicians agree that the complications and pain stemming from CRPS are due to exaggerated local inflammation. Basically, this means that if you have CRPS, you also suffer from chronic inflammation.
What is an anti-inflammatory diet?
An anti-inflammatory diet focuses on eating foods that heal and naturally reduce inflammation and also reduce triggers of inflammation. It means seeking out fresh greens, vegetables and fruits, giving up processed foods, watching salt and sugar intakes, eating whole grain carbohydrates, increasing intake of legumes and healthy fats, cutting out unhealthy fats, seeking out grass-fed and wild sources of proteins and increasing daily water intake.
Foods in an anti-inflammatory diet are nutrient dense; they provide a high nutrient ratio for the amount of calories. They are easy for our body to break down and extract nutrients from and in turn we get energy and healing agents from them. We call these foods anti-inflammatory foods because they literally promote calming of inflammation in our bodies. On the other end of the spectrum are foods that are difficult to break down, don’t provide much nutrition, and actually increase inflammation in our system. We call these foods pro-inflammatory foods because they add fire to the inflammatory cycle.
Benefits of an anti-inflammatory diet
Following an anti-inflammatory diet provides the building blocks to:
- prevent further nerve damage
- help heal current nerve damage
- increase circulation
- improve sleep
- increase overall health
- restore optimal weight
- improve nutrient absorption
- increase energy
- decrease pain perception
- improve mood
- increase joint mobility
- prevent major and minor illnesses
- strengthen immune system
Super-foods and super-nutrients for those with CRPS
Four primary groups of foods directly fight inflammation:
Healthy fats, especially omega-3s, decrease cholesterol, hypertension, clumping of blood vessels, increase circulation, aid the cardiovascular system and are COX-2 inhibitors (decrease inflammation and pain pathways).
Examples: fish, olive oil, flaxseed oil, canola oil, walnut oil, nuts (especially almonds), and avocados.
Foods that contain bromelain, carotenoids, flavenoids, and magnesium salicylate work to decrease inflammation in the body. Magnesium salicylate is even classified as a NSAID (non-steroidal antiinflammatory drug) in high doses.
Examples: artichokes. spinach, sweet potatoes, apples, all berries, basil, mint, broccoli, cucumbers, parsley, onions, tomatoes, and many more.
Foods that contain amino acids glutamine and lysine. Glutaminc aids in anti-inflammation, especially in the lower digestive tract, while lysine decreases inflammation by maximizing other molecules’ effects of anti-inflammation.
Examples: fish, seafood, poultry, grass-fed beef, bison, soy, lentils, peas, and many more.
Anti-inflammatory herbs decrease inflammation by “altering the levels of molecules that stimulate inflammation.” Examples: Aloe vera, echinacea, garlic, ginger, licorice, tumeric and manymorc.s In addition, those with CRPS benefit from a daily multi-vitamin, high doses of omega 3s capsules along with vitamin E (protects the anti-inflammatory powers of fish oil), complex B vitamins, and vitamin C (to increase circulation and blood cell production).
Pro-inflammatory triggers for those with CRPS
There are a number of pro-inflammatory triggers that are particularly important to watch, including:
Unhealthy fats (over-consumption of omega 6s and saturated fats as well as hydrogenated [trans] fats; found in high-fat cuts of meat and whole-dairy products) promote increases in blood cholesterol and LDL cholesterol as well as increases the risk for atherosclerosis, increased triglycerides, increased C-reactive proteins (which lead to inflammation) and decreased HDL (good) cholesterol. They increase the risk of heart disease and type 2 diabetes and contribute to the development of cancer. Trans fats are the worst of the bunch because they provide no benefit whatsoever.
High levels of sugar and empty carbohydrates (high glycemic index foods) provide no nutritional value and are pro-inflammatory. Sugars along with alcohol block absorption of many nutrients including water-soluble B and C vitamins that are crucial for people with CRPS.
Smoking (cigarettes, pipe or marijuana), “exacerbates the activity of your body’s inflammatory cells… and accelerates the formation of highly toxic and mutagenic substances… fueling inflammation.
Alcohol (regular drinking) raises your body’s inflammatory level by increasing oxidative stress and blocks the absorption of essential nutrients (water soluble vitamins in particular).
Lack of sleep (less than six hours of sleep per night) raises pro-inflammatory markers IL-6 and TNF-alpha and C-reactive proteins. Sleep is also the time that your body uses to heal and create new tissue.
Excess weight/overweight not only promotes inflammation but is considered a “state of low-grade systemic inflammation,” which is also a state of chronic inflammation.
Gluten intolerance does not simply manifest as digestive unrest or inflammation but it can cause nerve damage. Therefore, people with any sort of neuropathy, including CRPS, are at higher risk for having this intolerance. I suggest that people with CRPS do an elimination diet (remove all triggers) or some other type of testing to measure food intolerances.
Although CRPS can be difficult to manage, making even small changes to your diet can help you feel better.