The Link Between Joint Pain & Gut Health
Did you know that joint pain could be related to your gut health? In this article will discuss the mechanisms and how you could help improve your joint pain through nutrition to optimise your gut health.
Chronic Pain
Chronic pain is a common, complex, and distressing problem that has a profound impact on people and society. Over 28 million people in the UK experience chronic pain, in England and Wales, more than 2 million women have osteoporosis, 8.75 million people aged over 45 years in the UK have sought treatment for osteoarthritis. Conventional approaches to chronic pain often lack efficacy, and many are left taking pain-relieving medications daily to manage symptoms.
Gut Health
Disruption of the microbial balance (dysbiosis), can lead to inflammation through the release of proinflammatory cytokines and the production of inflammatory metabolites. This means that intestinal dysbiosis could be a contributor factor to systemic inflammation and joint pain. Moreover, research is increasingly pointing towards dysbiosis as a contributing factor to metabolic conditions like obesity and type 2 diabetes, which further increase inflammation and the risk of chronic pain. Our nutritional approach to achieve pain relief includes a comprehensive evaluation and treatment of the gut health as well as osteopathic and nutritional support of the entire musculoskeletal system.
What is the Gut's Role in Joint Pain?
The gut and joint pain are related through a complex interaction known as the gut-joint axis. The gut plays an important role in regulating the body's immune response, and it has been suggested that disruptions to the gut microbiome can affect our joints through the development of autoimmune disorders, inflammation and pain.
Below are few of the most common culprits:
Inflammatory Diet
An inflammatory diet is normally low in fruits and vegetables and high in unhealthy fats, sugar, and processed foods. Large portions of nutrient-poor foods could exacerbate common nutrient deficiencies afflicting the majority of the population. Also, plenty of evidence supports the hypothesis that poor quality diet lowers immune function and increases systemic inflammation.
Autoimmunity
Dietary influence on autoimmune and arthritic conditions like Rheumatoid Arthritis (RA) has been widely studied as a potential tool for prevention and management of RA. RA is an autoimmune disease that causes joint pain, swelling, and erosion. Dietary habits could represent both disease risk and protective factor, based on the properties of specific foods. In fact, specific dietary choices can indeed show pro-inflammatory effects or on the contrary reduce inflammation. RA is more prevalent in Western countries compared to the Eastern world and developing countries. The Western diet is characterised by a high intake of red meat, saturated and trans fats, a low ratio of omega-3:omega-6 fatty acids and high consumption of refined carbohydrates, which increase inflammation and induce insulin-resistance and obesity. Moreover, diet represents a major factor influencing our gut microbiota, which has been involved in the development of the disease. In fact, studies suggest that alterations in the composition of the microbial flora occurs in individuals in the preclinical stages of rheumatoid arthritis (RA) and in those with established RA.
Autoimmune thyroid conditions like Hashimoto’s thyroiditis can also be a cause for achy muscles and joint pain. Hashimoto’s can be linked to poor gastrointestinal tract health like leaky gut and food sensitivity.
Obesity
Over one in four adults in England are living with obesity. Increased body mass index (BMI) and obesity are know risk factors for soft tissue and joint damage, commonly contributing to arthritis and exacerbating the severity of associated joint pain. Modest weight loss through dietary and lifestyle modifications, among other therapeutic interventions, can limit arthritis progression and improve activity levels.
Dysbiosis
Our gut hosts 70% of our immune system. The immune system and the gut microbiome are intimately connected and a healthy gut microbiome is essential for our immune system regulation and for normal inflammatory responses. In fact, the immune cells and gut microbes constantly communicate to influence body function. Changes in microbiome composition impact immune function, and specific dysbiotic patterns can promote pro-inflammatory immune responses. That’s how gut dysbiosis has been implicated in the development of multiple forms of inflammatory arthritis.
Neuroinflammation
Furthermore, microbes mediate communications among the metabolic, peripheral immune and central nervous systems via the gut–brain axis. Dysbiosis, therefore, can interfere with neurotransmitter synthesis in the nerve cell and trigger neuroinflammation, negatively influencing how the nervous system sends and perceives pain signals.
Leaky Gut
Intestinal dysbiosis can also increase the production of zonulin, a protein that increases the permeability of tight junctions between cells of the wall of the digestive tract. Leaky gut causes an exaggerated pro-inflammatory immune activation and the additional increase in environmental agents damaging the gut epithelial barrier underlies the rise in allergic, autoimmune and other chronic conditions.
Food Sensitivities
Food sensitivities like gluten sensitivity or lactose intolerance can cause or occur from a leaky gut. Unlike food allergies, food sensitivities are not immune mediated. People sensitive to a certain foods experience discomfort symptoms (like IBS, reflux, bloating etc) but also more systemically around the body. Symptoms like joint pain, abdominal pain, changes in bowel movements, fatigue and skin rashes can be related to food sensitivities which can occur immediately or days after ingesting the trigger food(s).
Nutrient Deficiencies
Moreover, genetic conditions like Coeliac disease or IBD, characterised by chronic intestinal inflammation, impair proper nutrient absorption due to their altered digestive processes. This impairment can lead to malabsorption and micronutrient deficiencies commonly causing low levels of iron, vitamin D, magnesium, omega 3 fatty acids and zinc, all of which are essential for proper musculoskeletal health function.
How to Reduce Joint Pain Due to Poor Gut Health
A nutritional approach to the gut-joint axis is personalised and based on symptoms, diagnosis, test results, and food intake. Proper nutritional intake and absorption, adequate hydration and lifestyle changes are some of the basic principles to address for optimal joint pain resolution.
Dietary Changes
Dietary changes can lower systemic inflammation and result in the improvement of joint pain. There is no magic diet to treat joint pain, but by being targeted and utilising a food-as-medicine approach, we give our bodies the best chance of recovery. We can build a healthy microbiome, regulate the immune system and reduce systemic inflammation in the body.
Anti Inflammatory Diet
Anti-inflammatory or mediterranean diets can help to reduce inflammatory markers as typically these diets include fibres, omega 3 fatty acids, magnesium and B vitamins. Elimination of processed foods is important due to their negative impact on the gut microbiome and general health. Increasing plant based diets rich in fibres, prebiotic and probiotic foods is beneficial for gut health.
Hydration
Lack of proper water intake can increase pain sensitivity and affect your bowel function. General water intake recommendations are 6-8 glasses of water per day.
Stress
Stress and dysfunction of the vagus nerve can have a negative impact on the gut-brain axis and it can affect your digestive, immune, and nervous system function. Increasing your vagal tone can help balance neurotransmitter production and improve health outcomes especially in the gut. Vagal nerve stimulation practices include Pilates, meditation, breath work, humming, gargling water, and heat and cold exposure.
Summary
The gut plays a critical role in regulating the immune system and maintaining a healthy inflammatory balance. An increasing number of scientific research acknowledges the relationship between arthritis, chronic pain and poor gut health. This is why supporting the gastrointestinal system, through cranial osteopathy and nutrition, is one of the primary aims with joint pain sufferers. Promoting structural and mechanical gut function, balancing the gut microbiome, and healing intestinal permeability and inflammation are key components involved in our joint pain treatment plan.
Eleonora is a Nutritional therapist, structural & cranial Osteopath and Pilates instructor. She is passionate about getting to the cause of chronic joint pain issues so believes the combination of nutrition and Osteopathy makes the difference.