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Pain: Causes and Cures

Over the past few months, I have had a run of clients reaching out because they were suffering from various pain issues – headaches, migraines, joint and muscle problems, and sometimes full body pain of unknown cause.  It has been so rewarding helping them reduce inflammation to reduce pain — and I thought this would be a good time to share more about the causes behind pain, since June is National Migraine Month!

Here is the super quick ‘n’ dirty summary: Three top factors are Food, Stressors, and Sleep issues. When these are off, they cause the release of proinflammatory cytokines and MEDIATORS. The over-release of these cytokines is known as “inflammation.” An “inflamed” body is also one of those Stressors (chemical stress) that triggers more mediators and thus more inflammation – a perpetual downward cycle. All of these mediators can hyper-stimulate a specific type of neuron in the body called a nociceptor. This can cause, sustain, and/or exacerbate pain… and that can cause more stress in the body, which can cause more inflammation, and the cycle repeats.
We must break the cycle of pain and inflammatory responses.

So this message will look at that in more detail – but still on an overview as it’s a VERY detailed topic – and then look at some of the ways lifestyle can be a factor in pain-inducing inflammation.

PAIN, CHEMISTRY, CAUSE

PAIN is multifaceted, and often have similar ROOT CAUSES whether it’s migraines, headaches, arthritis, fibromyalgia, or even DOMS and workout recovery aches and pains.

But before we go further…. If this is a topic of interest to you, then put away distractions.

We’re going science deep here….

Seriously, this won’t be a light read. Since pain is so pervasive, and such a generic symptom, I want you to be EMPOWERED to understand what is going on in your body. So wait till you have some time to focus on this. And know there ARE things you can do! If you’re struggling to understand, please reach out. I’m happy to talk more and try to answer questions.

First… what IS pain? Why does it happen?

I think most of us realize that our nervous system has a role in it. Did you know that only 10% of your nerves actually communicate pain? The major role of your nervous system is actually for the functioning of your body – to tell your heart to beat, to work your digestive system, to stimulate muscle contractions and movement… it takes external stimulation and helps translate it into response. But when that 10% is triggered, oh man do you know it!

Sometimes the triggering is obvious – an outside factor is causing damage, so your nerves tell you. The stove is hot. The nerve is pinched. The sun is too stark and hurts your eyes. The food is too spicy and burns your tongue. These are all over-stimulation of our nervous system.

But what about internal triggers that we can’t detect so directly?

There are different types of sensory neurons in your body. They include:

  • Mechanoreceptors – which sense touch and position (if your arm is bent at an bad angle)
  • Thermoreceptors – which sense temperature
  • Chemoreceptors – which sense taste and smell
  • Photoreceptors – which sense light and darkness
  • Nociceptors – which sense pain

And so that final one, nociceptors, is what we’re going to talk about.

When any other sensory neurons are so strong that they risk damage, or potential for damage, in the tissues or body, the nociceptors activate and kick in to warn us. That badly bent arm is TOO bent — pain. That stove is TOO hot — pain. And so on

But again, these are all external factors we can usually account for.

What is going on INSIDE that causes pain that we can’t figure out?

“Activation of nociceptors is modulated by inflammatory and bio-molecular influences in the local extracellular environment” according to Dr. Eric Garland in the article Pain Processing in the Human Nervous System: A Selective Review of Nociceptive and Biobehavioral Paths.

Note that: inflammation. A big part of the root cause.

“Proinflammatory cytokines” is a term for a group of small proteins that act on other cells, often causing pain or inflammation. There are many types of cytokines, including some odd names you may have heard of more with the events of the past 18 months: Interleukin-6 (IL-6), IL-1β, TNF-α, and so on.

Each of these different “proinflammatory cytokines” have different effects on the body. They all create inflammation (pro-inflammatory) which manifests in a variety of ways. Some cause heat like a fever, some cause GI disturbances like diarrhea or bloat, some cause pain, some trigger sinus issues, and yet others cause fatigue. But they all stem from things triggering inflammation in your body, setting you “on fire” so to speak.

These proinflammatory cytokines and other inflammatory MEDIATORS of the immune and inflammatory response can trigger and stimulate those nociceptors, influencing the sensation of pain.

“There is significant evidence showing that certain cytokines/chemokines are involved in not only the initiation but also the persistence of pathologic pain by directly activating nociceptive sensory neurons. Certain inflammatory cytokines are also involved in nerve-injury/inflammation-induced central sensitization, and are related to the development of contralateral hyperalgesia/allodynia.” And some cytokines stimulate the creation of additional cytokines (if you heard the term “cytokine storm” at the beginning of the pandemic, this is a simplified explanation of that. One cytokine triggers another to respond, which triggers another, and another). The overall summary meaning of that is that proinflammatory cytokines can cause pain, can make pain last, make pain worse, and cause additional inflammation which cyclically perpetuates pain issues.

So.. inflammation = pain, in many cases. And Pain increases inflammation.

Viscous cycle.

Inflammatory responses in the peripheral and central nervous systems play key roles in the development and persistence of many pathological pain states. They are a part of the immune system, and often SHOULD be triggered when there is a legitimate invader in the body that must be attacked. When the immune system sees a foreign entity, such as a bacterial or viral invader, it is supposed to react and release some inflammatory response. A moderate response is good: sending white blood cells to a cut to prevent infection. The heat of a fever to kill off a pathogen. (Note: 80% of your immune system is affected by your GI tract, hence my large focus on GI health and inflammation for wellness)

But when it is caused from other sources (such as food that normally is considered healthy), or is over-reacting, or is reacting to a PERCEIVED threat rather than an actual threat (such as autoimmune, when your immune system attacks your own body in mistake), then we start to have chronic issues. Among many other manifestations, pain is common.

So inflammation is a big factor – and many things cause inflammation in the body. The biggest 3 are Food, Sleep Issues, and Stress (physical stress, psychological stress, chemical stress, biological stress, hormonal stress).

Foundations of Health

I believe each of these factors is important to address in nearly all health issues. Each plays a role in health, and each includes possible causes behind pain. So let’s explore them!

NOTE: This is a very abbreviated list, as I’m already on page 3 of my notes – and the full summary came out to 8 pages and was growing! So this is the shortened version, but I hope gives you some ideas of places to start. Just know that, if this doesn’t help, there is a lot more that we can dive into more deeply and personalized.

Mindset – self talk, thoughts, goals

While the mind is incredibly powerful, and I do believe it can have SOME impact on our physical sensations… This is NOT the major factor for the majority of people. Instead, when people are told “it’s all in your head,” that is an arrogantly obnoxious and viciously ignorant way of saying, “I don’t know the solution so rather than admitting my limits or conceding there could be a cause I am just unaware of, I will brush this off on you and say it is you faking it or needing psychotherapeutic help. There’s no way I could possibly be unaware of the solution – it’s just you.”

My first business motto had been “Validation, Answers, Restoration.” And it still is, in my mindset with my work.

It is NOT just in your head. You are NOT crazy.

If your doctor EVER says that it’s all in your head and there is no solution, fire them, find a better doctor, and come talk to me. This enrages me!!

Moving on…

A mere SAMPLING and highlighting of the VAST possible things that can be behind pain and health issues. And I’ll admit right here, there are many things I’m not including in this list due to time (I could write volumes!), and probably others that I’m not including because I am not aware of them. I, too, have limits to my knowledge and training and time for research.

Physicality – posture, alignment, movement.

This sometimes is the simplest to explore and use or rule out. If our posture is bad, our body often will ache. Sitting all day at a desk, hunching over a screen, sleeping on a bad mattress will all lead to stiffening of the joints and muscles, headaches and backaches.

  • Address posture throughout the day
  • Work on range of motion, stretching
  • Ergonomic workstations
  • Routine movement throughout the day, not just the gym
  • Massage and muscle tensions
  • Myofacial Release work
  • Proper breathing … which segues us to the next wedge

Stress – breathing, cortisol or other hormonal stresses, tension, lack of outlet

We spend the majority of our life in a low-level “fight or flight” mode – “being chased by a tiger in slow motion” as one of my teachers put it. We are constantly vigilant to “threats” around us. That looming deadline. That stressful company meeting. That nausea-inducing public talk. That financial worry. That intimidating boss or co-worker. That chaotic schedule.

And when we are in that state, this can lead to:

  • Shallow breathing
  • Tension in head, neck, shoulders perpetuating headaches and migraines
  • Stiff ribs, back, hips perpetuating low back pain
  • Elevated cortisol (stress hormone), chaotic heart rate and anxious brain waves
  • Shifted ratio of oxygen and carbon dioxide in our bodies which boosts anxiety
  • Less ability to release metabolic waste through respiration (which SHOULD be happening), which can then get shunted to muscles and joints, and perpetuate stiffness and fatigue.

We need to learn to breathe right – as odd as it sounds! It can help with pain. It helps with fixing those muscle imbalances, stretching the body, providing needed oxygen, and even helps lessen the messages to and from the nociceptors.

Other Types of Stress:

  • Hormonal stress  (think PMS and elevated headaches, back aches, etc) Imbalanced progesterone and estrogen can worsen pain
  • Chemical stress, such as certain medications, pollutants, cleaning supplies, etc. (ie: bonfire headaches, sensitive to perfumes or detergents, toxic burden buildup, mold, heavy metals, mercury fillings, etc)
  • Psychological Stress: Anger, jealousy, envy, grudges… they all hold on to negative emotions that shift our hormonal balance. It keeps your cortisol, blood sugar, and potentially blood pressure up. All inflammatory and risk stimulating pain. And mental stress from work, responsibilities, classes, and more. It works in similar ways.

Sleep – Poor Quality, Poor Quantity

QUALITY matters:

  • Practice good sleep hygiene, such as having a screen-free wind-down routine, early dinner, cool and dark room, and proper bedding.
  • This overlaps with Physicality – if you have poor support from your bed or pillow, it can exacerbate pain issues.
  • Even one night of poor sleep, can double the amount of inflammatory agents (UCLA study)

And QUANTITY matters:

  • The average person really does need 7-8 hours of dedicated sleep time, and it needs to get you into deep sleep and REM cycles. More if you are active, or have a chronic illness, or are in pain.

Nutrition (and gut health) – the foods and supplements we consume, and our body’s ability to actually absorb and utilize.

  1. First and foremost – stay hydrated. It helps lubricate joints, flush your system, and sometimes can help with pain issues and head pressure.
  2. Start with the basics – cut the junk. Sugar, processed foods, fried foods, fake sweeteners, and more are all inflammatory. So eat whole foods.
  3. Go a step deeper – aim for high quality. Organic, free range, grass-fed and grass-finished, wild caught. That reduces the chemical burden in the food, and thus helps with your own inflammation.
  4. Go another step deeper – remove whole foods that are commonly inflammatory: Gluten, dairy, soy. I have run many free 7 day challenges on Facebook using a whole foods, low inflammatory food list and I often hear people state that their pain levels drop and sleep improves in a mere 7 days. (Jump in my free Facebook group to learn when the next 7 day challenge will be!)
  5. Supplement it up – (nutrients involved in pain) get a blood test to see which nutrient you may be lacking. All of these can play a role in triggering or sustaining pain if lacking, especially when combined with previously discussed issues.
  6. Gut Check – focus on gut health. This is where the immune system and inflammation stem from. This is where nutrients get broken down so they can be absorbed. This is where the fuel you need can get to your body. IF it’s all functional. If your gut is not functioning correctly, YOU are not functioning optimally. And the cycle of inflammation causing pain perpetuates.
  7. Step it up to a THRIVE Level – get your blood tested by signing up for the ImmunoCalm Diet Program and MRT Test “Mediator Release Test” (vid example here) where we not only address all lifestyle factors and get you set for SUSTAINED results, but we test your blood against 170 foods and chemicals to see exactly how much of an inflammatory response each item has in your body. We then work systematically through an elimination diet over 6 weeks to make sure we minimize as much inflammation and therefore pain as possible. Once your body has had time to “cool off” from the fires of pain, we then can ease you back into a sustainable eating style to maintain for life.

I discussed more about the role of food sensitivities in migraines in this blog post from 2019, “Migraines and Food Sensitivities” A key takeaway:

“Diet often plays an important role in migraine pathophysiology because 60% to 80% of the immune system is in the gut… When a susceptible individual eats a reactive food or chemical, the immune system releases mediators such as cytokines, leukotrienes, or prostaglandins, which in turn produce pathophysiologic effects such as clinical and subclinical inflammation, pain receptor activation, neurological and endocrine dysfunction, or edema. These effects are implicated in chronic inflammatory conditions such as migraines, irritable bowel syndrome, eczema, fibromyalgia, chronic fatigue, and rheumatoid arthritis, which is why these conditions are frequently comorbid.” [meaning: certain foods trigger your immune system to go haywire, leading to many different types of symptoms, including pain!]

SUMMARYLifestyle as Medicine

ROCKET up to the top level – combine it all with the Empowered Healing Program! In addition to the MRT test and ImmunoCalm diet, you are guided through 10 weeks of lifestyle resetting where we go into more depth with these topics to make sure we’re tackling your pain from all angles and ruling out as many paths as possible while optimizing each. We also include 1 additional lab based on your symptoms so we can make sure we hit it all (GI test, adrenal test, nutrient test, etc, tailored to your needs)

  • A young woman with migraines who is a piano teacher learned her issues were: food, posture, stress. We did her ImmunoCalm diet, worked out knots in her neck from hunching over students’ shoulders, and she reduced her work load from 5 days to 4. And she now doesn’t have to call off sick twice a month due to migraines.
  • A Boxing instructor with weekly migraines focused on her ImmunoCalm program and went from weekly migraines that lasted 3-5 days, to monthly migraines lasting only 1 days and reduced intensity.
  • A mother with constant unknown pain from feet to torso for years reduced pain to almost zero in weeks with food choices.
  • A 52 year old tennis player and business owner with screws in her ankle got back to the courts lighter and more spry than she had in years, with much less stiffness and pain in her body and ankle, gaining compliments on her performance and youthful looks after focusing on sleep and diet changes.
  • A 40 year old woman who had to quit working a job she loved due to excessive pain and brain fog. She worked with over 40 other health professionals with no results. We focused on clean eating, myofascial work, and gut health to get her to her lowest pain in 7 years.
  • A busy mom of 3 who had been trying sub-par food sensitivity tests every 4 months for 4 years without migraine relief, still having them 3-5 days per week… went down to 1 per month with just a food focus.

So if you’re sick and tired of being sick and tired, let’s dive in. Let’s get you feeling better FAST so you have more energy and less pain to then dive deeper if needed into other layers of the root cause.

Fill out this form if you’d like a free consultation call to see what the best strategy is for you!

Stop hurting, start living your best life!

Strive to Thrive.

Published by Kate Cline, RD

Registered Dietitian with a focus on Gut Health, Inflammation, and Functional Nutrition. Personal Trainer with a focus on corrective exercise. Yoga teacher, traveler, empowerment coach.

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