Healing Foods for Back Pain
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Welcome to the Back Pain Solutions Podcast – Healing foods for back pain
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Introducing ‘Healing foods for back pain’!
Most people would not expect their food choices to have an influence on pain and recovery. However, research demonstrates that nutrition can have an impact on inflammation as well as overall health. So how does nutrition affect pain, and what food choices should we be considering to help manage inflammation?
In this episode we discuss the impact of nutrition on pain and recovery. Just how important is our gut health, and how can the foods we eat influence the body’s response to injury? We discuss how there is a growing body of research, which supports the link between nutrition and inflammation. We also discuss just how nutrition can influence pain, and the considerations that should be made to help optimise it?
How can nutrition influence pain?
There are multiple factors to consider when looking at the impact of nutrition on our health but broadly speaking there are 2 key elements that we want to consider. Firstly there is our gut health, and the influence this has on our response to inflammation. Then there is a consideration for the availability of energy to support recovery.
The gut is composed of both the small and the large intestines, which differ considerably. The small intestine is much longer, and is enzymatically driven, whilst the large intestine is shorter and bacterially driven. The role of the bacteria within the gut is a matter of considerable interest and studies have established that our intestinal ‘microflora’ are essential for the development, and function, of the immune system during early life as well as to overall immunity in adults. Poor gut health, and resultant absence of intestinal bacteria is associated with reductions in digestive enzyme activity and defective cell-mediated immunity.
If the body experiences an injury, such as an ankle sprain, there will be an immediate inflammatory response, which the body will respond to. The way the body responds to that injury will be very much dependent on the state we are in at the time of the event. The inflammatory response will be very different between those individuals that have the optimal nutrients available to react quickly to the event, compared to those who do not.
Our ability to recover successfully from injury is also dependent on the energy available to us at the time. The body’s main priority is to survive so we will always use up the energy available to us in order to survive, in the first instance. As a result, if we eat the wrong food then we won’t have enough energy to recover effectively. Eating the wrong foods, and eating too often during the day, means our digestive system remains active, and is not given the time to rest. This uses up energy and leaves us short when we need it for recovery. People would benefit if they ate the right foods only 3 times per day as that would support the digestive system with the right nutrients as well as giving it time to rest each day. We need to give the gut a break because that’s when the immune system, and the energy left available, can be used for recovery.
Show Highlights – Healing Foods for Back Pain
The problem we face is still a lack of education, both by the medical industry as well as ourselves. There is still a lack of focus on nutrition within the medical profession and until more recently were told that it doesn’t matter. As a result, when asking for advice we’re not always getting the information required to support a change. In addition, there is a lack of accountability in the food industry where they’re focussed on products that taste good rather than on foods that would support our health!
Interview Transcription for Healing Foods for Back Pain
Ben James 0:00
When we’re young, we move with freedom and confidence with a great resilience to injury. Somewhere along the line, we’ve developed poor habits and become more vulnerable to back pain. Back pain solutions features evidence based and practical advice to help you take back control of your health and get back to the activities you love. This is your guide to better health. So join us as we demystify some of the commonly held beliefs about back pain. build your confidence to a stronger back, the smart Welcome back to smart strong podcast with me Ben James and my good friend and co host as always, Jacob state today we’re talking pain, nutrition. We’ve talked about acute pain today we’ve talked about chronic pain, and how we’re managing acute and chronic pain with an active based approach to recovery. Today we’re talking about the impact of nutrition on pain and the impact of nutrition on inflammation and recovery. So Jacob a good place to start does die influence pain?
Jacob Steyn 0:57
I think we have an absolute Yes.
Ben James 0:59
So, the research is quite compelling you feel?
Jacob Steyn 1:04
Yes, I think of course, it’s it’s been proven and discussed already for years. And I think it’s only becoming more and more clear. And it’s becoming more specialized and how and different ways and the different approaches we can follow to not only influence pain and desensitize nociceptors but also, obviously, going the whole way. Also in getting recovery, maybe after years of not being able to recover.
Ben James 1:39
Okay. And I guess the question there or the natural question for the people listening as well how does nutrition influence pain because for, for people listening, they’re gonna think, well, I’ve had an injury. I understand that or you’ve talked about repetitive movements and motions and the creep effect of tissues, and how that Ultimately cause damage and with it cause injury and activation of those nociceptors and pain. So just how does nutrition influence that? Are we talking very much on the kind of biochemistry and the impact of things like the chemicals that that are aggravating? nociceptors? How is it that nutrition has an influence on pain? I guess is the big question,
Jacob Steyn 2:28
I think, broadly speaking, we’re going to look at two things. There are more factors, but we’re focused on these two factors one now, I think the first one is gut health. So the actual inflammatory response we have when we have an injury, so So let’s say we play rugby or football or whatever and you twist your ankle. So immediately, you’ll have this acute inflammation, inflammatory response. So the body and the immune system is now dealing with that and that the The way it deals with it is based on the state that your body’s in. So if there’s a low grade, inflammation present, the inflammatory inflammatory process will be different to when you are equipped with all the right nutrients that you need to go through that inflammatory response very quickly and go through those three phases of recovery, where you can afterwards then strengthen again.
Ben James 3:29
Yeah. And back to gut health. I think that’s that’s an important point there because this seems to be something that is that is overlooked by a lot of people. And I know we’ve talked a lot about the immune response and the activity within the gut. If you want to talk a little bit more about that at this point, having discussed it or introduced it a little bit there and what you’ve said just so people get a bit of an understanding of the importance of of gut health.
Jacob Steyn 3:59
Yeah, it’s a topic I can speak about for a whole day in one breath, so I’ll keep it short. But the important thing to know is that the so if you look at the gut, you’ve got the roughly one and a half metre long, large intestine and a six and a half metre long small intestine. And the difference between these two is actually quite big. So that the large intestine as a is bacteria Lee based and the small intestine is is very much enzymatically based, which means that you know, you got to have the proper bacteria functioning in large intestine, and that has its role and then you have the, the, the, the, what’s called the mucosa. It’s a slime layer on the inside of the small intestine that produces a lot of things that we need, and that actually is the home of the immune system for about 70 or 80% of So, the small intestine has a very thin one cell layer thin wall which needs to be protected by the slime layer that may pose up. And you know when it with I don’t know, I can’t put a percentage on it but a great deal of the population actually suffers from poor small intestine or gut health. And so we’re exposed to damage to the, to the wall lining of the small intestine. And so basically you have you have an immune system constantly trying to clear up, clean up its own home where it resides instead of actually flourishing and then being able to go to somewhere else in the body and do its job over there. And that’s why God health is so important because number one, that’s where the immune system functions from And if not, then your immune system will be constantly busy trying to clean up the growth.
Ben James 6:08
So when we put that into the context of someone potentially with back pain that isn’t necessarily on a good diet, are we saying that because of the activity that that is performing to try and keep that healthy and optimum, then that potentially is taking away some of the nutritional benefits to managing pain?
Jacob Steyn 6:32
Well, yeah, that’s initially I said, I have two points I wanted to discuss net, that’s actually the second one. So when we look at your ability to recover, we talked about the energy available. And I like to tell patients look, we have the broad priority of the body is not to recover their priorities to survive. So if you’re chronically fatigued, or you don’t have enough energy, you don’t wake rested In the mornings, then there’s a good chance your body doesn’t actually have the excess energy after the main priority of surviving, which it needs to recover. So then we have a little problem there. And so this is what happens we we eat the wrong food, the digestion stays active throughout the day, instead of maybe only the other three meals that we should digesting. And because of this, every time we eat, the immune system gets activated. So all of this kids, all of this is eating up our energy. So we’re having five, six snacks throughout the day where you know, we’re chewing chewing gum and stuff like that. So we’ve got a very active immune system all day immune system, or the digestive system doesn’t get any rest. So there’s actually no energy left for recovering and, and that and That’s the main point. So you know, the your ideal would be looking at having three meals a day. And if you want to go a step further, you look at intermittent fasting, maybe two meals a day. And then you have these big pauses between the meals where the digestive system is actually turned off. And the immune system can do its work wherever recovery is needed.
Ben James 8:20
And so just to kind of conclude on that point, we’re almost saying you wouldn’t go to the gym throughout the day, you know, you’d give your body a break. And in the same way, to some degree, what you’re saying is, we need to have a consideration on the gut and give that a break.
Jacob Steyn 8:37
That’s not 100% what I’m saying exactly, yeah, we want to we want to give the gotta break because that’s when your immune system and the energy that you know there’s a limited amount of energy, then we can use the energy to actually recover and heal.
Ben James 8:53
Okay. And before we kind of move on a little bit, with with that and talking about that and talking about Some of the things that people can be considering in terms of changing their diet in terms of some of the things they’re eating already in terms of hydration, and natural question for me at this point is why is this? Why is this overlooked? Because there’s a lot of compelling evidence. Now there’s a lot of research. So why is it that we’re not getting more of this advice? Is it again, back to a lack of knowledge with the professionals that we’re seeing? Is it just overseen by many or is it not accepted by them? What do you think the the views are there?
Jacob Steyn 9:37
Yeah, I think it’s, it’s multifactorial, and I think that we, you know, the main driver here is the food industry, and the advertisements and the things that we’re exposed to. And that’s not based on a anti inflammatory diet that’s based on what is palpable and what appeals and what tastes Good, we all know that most of those things are actually causing more harm than good. And the other factor is what you mentioned, I think that we, I mean, we can gradually see some changes here and there but not fast enough if you ask me, amongst the specialists or the doctors or the approach that you have, that you that you get when you go to a hospital, you know, if you look at what people are fed in a hospital, then you’d rather just have water. The point is that specialist and medical professionals are not trained in this field, unfortunately, and until recently, they were told it doesn’t matter. Yeah, and I think I think that’s where the biggest problem lies. So if if you’re someone who doesn’t know about it and you go to a professional and the professional will tell you that you know, you need to take your your anti inflammatory medication when you twisted your ankle and for the rest of the season. really matter, then I suppose you’re going to believe that.
Ben James 11:01
Yeah, absolutely. And I suppose as well, there we’re seeing a bit of a shift. And maybe that’s a cultural thing where the younger generation are actually coming through and being more questioning of everything, you know, whether it be workplace culture or or all the advice they’re given by medical professionals, they’re starting to question things a lot more. So we’re almost seeing a shift. We know now that kind of the next generations, we’re drinking less, for example. So like you say, back to your point, we’ve almost taken the advice from the professionals as gospel and that that includes government advice regarding nutrition and eating your five a day, etc, etc. Because I think a lot of people want some advice to know that they are eating well. Then you’ve got the proportion of the population who, who don’t care and they’ll just eat what tastes good and Feels good, rather than what is good for the body. But it comes down to how some of this information is advised from from government agencies and recommended because there are a lot of people that that would not wish to eat unhealthily are probably eating unhealthily, unbeknownst to them, unless they do a lot more research.
Jacob Steyn 12:24
Yeah, exactly. I mean, when I speak to patients, and quite often, if you ask, you know, what do you eat? The first answer would be, well, I have a healthy diet, and then we go into what they eat, and then I suggest something quite different to what they are. And I explained to them, of course, why we want to move away from one thing and toward another thing, focus more on eating or that thing, and can people generally have the idea that they’re actually eating quite healthfully? And that, that they’re not really doing their bodies any harm, and that’s exactly what you’re mentioning. There. It comes. back to what we recommended from the guilt from the government agencies. But I think we all know that that’s generally the information in these coming from these agencies are just outdated. It doesn’t work. I can’t imagine any high, high level athlete and I know of multiple, who does not follow this advice was they follow the latest advice.
Ben James 13:22
So jumping in there, Jacob, what, let’s describe the kind of average diet, shall we say, of the patients, you see? And clearly that’s going to vary. But in terms of some of the consistencies that you see, what are you? What are you seeing from patients and what what is the impact of that? And where are the I guess, where the first what are the first steps that you try and get them to take to change because obviously, first of all, they’ve got to buy into what you’re saying before then they actively do something about it.
Jacob Steyn 13:53
Yeah, so you know, not for everybody I see. But a lot of people it would be bread Twice a day would be bread for breakfast and some sandwiches again for lunch. And otherwise, I would see people, people would tell me that they’re having yogurt with fruit in the morning, and some sandwiches for lunch. And then generally people have a warm meal in the evening. And they’ll say, vegetables and meat. And I question them a little bit more about vegetables and meat, it would be potatoes, maybe a few beans, and a piece of meat. And so that would that would be the general answer. And I snacks in between. Often, yes, they have snacks. It would usually be fruit, either banana or Apple, something like that. And then generally people admit they don’t drink enough water. Some of them will be drinking too much coffee. And then I think, yeah, and then sometimes I have I have people who are skipping meals and No one having a regular routine of eating meals. And I think that if people skip meals with the idea to do intermittent fasting, and that’s good. But if somebody skips meals, because they’re exhausted and they have a too busy schedule, and they don’t get around to eating them, I think they’re probably on the wrong path.
Ben James 15:20
Yeah, absolutely. And and I guess then the next question is, how do you how do you approach it with a with a patient patient comes in because the diet you’ve described there is, is I would say, pretty, pretty standard for a Western diet for most for the large percentage of the population toast in the morning or cereal and sandwiches at lunchtime, followed by an evening meal with maybe the odd snack in between, even if it’s a chocolate bar that for them for many is going to feel pretty, pretty balanced. I mean, we’ve certainly seen people with Far, far worse diets. So how do you kind of approach the subject with those guys to say well, actually That’s not a great diet, because often you get challenged to say, well, what’s wrong with that? You know, I’ve had many arguments with friends about, you know, eating cereal and toast in the morning and why that should be something they might consider changing, but it often comes with, shall we say, a heated debate for want of a better discussion.
Jacob Steyn 16:22
Well, yeah, well, I think the the best way to understand this for yourself would be to experience it. Because you can tell you know, we don’t know what we don’t know. What I mean with that is we don’t know how good you can feel. We don’t know. Maybe we forgot what it feels like to wake up in the morning with energy. Because we’re so used to wake up waking up in the morning, you know, feeling really crappy and accepting it as being normal because it’s earlier, something like that. You know, if you sleep properly and you wake up before your alarm clock, it probably means that you you’ve had enough sleep, you wake up Rest, you’re ready for the day.
Ben James 17:01
Yeah. And I have to say, you know, bringing that what you’ve just said back to me personally. Towards the end of last year, I know I was kind of slipping into some poor habits just more by complacency than anything. But then in the turn of the year when I kind of reviewed my diet and started becoming more strict with the diet, and just more focused, there’s no doubt that, that it had an impact on me. Certainly waking up in the morning, before any alarm, feeling awake, you know, the order a campaign that really there was no justification for went quite quickly. And, and I think the key thing for me was was certainly introducing that hydration, because I think a lot of people think God, I feel hungry. I think this is one of the bigger problems for people when you think about eating three times a day and that’s kind of it is I’m going to be hungry. But actually, what we find is a lot of those people are drinking a glass of water a day. If you’re introducing and one to two liters, ultimately, of water a day, then suddenly, you’re far more satisfied in terms of satiated, you know. So there’s the that that’s another element of this that I think is overlooked. Is that general hydration that people are, are considering.
Jacob Steyn 18:28
Yeah, I’ll just continue with your with your question. How do I approach it with patients? Basically, I you know, there’s a few questions you ask people and if they ask answer, yes, then it becomes quite obvious that they know that they’re suffering from something going wrong in their gut. And I think that the way to approach it is to just give people guidelines and that’s what I do. I give them guidelines I we talked about with me write that down. And I explained to them what the ideas between but you know, comparing eating all day and, and having three meals a day and making sure that you get some energy or the actual recovery which we’re after. And people get it, you know, if you explain to them the effect of certain things and get too much omega six in, you know, therefore you want to you want to eat less, eat less grain, you want to make sure that you get good fats in if you get too much of the one fat end and your omega six goes up, especially vegetable oils that’s pro inflammatory. And if you explain these things to them, that makes a lot of sense. And I think people are good at making small changes. Sometimes it’s needed to make big changes. If somebody has a real problem and they’ve, you know, they want to they want to get better then it’s up to them, you know, you can you can give somebody the information but you know, ultimately the responsibility lies with a patient.
Ben James 20:01
Yeah, of course. And I think you know, like you say there are a lot of it comes back to a lack of education. And like I say, there’s a lot of people that that the want to eat healthily and think they probably are eating healthily from the advice they get. So for those people that maybe suffer a back injury and come and see you and then get that advice, then it’s what you’re saying is they kind of take it on board, and it’s quite, quite a simple change for them to make because they buy into it, there’s always going to be those people that are complacent, and, and don’t acknowledge it, or certainly don’t implement it.
Jacob Steyn 20:40
That’s it, you know, and I think that I still try to help them as much as I can. But in some cases, you know, if you have trauma to the bone in the low back, you know, and you know, there’s there’s a, there are some motor changes and you you’re dealing with a lot of inflammation and it’s a long Long Term process then I’ve seen how people have turned that around in a few months by going onto a very relatively strict anti inflammatory diet and doing specific exercises, where that sort of problem can carry on for years. You know, if you look at the X ray, especially, you know that that’s pretty fresh and it’s it’s been chronic for a while, but, you know, the patient’s been to a few other people into some medical specialists and they have not gotten better and they’re not with you and, and they don’t know what to expect, obviously, when it comes, I think there’s there’s a great deal of recovery within that lies within good nutrition. And I think not only for the chronic patient as we see, when we see mostly chronic patients, you know, that that gets stuck in that chronic inflammatory process and it just doesn’t get better. But also if you, you know, the benefit of actually fixing your diet properly. Or when you would have an injury, when you roll your ankle or when you fall and you hurt your shoulder when you go skiing or, or even just day to day strains, if you have a job where you set the lot, you know, on your back, your neck, the recovery at night, and throughout the day, the so much more enhanced if you eat properly, which means it’s probably going to keep you out of trouble.And that’s what grounds right.
Ben James 22:31
Exactly, yeah. And I mean, it’s not rocket science is it when we, you know, when you really think back and, and strip things back if you’re, if you’re moving, as you’re genetically designed to do and if you’re eating the foods that you’re genetically designed to eat or certainly you know from a nutritional point of view are going to support your body and the systems and organs within it. Then Not only are you going to surely get out of pain, and manage that pain more effectively, but you’re going to feel so much better as well. So this isn’t just, this isn’t just about getting out of pain, you know, this extend into quality of life and overall comfort, you know, along the way along that journey, you know, and, and sometimes, you know, it takes, as we know, with a lot of things in life it takes, it takes a point of pain, and in this case, genuine pain, if in terms of the back that, that maybe stop, make, make people stop and think I’ll hang on a minute, okay. And what have I been doing wrong? How the hell do I get out of this pain initially? And what are the things that are going to optimize that and that that’s often the starting point for people to reflect on nutrition and other things when they get that advice, and, unfortunately, the general advice that we’re getting in terms of nutrition and in terms of the Pain Management are not necessarily accurate. So the information that people do absorb in terms of their education is, is unfortunately limited. Or at best limited, at worst, just incorrect.
Jacob Steyn 24:13
That’s a very unfortunate, sad truth. And, you know, especially when you try to do your best based on the information you’re given, and when the information given to us all to you as a truth, then it’s really sad. So that’s, that’s it. I think it’s an educational process for for most people and, and I think a lot of people realize they know, you know, them. These days, they’re more open to this sort of advice because if you compare it to maybe five or 10 years ago, there was a much stronger belief in the sort of government policy when it came to what we should eat, you know, and we should get our fiber from grain this net, the other and you know, You’d go to the GP to the doctor and say I’ve got constipation and they’ll be like, yeah, you need to eat more whole grain bread. Okay, well, I’ve been doing that for the last six months and it’s getting worse. Yeah, but I think people slowly they’re, you know, becoming more aware of this. And also because there are some breakthroughs. There are some people individuals writing books about it. We know that some some, some things have been debunked, you know, the saturated fats and cholesterol.
Ben James 25:31
And so, I guess for the people listening a good place to, to end would be we, we’ve kind of touched on eating maybe three meals a day, given the gut, an opportunity to rest in itself. And we’ve talked about hydration. We’ve talked about trying to limit the grains and certainly bread, what would be a good day in terms of a diet for you, just so that people can go With with a thought on what could be a beneficial diet for them on a day to day basis in terms of breakfast, lunch and an evening meal, just so there’s a there’s a bit of structure behind that for them obviously there’s a massive different foods that are that are open to us. So we can’t cover all the different menu options as it were, but just in terms of a, I guess, an outline for people to consider on a day to day basis and and also kind of volumes of water. I’ve suggested one to two liters and just so people have got a bit of a takeaway message on on that.
Jacob Steyn 26:39
I think as a general guideline, I would suggest trying to eat the vegetables twice a day. And what I generally recommend is actually steaming the vegetables because that’s more nutritious than putting them in the oven or frying them and it’s also much quicker. So vegetables twice a day, I would suggest trying to stay away From a sugary breakfast, something like like a normal length or eggs in the morning with again, some badge and some good fats good saturated fat in a real butter. It’s a good start because you get some protein, some fat and a little bit of carbs in but you’re not getting that sugary, sugary breakfast and that’s going to spike your insulin in the morning. So you have a good, steady start in the morning. And then I’m generally suggesting that you do have meat. The problem with not having meters, that you’re missing out on a lot of essential nutrients, and obviously the protein. That’s another topic we need to make sure we get enough protein. And so I would suggest, you know, vegetables twice a day with some meat, maybe an omelet for breakfast, and stick to trying to eat three times a day, you know, and if you want to go a step further, especially if you’re your Insulin responses. Good, then you can even try to do twice a day. But you have to make sure that you get an You have to eat enough at your meal so that you can last until the next meal, even if you do three times a day.
Ben James 28:12
Absolutely, no, it’s good advice. And I think that’s a good place for us to draw to a close. And, you know, there it is everybody that nutrition does have an impact on pain, it has an impact on inflammation. And it’s something that we really need to consider, not just when we’re suffering from pain, but it’s something that we need to consider just for our general health and wellness. And if you’re feeling sluggish in the morning, and you’re listening into this podcast without suffering from any back pain, then it’s something that you can also reflect on and consider changing, to improve, improve your health and improve how you feel day to day and I think there’s some good advice there in terms of the approach that you can take and some of the considerations you need to make in terms of changing your diet and no doubt this is a subject that We’ll come back and discuss further in future podcasts in terms of some of the different and key focuses as they as they come up. And as we feel that they’ll be beneficial, but just as an introductory podcast for the listeners to give them some advice that nutrition matters, and it matters if you’re going to get out of that back pain and recover optimally and effectively, and the side effect is you’re going to feel a lot better for it. So, once again, thanks, Jacob. Thanks everyone for listening. As always, head on over to the iTunes to give us a review, give us a rating so we can spread the message. We’re going to continue with our podcast episodes and keep you updated with information. So listen in next time and we’re going to be talking about movement, resilience, building movement resilience, when we’re focusing on Lower Back recovery specifically. So thanks again for listening guys. And we’ll speak to you next time
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