Low back pain effects nearly 2/3 of all Americans, yet over 1/3 of them never seek out treatment.
Will low back pain go away on its own? Maybe, depends on what’s going on. Are there natural remedies we can use to promote low back pain healing? Definitely.
Now, advising on medication is out of my scope of practice, but people have become so resistant to medications these days that it felt only natural to pursue additional certification and training in nutrition science.
The health care world is shifting, slow but sure. We’re learning where medicine has its strengths and weaknesses, we’re learning that putting chemicals in our body might be doing more harm than good, and we’re seeking alternative answers in things like essential oils, herbs, needles and even tape.
I firmly believe our bodies are completely capable of healing, but we need to set the right environment for maximal healing potential. And this is where all these alternative therapies, including nutrition, can positively impact the healing process.
Let’s first take a quick look at the science behind injury and tissue repair, and then we’ll dive into what supplements could potentially help during different phases of healing.
Stage 1: Initial Inflammation. When you first hurt yourself – threw your back out or sprained an ankle or whatever – the body sends an immediate cascade of helpers to brace the initial trauma and clean up the debris. This is the definition of an inflammatory response. In this case, it’s a good thing.
This initial stage will last for about 4 days. During these few days we may experience pain and swelling. We want to be careful here – icing and compression should be use to manage, but not shut down, the inflammatory response. This is a good time to follow a general anti-inflammatory diet so that we are not adding more inflammatory agents to the system through food(more on this in a bit), but there’s no real need to add in supplements here.
Stage 2: Proliferation. This is when the first layer of scar tissue starts to form, essentially acting as scaffolding to bridge the repair site and start to add back strength to the system through stiffening. If you think about when you cut your skin, this is the phase when you see scab formation. It’s tough and hard and protects the underlying wound as it continues to heal. Soon, the scab falls off and we’re left with a scar. Incidentally, if your primary complaint is stiffness, it’s likely you’re in this stage of healing.
Stage 3: Remodeling. This can take months to years, and it’s the process of that scar tissue continually strengthening and re-forming itself to look and behave just like normal tissue. On the outside surface it’s the time it takes for the scar to all but fade completely away.
Ok so now let’s talk about where food can help, or hinder healing.
Assuming your injury follows this nice smooth timeline (spoiler alert, some get stuck spinning their wheels in chronic inflammation), your main goal is to avoid pro-inflammatory foods, because why give your body more work than is necessary? Let it focus on the important objective of healing.
I would also suggest you question the use of NSAIDs during that initial inflammatory stage. Remember, we don’t want to squash inflammation, rather we want to prevent it from getting out of control. If rest, ice, and compression don’t help discomfort then I think there’s a place, but I wouldn’t grab the advil right away just because. Again, medications are out of my scope of practice, so you do what you and your doctor decide is best.
Pro-inflammatory foods to avoid include:
- Added sugars and artificial sweeteners
- Corn/high fructose corn syrup
- Excess sodium (>2400mg/day)
- Omega 6 fats – red meats from feed lots (vs grass-fed organic beef that is higher in omega 3), soybean oil, margerine
- Trans fats
- Refined grains
During acute injury, not only do we want to reduce the omega 6’s, we want to increase omega 3’s. Adding in good quality oils like extra virgin olive oil, avocado oil, and flax oil, and eating foods like salmon, nuts and seeds. Studies have shown good facilitation of healing with higher omega 3 intake that does not interfere with the natural inflammatory process the body needs.
Now remember, if you’re in the initial stages of healing don’t worry about piling on a bunch of supplements. Let the body do its thing.
BUT…if you get stuck in a chronic inflammatory phase, or if you’re dealing with something like osteoarthritis, then we can talk about supplementing with super herbs and such.
So say you have osteoarthritis in your knee, or a shoulder pain that just won’t let up, or a chronic back pain that comes and goes depending on what you do. These are what I consider chronic inflammatory conditions. Somewhere along the line the body got stuck, and it can’t seem to push through to the other side. To help you manage pain and discomfort, and to minimize inflammation in your body, here are a few supplement ideas:
- Tumeric: Current research is showing that the active ingredient, curcumin, is responsible for most anti-inflammatory and healing benefits. You’ll need a little more than a dash of spice on your food though. The recommended dosage is 400-600mg of turmeric extract 3x per day to see any measurable reductions in inflammation. Here’s my recommended supplement if you’re looking for tumeric. You could also check out Gaia Herbs Golden Milk on Amazon for a daily dose of tumeric, but I have yet been able to pin down exactly how much is in a serving.
- Garlic has also been shown to be a powerful natural anti-inflammatory agent. Again, if you’re really looking to pump up its power, you might need a supplement. Typically the recommended dose is 2-4g (one whole garlic clove is about 1g) or 600-1200mg garlic extract.
- Bromelain is an anti-inflammatory plant extract that we get from pineapple. Bromelain dosage is recomended at 500-1000mg/day for the management of inflammation.
- Flavanoids such as cocoa, blueberries, red wine (YESSS! see, I got your back, I’m giving you permission to drink wine to heal!!), and green tea are also known to have an anti-inflammatory effect. These are good things to add to your diet overall, but don’t go out of your way to dose up on green tea extract pills or anything. Keep the sources natural and the red wine in moderation! (If you need a quick & easy whole food source of anti-oxidants you can check out my go-to superfood supplement here.)
KEY POINTS TO REMEMBER:
- Follow an anti-inflammatory diet and avoid pro-inflammatory foods during the acute phase of injury (first 4-5 days)
- Use supplements in moderation during the subacute through chronic stages of healing in order to manage inflammation and speed up the healing process
- Question if the use of NSAIDs are helping or hindering your natural healing process
- View nutritional supplements and food as a way to support the body and let the body do the healing work!
Now I’m going to back up for a minute. This is all good, and helpful information, BUT I find that for most of my clients its way beyond where I need them to focus. In reality, I would first focus on your macronutrient intake.
If you are healing or trying to heal, increased protein is recommended from the usual 0.8g/kg to 1.5-2.0g/kg…basically double it. You can also look at it as 1g/lb of body weight.
We also talked briefly about omega 3&6 fat. The idea is to balance out your intake and get that 6:3 ratio down closer to 1:1.
Micronutrient helpers include vitamins A, B, C, and D as well as calcium, copper, iron, magnesium, manganese, and zinc are important, especially in the acute phase. The bottom line is, following a whole food, mostly plant-based diet when you are healing is more important than ever. If you have trouble getting those fruits and veggies in then try a whole-food based supplement or vitamin. This is what I use as my nutritional insurance every day.
One last note on glucosamine and chondroiton, which are commonly prescribed for osteoarthritis management.
In general, the research is promising, yet inconclusive for managing long-term inflammation, and preventing further joint degeneration. For right now, we can say these agents will probably offer some help, but I tell my clients if you don’t feel any different taking them, don’t bother. You will know if it’s helpful. Unfortunately we have not learned how to re-grow cartilage, so if your degeneration is that far gone it’s probably time to start preparing for joint replacement surgery.
It is my true belief that the best healing comes from combining movement with nutrition therapy.
Make sure you are seeking help from a provider if you are having trouble managing a pain syndrome.
Living in pain is NOT normal, it’s NOT ok, you have every right to live a life free of pain!
If you’d like to start working on the movement end of the spectrum, I want to invite you to try a week of yoga with me! I’ve designed this week to tackle and balance out the most common patterns of dysfunction that I see year after year, so that you can realign your posture and facilitate the best possible healing.
Sometimes if your body is stuck in a dysfunctional movement pattern you cannot break out of the chronic healing phase. That physical re-alignment can be the most powerful (IMHO!) facilitator of healing, so give it a try, it’s totally free!
**For more information check out Precison Nutrition’s report @ precisionnutrition.com
Nutritional Strategies for the Management of Sports Injuries: John Berardi, PhD, CSCS, Ryan Andrews, MS, MA, RD, CSCS