Good nutrition is key to feeling your best, whether or not you have pain, but is especially important in bodies that are under stress from chronic pain. Staying well hydrated, limiting alcohol, and eating a low fat, low salt, and low or moderate carbohydrate* diet can go miles towards helping you feel your best physically and emotionally. Another thing to look for in a healthy diet is color! Eating a variety of bright or dark colored fruits and vegetables means you are eating a lot of anti-oxidants. Anti-oxidants help your body clean up the messes that come along with normal cell function and with exposure to toxins in our environment. Look for natural color though – food dyes are NOT the same thing and can create more problems!
Sometimes, though, even good hydration and a healthy diet is not enough to keep us feeling at our best. Vitamin levels in food are reduced if the food has been in extended storage, exposed to light or air, or undergone processing such as freezing, canning, or cooking. There are a few supplements that can be helpful in managing pain, and risk of overdose or adverse effects is usually low, although it can happen. Supplements sometimes need several weeks or months to work, so you might not see the effects right away. Pay attention to how you feel before starting a supplement, and compare it to how you feel after 2-3 months of taking a supplement on a regular basis. Today, we’ll talk about magnesium, vitamin B complex and vitamin C.
Magnesium is a mineral and is an important supplement for people with chronic pain. It’s involved in hundreds of cellular processes, and can be thought of as a natural muscle relaxer. Magnesium can be helpful with muscle pain and stiffness, nerve pain, and migraines. Even people with normal blood levels of magnesium can sometimes benefit from a supplemental dose, because the levels of magnesium inside the cells (which isn’t measured in bloodwork) can be low, or you might be someone who would benefit from a slightly higher level of magnesium than “normal”.
There are several forms of magnesium available. Magnesium citrate and magnesium hydroxide (AKA Milk of Magnesia) are laxatives, and are not effective as supplements. Magnesium oxide is the most commonly available form, but might also have a laxative effect in some people. Epsom Salts are magnesium, and warm baths or soaks with Epsom Salts provide magnesium that is absorbed through the skin, so there is no risk of stomach or bowel upset. As a bonus, the warm water can be soothing to a painful body. Other oral forms of magnesium that may be less likely to have a laxative effect are magnesium gluconate, glycinate, aspartate, maleate, and salicylate. Doan’s Back Pills are magnesium salicylate. Be careful with magnesium salicylate if you have trouble with anti-inflammatory medications like aspirin, ibuprofen, or naproxen (NSAIDs), because salicylate is related to aspirin.
Talk to your doctor before taking magnesium if you have kidney problems, heart problems, or are being treated for osteoporosis. Don’t take magnesium at the same time as medications that should be taken on an empty stomach – in fact, it’s best to take magnesium with food.
The B vitamins are also useful in managing chronic pain, especially neuropathy pain, and can also be helpful with fatigue and headache. Health care providers often measure vitamin B12 levels, but all of the B vitamins (B1, B2, B3, B5, B6, B9 and B12) are involved in nerve and muscle function, and in converting food into energy. There is research that reports reversal of neuropathy with some forms of B vitamins. The B vitamins are especially important if you drink alcohol or smoke, as these activities deplete B vitamins. Daily multivitamins usually contain some B vitamins, but people with chronic pain often feel better when they take an additional B complex supplement. Unless you take very high doses, toxicity is very rare, but B vitamins will make your urine a very bright yellow – I’ve heard it described as “nuclear yellow!” The doses in over-the-counter vitamin B complex tablets or capsules, taken as directed, are unlikely to cause any problems. If you find the taste or smell objectionable, try a different brand or try keeping it in the refrigerator.
Riboflavin, or vitamin B2, has been associated with reduction in headaches and migraines, when taken in very high doses of 200 to 400 mg daily. Riboflavin toxicity is essentially unheard-of, so if you have chronic headaches, a trial of high-dose riboflavin may make all the difference, and there is very little risk to trying.
Vitamin C is important for a healthy immune system to fight infection, and to support healing after injury. Research also suggests that vitamin C may be involved the production of endorphins, the opioid-like substances our bodies produce. This is another vitamin that is severely depleted by smoking, which explains why we often see increased infections and delayed healing in smokers. Other conditions that deplete vitamin C include illness, surgery, injuries, and cancer. Taking omeprazole (Prilosec) and aspirin can reduce the amount of vitamin C absorbed into the body.
Research studies have found an association between vitamin C supplementation and reduced pain with shingles, migraines, chronic pancreatitis, and cancer. Vitamin C is effective in preventing the onset or spread of a very painful condition called Complex Regional Pain Syndrome (CRPS, also known as RSD), which can occur after injury.
Although the recommended daily allowance of vitamin C is 75-120 mg, which is the amount required to prevent scurvy, there is very little toxicity associated with doses exceeding 20 times that. It is generally accepted that doses up to 2000 mg daily are safe. Vitamin C at very high doses has a mild laxative effect, and people with renal failure or kidney stones should limit their vitamin C intake to 1000 mg a day.
Eat a healthy diet, stay well-hydrated … and consider adding one or more of these helpful supplements to your pain management plan.
At North Shore Pain Management we provide advanced, evidence based, multidisciplinary and cost effective pain management. Our goal is to improve your ability to return to the activities you have been missing as well as provide a meaningful reduction in pain.