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  • Dr. Bettina Herbert

Pain Relief Using Food: the Elimination Diet

Last Sunday brunch I sat next to a very nice man who was, basically, miserable. He had endured back pain, surgery for a ruptured disc in his back, knee pain, shoulder pain from an inflammatory condition called Polymyalgia Rheumatica (PMR), had been prescribed a long course of steroids for the PMR that caused him to gain weight and acquired a "sensitive stomach" from those steroids.


The drive to visit his grandchildren was long enough that his pain increased and he could hardly sit still at brunch, even with prednisone (the anti-inflammatory prescription steroid) on board. Weight gain is, of course, not good for back pain. Plus his menu choices were dictated by what wouldn’t further upset his stomach. That takes all the fun out of a family brunch.

He is caught in a real Catch-22: take steroids to reduce inflammation and gain weight from the steroids that worsens the back and knee pain. Steroids also decrease the good bacteria in the gut, potentially leading to "leaky gut" that also increases inflammation as undigested food and bacterial particles can leak into the bloodstream where they don't belong. This triggers the body to increase inflammation. It's a real 'hamster wheel.'


What to do other than traditional medical solutions (medication and surgery)?


Perhaps the most difficult yet cost-effective solution is to look at what's on his plate. Changing what one eats is incredibly challenging for many reasons: childhood patterning (comfort foods), the marketing budgets of processed food manufacturers to convince us that our lives will be better if only we buy their products, the fast pace of living in our society today and the lack of time to shop and cook and ... fill in the blank.


The late Margaret Mead, a famous anthropologist who studied many indigenous peoples all over the world, noted it is easier to change a person's religion than to change that person's diet. That's how difficult it can be. However, there can be many motivations to try: lessen chronic pain without medication, reduce the progress of chronic illness, set a good example for your children and their children, and take back control of your life and activities. Get back your joie de vivre, the delight in being alive.


There are many, many published medical and scientific studies validating that eating anti-inflammatory foods such as ginger, curcumin (from the spice turmeric), fresh berries, green tea and even dark chocolate can decrease chronic inflammation and thereby reduce pain and disease states. However, simply adding these foods for a short period (14 or 30-day diets are everywhere) is not enough, though it is a good start. What is needed for long term pain relief is to eliminate the foods that stoke the fire of inflammation. Not doing that would be like mopping the floor while the sink is overflowing. You will never get ahead until you turn off the faucet!


An abundance of anti-inflammatory, low allergy, elimination and other food plans are available. One that has worked particularly well for my patients is from the Institute of Functional Medicine (IFM). click here or visit the library page to download this file. There is a surprisingly long list of foods allowed. Most of us are used to buying the same foods, the same brands, the same everything that we get into a 'food rut,' reaching for the same packages at every trip to the grocery or ordering the same thing when eating out. Trying new foods can not only be good for nutrition and wellness, it can be an adventure.'


The other key is to not eat the same food every day. Take it from someone (me) who thought if a little kale is good, more would be better, and thereby self-inflicted an acquired allergy to kale (and, yes, it was homegrown, organic AND heirloom). I mean, it takes a real genius to make oneself allergic to kale, of all foods. Let mine be a cautionary (if humorous) tale. Rotate how often you eat the same foods – every other or third day works.


Finally, be consistent to give your body ‘tincture of time’ to heal based on a new way of eating. Embark on this when you are ready because this is a long-term solution, not a quick fix. The occasional 'diet holiday' early in a routine will get the inflammation ‘overflowing’ again. See how you are feeling in 10-14 weeks. Compare with how you felt before starting. You can then begin to add back one food at a time and thereby discover what foods you can tolerate and which foods light your fire of inflammation.

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