Nutrition’s Role in Back Pain

As a physical therapist, back pain is a common complaint among patients. In fact, 10-30% of the United States adult population deals with back pain, and back pain affects 65-80% of adults at some point in their lifetime (1). This pain can stem from various causes, such as injury, overuse, and stress. However, a cause often overlooked is poor nutrition. The food we consume plays a crucial role in maintaining the health of our musculoskeletal system.

Nutrients such as calcium, magnesium, and vitamin D are essential for strong bones, while vitamins C and E contribute to maintaining joint health. A diet high in anti-inflammatory foods, such as omega-3 fatty acids found in fish and flaxseed, can reduce inflammation and pain in the body (2). On the other hand, a diet high in processed and sugary foods can lead to weight gain and inflammation, putting added stress on the spine and causing back pain. Studies have also shown that a diet high in processed meats may increase the risk of developing low back pain (3,4).

Maintaining a healthy weight is also important, as being overweight or obese can put added stress on the spine and lead to back pain. In a study of nearly 5,000 adults, researchers found that those who were overweight or obese were more likely to experience low back pain compared to those with a normal body weight (5).

Proper hydration is also crucial for the health of the spine. The discs in our spine mostly consist of water, and adequate hydration is necessary for the discs to function properly. Dehydration can cause the discs to shrink and become less flexible, leading to increased pressure on the spine and resulting in pain.

In addition to maintaining a balanced diet and proper hydration, paying attention to specific nutrients can benefit the health of the spine. These include:

• Calcium and Vitamin D: These nutrients are essential for maintaining strong bones, including the vertebrae in the spine. A deficiency in these nutrients can lead to osteoporosis, a condition that can cause the vertebrae to weaken and compress, leading to pain.

• Magnesium: This mineral plays a role in muscle and nerve function (6), and a deficiency can lead to muscle spasms and tension (7), contributing to back pain. There is also a relationship between magnesium and bone strength. (6)

• Vitamin C: Vitamin C plays a role in the production of collagen, the protein that gives structure to our joints and bones. A deficiency in vitamin C can lead to weak and fragile joints, increasing the risk of injury and pain (8).

• Omega-3 Fatty Acids: These healthy fats have anti-inflammatory properties, which can help reduce pain and inflammation in the body (9).

It is important to mention that processed protein bars and energy bars, although marketed as healthy and convenient snacks, should be consumed in moderation. These bars often contain high amounts of added sugars and artificial ingredients that can contribute to weight gain and inflammation. A diet high in these types of processed foods can also displace nutrient-dense, whole foods that provide essential vitamins and minerals for the health of the musculoskeletal system (10). In addition, many protein bars and energy bars are high in saturated fats, which have been linked to an increased risk of inflammation and heart disease (11). It is important to read the ingredient list and nutrition facts carefully and choose bars with natural ingredients and minimal added sugars.

In conclusion, it is important to recognize the impact that poor nutrition can have on musculoskeletal health, particularly in regard to back pain. Food is medicine, and should be treated that way. By maintaining a balanced diet rich in essential nutrients and anti-inflammatory foods, and paying attention to proper hydration, we can help prevent and manage back pain.

 References:

1. Urits, I., Burshtein, A., Sharma, M. et al. Low Back Pain, a Comprehensive Review: Pathophysiology, Diagnosis, and Treatment. Curr Pain Headache Rep 23, 23 (2019). https://doi.org/10.1007/s11916-019-0757-1

2. Park JH, et al. "The effects of omega-3 fatty acids on pain and inflammation in a rat model of osteoarthritis." J Physiol Pharmacol. 2015;66(3):399-407.

3. Kuorinka I, et al. "Musculoskeletal pain among meat packing workers." Am J Ind Med. 1987;11(6):611-622.

4. Luukkonen R, et al. "Body mass index and low back pain: a systematic review." Obes Rev. 2008;9(4):409-418.

5. Hilde G, et al. "The association between body mass index and low back pain: a systematic review." Eur Spine J. 2010;19(12):2075-2094.

6. Xue W, You J, Su Y, Wang Q. The Effect of Magnesium Deficiency on Neurological Disorders: A Narrative Review Article. Iran J Public Health. 2019 Mar;48(3):379-387. PMID: 31223564; PMCID: PMC6570791.

7. Bilbey DL, Prabhakaran VM. Muscle cramps and magnesium deficiency: case reports. Can Fam Physician. 1996 Jul;42:1348-51. PMID: 8754704; PMCID: PMC2146789.

8. Gao X, et al. "The role of vitamin C in the management of osteoarthritis: a systematic review." Nutrients. 2017;9(11):1224.

9. Simopoulos AP. "Omega-3 fatty acids in inflammation and autoimmune diseases." J Am Coll Nutr. 2002;21(6):495-505.

10. Leidy HJ, et al. "The role of protein in weight loss and maintenance." Am J Clin Nutr. 2015;101(6):1320S-1329S.

11. Siri-Tarino PW, et al. "Saturated fat, carbohydrate, and cardiovascular disease." Am J Clin Nutr. 2010;91(3):502-509.