Complex Regional Pain Syndrome (CRPS) is a chronic pain condition that can significantly impair one's quality of life. Characterized by intense, prolonged pain that is often disproportionate to the initial injury, CRPS typically affects the limbs, such as arms, legs, hands, or feet. The pain experienced is more intense and lasts longer than would typically be expected. While the exact cause of CRPS remains elusive, it is believed to involve dysfunction in the central and peripheral nervous systems, as well as inflammatory responses. Early diagnosis and holistic management are crucial for improving treatment outcomes. Dietary interventions, vitamins, and nutritional supplementation are increasingly recognized for their role in managing neuropathic pain, including CRPS. This article explores the relationship between CRPS and diet, providing insights into anti-inflammatory eating, foods to avoid and embrace, and the potential benefits of specific supplements.
Understanding CRPS and Its Connection to Inflammation
CRPS is often described as an injury to a nerve or soft tissue that deviates from the normal healing process. Many physicians believe that the complications and pain associated with CRPS stem from inflammation. In essence, individuals with CRPS experience chronic inflammation. As with many bodily reactions to outside forces, inflammation is a reaction that is intended to protect the body from further harm, such as infections. It increases the body’s blood flow to areas that need to heal. Of the diseases that can be linked to inflammation, many of them are chronic diseases.
The Role of Diet in Managing CRPS
Given the link between CRPS and inflammation, adopting an anti-inflammatory diet can be a powerful strategy for managing symptoms. Eating an anti-inflammatory diet focuses on consuming foods that naturally reduce inflammation and avoiding triggers that exacerbate the body's inflammatory response. Foods that tend to trigger the body’s inflammatory response can cause an increase in joint pain, stiffness, redness, swelling, heat, and even loss of function. By making conscious dietary choices, individuals with CRPS can potentially alleviate pain and improve their overall well-being.
Foods to Avoid
Certain foods are known to promote inflammation and may worsen CRPS symptoms. Limiting or avoiding these foods can be beneficial:
- Processed Foods: Consuming a lot of processed foods was found to be detrimental. Microwavable foods, often high in processed ingredients, should be minimized.
- Coffee and Chocolate: Coffee and chocolate contain oxalic acid, which can inhibit mineral absorption. Furthermore, chemical compounds in coffee may interfere with opiate receptor sites in the brain, potentially decreasing pain tolerance.
- Sugars: Sugar triggers an inflammatory process called "glycosylation." It is advisable to avoid white refined sugars and flour products, including white bread, bagels, and white rice.
- Animal Fats: Animal fats contain an inflammatory agent called arachidonic acid (AA). This means avoiding or strictly limiting red meat, butter, and whole eggs.
Foods to Embrace: An Anti-Inflammatory Approach
An anti-inflammatory diet emphasizes whole, unprocessed foods that are rich in nutrients and antioxidants. Incorporating these foods into your diet may help reduce inflammation and manage CRPS symptoms:
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- Fruits and Vegetables: Eating a variety of colorful fruits and vegetables, and rotating them, is essential to get the maximum nutrients. Fruits and vegetables are well-known for their ability to reduce inflammation, especially cherries and berries. As a general rule, vegetables rebuild your cells, and fruits clean (detoxify) them. Because most people with chronic diseases are also somewhat insulin resistant, it is best to keep your fruit/vegetable ratio at 30 percent fruit to 70 percent vegetables. A few additional things to remember: raw is always best (keeping the enzymes, nutrients, and alkalinity intact).
- Protein: The way to avoid inflammation in regards to protein is to monitor where you get your protein from. Your safest bet is to obtain your protein from plant sources. Nuts, whole grains and beans are great sources of protein, as opposed to most meats. If you are going to eat red meat, it is recommended to eat wild game or grass-fed meats as opposed to grain-fed.
- Fiber: Generally, fiber lowers inflammation. You can get fiber from many places like vegetables, berries, whole grains, oatmeal, nuts, popcorn and brown rice, as well as potato skins.
- Herbs and Spices: Some of the most beneficial anti-inflammatory herbs and spices to add to your diet are paprika, rosemary, ginger, turmeric, sage and cumin. Turmeric, ginger, nutmeg, and cinnamon are particularly good spices to try to include in your diet. Not only do they enhance flavor, they also have various phytochemicals that have been studied for their anti-inflammatory and analgesic properties.
- Healthy Fats: We all need fat, but keeping an eye on the types of fats is another way to reduce inflammation. Fats provide essential fatty acids, which are not made by the body and must be obtained from food. When it comes to being bad for you or fattening, it is not the amount of fats that count, but the quality and types. Some good and some bad, such as butter (limit), ice cream (limit), cream (limit), fatty meats (fine if grass-fed), avocado (good for you), nuts (good for you, with the exception of peanut butter), coconut (good for you if of good quality and virgin, and great for cooking, as it is not very damaged by heat. Divided into monounsaturated fats (olive and canola oils) and polyunsaturated fats (sunflower, fish, safflower, corn, and soybean oils).
The Importance of pH Balance
Maintaining an alkaline pH in the body is crucial for managing CRPS. Our bodies were designed to be alkaline by nature (at a tightly controlled pH of 7.4), and acidic by function-meaning that the waste products our cells produce when they work are usually acidic. An acidic diet will also decrease the body’s ability to repair damaged cells, as well as its ability to absorb minerals and other nutrients. This results in a decrease in the energy production of the cells, lowering their ability to detoxify heavy metals and other toxins. On the other hand, your health will greatly improve if your diet is more alkaline. For the most part, vegetables and fruits (and most nuts and seeds) are alkaline, and animal products such as meat and cheese, refined carbs, junk food, sugar, and pastas are acidic foods. As a general rule, if you are sick, you should aim for an 80/20 balance, where 80 percent of the food you eat has an alkaline pH or effect on the body (for instance, even though a lemon is acidic, it will have an alkalizing effect on your body). In order to maintain health, a 70/30 (70 percent alkaline foods, 30 percent acid foods) daily balance is recommended.
The Significance of Omega-3 to Omega-6 Ratio
The ideal ratio of omega-6 to omega-3 fats is 1:1, a ratio maintained by our ancestors for millions of years. Today, though, according to Dr. Mercola and other sources, our ratio of omega-6 to omega-3 averages anywhere from 20:1 to 50:1! This imbalance may contribute to autoimmune conditions, cancer, pain, Alzheimer’s disease, and cellular inflammation (of particular concern for those who suffer from CRPS), to name a few. By far, the best type of omega-3 fats are those found in that last category, fish. That’s because the omega-3 in fish is high in two fatty acids crucial to human health, DHA and EPA. These two fatty acids are pivotal in preventing heart disease, cancer, and many other diseases.
Hydration: The Elixir of Life
When it comes to what kind of water to drink, always ask yourself, “What would nature do?” We do not recommend that you drink water straight out of a faucet due to additives and toxicity issues. Ionized water is alkalized by electricity splitting the water molecules, without added minerals. In nature, water flows over rocks and through soil, collecting naturally alkalizing minerals such as calcium and magnesium. Distilled and reverse osmosis water is “dead” water that will leach minerals from your body. Always add the juice of half a lemon to filtered water, as this will add minerals back into the water and is also naturally alkalizing. (Do rinse your mouth out after with plain water in order to protect your teeth).
Addressing Food Allergies and Sensitivities
If there is a specific food that you crave, like sugar, there is a good chance that you are allergic to that food. Allergies to food will make the whole repair process rather ineffective, like a dog chasing its own tail. Also, it will increase cellular inflammation and therefore pain. First, get a proper blood test to determine which foods you are allergic to. Only IgE reactions are considered true food allergies, and will require a blood draw. Food sensitivity is a term that usually refers to delayed immune reactions to foods, or non-immune reactions to food. In addition, people who suffer from chronic pain have been shown to be sensitive to nightshade vegetables.
Dietary Supplementation and CRPS
Dietary interventions, vitamins, and nutritional supplementation are playing an increasingly important role in the management of neuropathic pain.
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A systematic review of studies published between 2000 and 2021 examined the effects of various supplements on different types of pain, including CRPS. While the review could not recommend specific supplements for chemotherapy-induced peripheral neuropathy (CIPN), it suggested that further research into N-acetyl-cysteine, l-carnosine, crocin, and magnesium is warranted. Acetyl-l-carnitine was found to be likely ineffective or harmful, and alpha-lipoic acid was not found to be effective.
For diabetic peripheral neuropathy (DPN), the review supported the use of alpha-lipoic acid, acetyl-l-carnitine, and vitamin D. The early use of vitamin C prophylaxis for the development of CRPS-I also seems promising.
Specific Supplements and Their Potential Benefits:
- Vitamin C: The early use of vitamin C prophylaxis for the development of CRPS-I also seems promising.
- Alpha-Lipoic Acid, Magnesium, and B Vitamins: Supplements like alpha-lipoic acid, magnesium, and B vitamins may support nerve health.
- Turmeric: Turmeric, derived from the Curcuma longa plant and rich in the bioactive compound curcumin, has emerged as a potential coadjuvant supplement in anti-inflammatory dietary strategies
- Curcuma Latte: The study consisted of 5 face-to-face and 5 telematic visits with in-person visits scheduled once a month and the first telematic visit being scheduled 15 days after the first in-person visit and monthly thereafter. Nutritional intervention study with an anti-inflammatory, supplemented MD diet.
Additional Considerations for Managing CRPS
In addition to dietary changes, several other factors can influence CRPS symptoms:
- Stress Management: Stressful emotional triggers cause stress hormones like cortisol to be released, which in turn, increases inflammation and impedes the body’s ability to heal.
- Caffeine and Smoking: If you have CRPS, it is recommended to limit caffeine, such as coffee or energy drinks, intake as much as you can. Smoking is especially detrimental to those who suffer from CRPS because it decreases oxygen to the brain and increases neurological injury.
- Toxic Chemicals: It’s best to avoid cosmetics and personal care products with toxic chemicals.
- Sleep: Sleeping serves a very important function, especially for those suffering from chronic diseases, such as CRPS. CRPS patients often have lowered immune systems due to the chronic stress their bodies are undergoing physically and emotionally. As a result, poor sleep can exacerbate CRPS symptoms. While you are sleeping, your nervous system has much more energy available for healing. If you are sleep-deprived, your body is missing out on this golden opportunity.
The AnMeD-S Diet: An Anti-Inflammatory Approach
After an exhaustive bibliography search, we designed a 13-item anti-inflammatory dietary guide based on a Mediterranean diet without red meat, gluten, or cow’s milk (the AnMeD-S). We then conducted a pilot study to evaluate the efficacy of this anti-inflammatory diet in patients with CP. A food consumption score (with a maximum of 156 points) was then applied to evaluate patient adhesion to the proposed diet. Forty-five patients with CP were followed-up for 4 months. We found a correlation between increased anti-inflammatory food intake and improved physical characteristics, stress, and pain in the patients we assessed. Moreover, decreased consumption of pro-inflammatory foods was positively correlated with sleep satisfaction.
The Importance of a Holistic Approach
Most importantly, it will do you no good if you attempt to treat specific areas of the body where you are experiencing symptoms. Unlike the mechanistic approach (that which most medical doctors follow today), the body is not like an engine. What I mean by that is that you cannot just treat different parts, forgetting that every part is connected to every other part. The body is incredibly intelligent, far above our understanding as human beings. Together with our treatment system, we believe that there is one crucial ingredient that should be part of patient care. You need a doctor who, above all else, truly cares about you. Doctors are not gods. They are not power figures who may not be questioned. We work for you. Like any good employee, if we are to help you, we have to listen to you and care about you. I throw my passion into every single case that I treat. Every patient represents a goal to me. When listening to my patients, I don’t just want to hear about their pain, I want to know what CRPS took away from them.
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