Should You Switch to an Elimination Diet to Fight Chronic Pain?

Pain management specialist answers 7 key questions
Should You Switch to an Elimination Diet to Fight Chronic Pain?

People rave about elimination diets for easing chronic pain, but do they work? Experts say, sometimes they do help. In many cases, it’s worth a visit to your doctor to see if an elimination diet could be right for you.

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Pain management specialist Hong Shen, MD, suggests discussing an elimination diet with your doctor if you have:

Here, she answers common questions about how elimination diets work.

1. How can an elimination diet relieve pain?

Inflammation is the root cause of chronic pain. Some foods are highly inflammatory, especially sugar, hydrogenated oil and highly processed food.

Many patients can develop sensitivity to gluten, dairy, corn and soy. Those foods can trigger your body’s immune response and cause pain, so eliminating the problematic foods can sometimes ease your pain.

2. What foods are usually eliminated?

The first foods Dr. Shen recommends that you eliminate include gluten, dairy, sugar, packaged foods and processed foods. If you’re still having pain, you may also need to eliminate corn, eggs, shellfish, beef, pork, coffee, tea and chocolate.

“Not everyone needs to eliminate all of these foods,” says Dr. Shen. “It just depends on what you’re eating on a regular basis.” 

3. How long should you eliminate these foods?

It depends on the type of problem you’re having.

If you’re on a strict elimination diet that includes avoiding all or most of the problematic foods, Dr. Shen recommends that you restrict them for between four and six weeks. If you’re on a diet that’s free of gluten, dairy or sugar, you can stay on it indefinitely. 

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4. How do you determine which food is causing the problem?

“The elimination diet serves both diagnostic and treatment purposes,” Dr. Shen says. “I will have my patients eliminate certain foods for four to six weeks, or, ideally, eight weeks.”

After eight weeks, if all your symptoms resolve, you can start reintroducing one food at a time and try it for three days. Dr. Shen recommends eating a significant amount of the targeted food at least twice in those three days.

If you develop discomfort, stop the new food until the symptoms completely disappear again. Then reintroduce the food a second time. If the same symptoms reappear, you stop it again and reintroduce a different food.

“From this test, you can find which food gives you pain,” she says.

5. How effective are elimination diets?

According to Dr. Shen, 30 to 40 percent of patients put on elimination diets get better just from changing their diets alone. Sometimes the changes are gradual. Other times, they’re more dramatic.

“You can have headaches for your entire life, then be pain-free after four to six weeks on an elimination diet,” she says.

In one study, 246 fibromyalgia patients followed either a gluten-free or dairy-free diet.

“Many responded to treatment, although some quicker than others,” says Dr. Shen. “The results of the study were similar to the 30 to 40 percent success rate we see at Cleveland Clinic.”

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How effective an elimination diet will be for you will depend on your condition. And everyone is different, so it also depends on how well your body responds. 

6. Are elimination diets used along with other treatments?

Treating pain is often complicated, Dr. Shen says, so it must be addressed on an individual basis. Doctors sometimes recommend other treatments as well, including:

  • Pain medications.
  • Mind-body medicine (using your mind to influence your body).
  • Guided imagery (a technique that focuses on mental images to help relieve pain).
  • Hypnosis.
  • Meditation.
  • Yoga.
  • Reiki (a healing technique in which touch channels energy to activate the natural healing processes of your body).
  • Acupuncture.
  • Chiropractic medicine.
  • Massage.
  • Herbal supplements.
  • Addressing other nutritional issues (such as potential deficits).

7. Why should I see a doctor before beginning an elimination diet?

In some instances, eliminating certain foods affects treatments for other health conditions.

“If you’re on diabetic medications, blood pressure medications or blood thinners (e.g., Coumadin), you may need to have your medication adjusted, depending on what you’re eliminating,” Dr. Shen says.

If you have food sensitivities, even healthy foods may trigger symptoms. Treating chronic pain requires a multi-level approach. “It’s not just diet alone,” she says.

Stress reduction is also important, as is exercise and getting a good night’s sleep.

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