by Dr. John Neustadt

Chronic pain is one of the most common reasons people go to the doctor. According to the CDC, approximately 50 million adults (20% of the population) struggle every day with chronic pain, which costs Americans $560 billion a year in medical expenses, reduced productivity, and disability programs.¹ Chronic pain makes it harder to move, kills the enjoyment of activities people love and can make it difficult to simply get out of bed, brush their teeth, or cook a meal. Pain wreaks havoc on people’s sleep, making it harder to fall asleep or stay asleep because they can’t get comfortable. Pain creates anxiety, depression, and ruins people’s quality of life. The financial costs are also devastating. 

The conventional approach of medicating away the pain puts you at risk for a whole list of dangerous side effects without fixing the underlying problem. Every day, over 30 million Americans take over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs). This category of medications includes over the counter ibuprofen, naproxen, and acetaminophen (the active ingredient in Tylenol). NSAIDs have been linked to gastrointestinal problems such as stomach upset, heartburn, nausea, ulcers, kidney damage, and liver injury.² In fact, acetaminophen toxicity is the number one cause of liver failure not caused by a trauma such as a car accident. Prescription medications are stronger and may contain highly addictive narcotics.

Fortunately, there are effective natural approachs that can help. Here we look at four simple, life-enhancing ways to feel better and that all have additional benefits, including improving peace of mind, longevity, vitality, fitness, immune function, and mood.

Sleep

A good night’s sleep allows the body to heal, boosts the immune system, improves mood, and the ability to process information and handle everyday stress better. But optimal sleep eludes too many people. The National Sleep Foundation reports that about 50% of Americans feel inadequate sleep impacts their daily activities at least once a week.³ 

Poor sleep and pain are intimately linked. Not getting enough sleep reduces a person’s pain threshold. This makes people more sensitive to pain; they experience more pain and the pain is more intense. Sleep deprivation also increases the risk of injuries, which creates a dangerous situation where people are experiencing more pain and also injuring themselves more, which in turn creates more pain. 

Lack of sleep not only predicts new occurrences of pain, but it also causes flare-ups of chronic pain. Pain and sleep are so closely linked that up to 88% of people with chronic pain struggle with sleep disturbances⁴ while half of the people with insomnia suffer chronic pain.⁵ Everyone has had a headache at one point, and even that common discomfort is linked to poor sleep, which then increases the pain.⁶ 

Insomnia has also been directly correlated with pain syndromes such as fibromyalgia.⁷ One large Norwegian study found that women suffering from sleep disturbances were more likely to develop fibromyalgia a decade later.⁸ In fact, 90% of fibromyalgia patients suffer from sleep problems, and their pain is directly correlated with poor sleep. 

In a 2017 review of sixteen different studies carried out between 1996 and 2015, nine of the studies found sleep had a significant effect on fibromyalgia pain. Four studies showed that pain, in turn, also influenced sleep, suggesting an insidious feedback loop between the two.⁹ Pain kept them from getting a good night’s sleep, which created more pain and made their sleep worse, which in turn made their pain worse. 

For these reasons, to reduce pain its crucial to get good, restorative sleep. Healthy sleep has been cited as a potential cure for pain and strongly correlates with the resolution of chronic pain.¹⁰ There are many ways to improve sleep, including meditation apps, calming music, gravity blankets, sleep hygiene practices, a warm bath, and exercise. 

Exercise

Healthy sleep and exercise go hand in hand, and both are able to reduce pain. An exercise training program improved sleep quality in middle-aged and older adults.¹¹ When it comes to exercise, there are options for every interest and ability level. There are even many great ways to work exercise into your daily life. Aerobic exercise can include brisk walking, jogging, Stairmaster, cycling, swimming, or using an exercise video at home; all are effective at improving self-reported sleep quality, mood, and quality of life in adults with difficulty sleeping.¹² Exercises that are gentler and more meditative, such as yoga and tai-chi, can also help.

Exercise not only improves sleep it has a direct effect on pain as well. Exercise programs that include aerobic and resistance as well as flexibility workouts significantly reduce pain in fibromyalgia, rheumatoid arthritis, chronic low back pain, and osteoarthritis.¹³ For individuals suffering from fibromyalgia, warm-water pool exercises twice a week for twelve weeks immediately reduced chronic pain, and the results were sustained throughout the program.¹⁴ Yoga also proved beneficial: eight weeks of yoga improved pain in twenty-two fibromyalgia patients.¹⁵ 

Meditation

Mindfulness meditation is an ancient practice that is well known to reduce pain both by altering the perception of pain and its significance and by relaxing the body. Mindfulness is ultimately a very simple and profound way to create a state of non-judgmental awareness. 

Jon Kabat-Zinn pioneered studies of mindfulness and chronic pain in the early 1980s and subsequently created the Stress Reduction Clinic and the Center for Mindfulness in Medicine, Health Care, and Society at the University of Massachusetts Medical School. One of his landmark studies found that chronic pain patients significantly improved after an eight-week mindfulness-based stress reduction program. The effects lasted up to four years after the eight-week training.¹⁶

This powerful pain reduction is not simply due to cognitive reframing, however. Research using functional magnetic resonance imaging (fMRI) found that meditation during pain reduces brain activity in the prefrontal cortex, amygdala, and hippocampus compared to non-meditators.¹⁷ Meditators also have a smaller cortisol (stress) response compared to non-meditators when exposed to capsaicin cream on their forearm.¹⁸ 

Healthy Diet

Many Americans eat a calorie-rich but nutrient-poor diet that’s low in health-promoting polyphenols, vitamins, minerals, and antioxidants. Excess salt, sugar, and unhealthy fats in our diet can lead to inflammation, and inflammation increases our risk for chronic pain.^19,20,21 Diets that increase inflammation are high in refined carbohydrates, sugar, saturated and trans-fatty acids, and low in omega-3 fatty acids, antioxidants, and fiber. Around the world, healthy diets that lead to vital, long lives are rich in fruits and vegetables.²²

Chronic pain is often caused by chronic inflammation, according to Fred Tabung, MD, a visiting researcher with the Department of Nutrition at Harvard’s T.H. Chan School of Public Health. And, says Tabung, changing your diet is one of the best ways to reduce pain.²³ Aim for a rainbow of colorful, whole foods on your plate, which you can do by eating a variety of fruits and vegetables. Eat whole grains, healthy proteins such as fish, chicken, beans, and nuts and use healthy oils rich in polyphenols and flavonoids, such as extra virgin olive oil. When choosing fruits and vegetables, select ones high in flavonoids and immune-boosting molecules. 

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