Role of Nutrition in the Management of Patients with Chronic Musculoskeletal Pain

Figures & data

Table 1 Impact of Diet on Chronic Musculoskeletal Pain

Dietary Factor	Influence on Chronic Musculoskeletal Pain	Study
Obesity, high-calorie, sugar, fat, sodium, and caffeine intake	Predicts, perpetuates, or contributes to chronic musculoskeletal pain	[43]
Dietary fiber intake	Negative correlation with the risk of symptomatic osteoarthritis	[46,47]
Mediterranean diet	Reduction in the risk of worsening pain and symptomatic knee osteoarthritis	[48]
Dietary inflammatory index (DII^®)	Higher inflammatory potential increases the risk of knee osteoarthritis and other pain symptoms	[49,50]
High-protein dietary pattern	Linked to a lower prevalence of chronic lower back pain	[51]
Energy-dense diet	Positive association with chronic lower back pain	[51]
Various dietary approaches (eg intermittent fasting, ketogenic diet)	Improvement in pain assessment and quality of life	[52]

Table 2 Specific Nutritional Interventions and Their Impact on Chronic Pain

Intervention	Outcome	Study
Nutritional changes (dietary patterns, nutrients, meal frequency)	Relief comparable to antidepressants, improvement in musculoskeletal conditions	[45,55,56]
Mediterranean diet	Alleviating pain, reducing stiffness, and addressing biomarkers in OA	[58]

Table 3 Microbiota and Its Role in Chronic Pain

Microbial Factor	Association with Chronic Pain	Study
Gut dysbiosis	Increased risk of developing chronic pain conditions	[69]
Specific bacterial species (eg Streptococcus)	Correlated with severe knee osteoarthritis and increased pain	[70]
Lipopolysaccharide levels	Correlated with inflammation, symptoms, and abnormalities in knee osteoarthritis	[71]

Table 4 Nutrition and Sarcopenia – Risk Factors and Impacts

Factor	Association with Sarcopenia	Study
Malnutrition (overnutrition and undernutrition)	Prevalent cause of sarcopenia, leading to muscle mass and strength decline	[77,78]
Dietary protein, vitamin D, and other nutrients	Potential interventions in the management of sarcopenia	[80–82]
Sarcopenia	Associated with increased vertebral slippage, pain intensity, and risk of falls in lumbar spinal stenosis	[83–85]

Figure 1 Interrelation of sarcopenia, malnutrition, and chronic musculoskeletal pain and their risk factors.

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