5 Points To Know When Dealing With Peripheral Neuropathy


Living with peripheral neuropathy can be full of ups and downs from day to day, especially if you have been recently diagnosed. Managing this painful condition is frustrating at best, and can feel overwhelming at times. Patients often experience changing symptoms and debilitating pain. Learning more about potential treatment options should be a first step for anyone confronted with this condition, since treatments can go a long way to improving quality of life for those who are suffering.

Physiology & Pathology

Understanding a little more about the physiology of peripheral neuropathy, let’s start at defining the nerves involved in this debilitating condition. Peripheral nerves are the longest nerves in the body, extending all the way from the hands to the feet. When damaged, common symptoms are pain, numbness or tingling in the hands and feet. Unfortunately, these symptoms are far more severe and far-reaching than this. Some have reported experiencing such symptoms as stabbing pains and incapacitating weakness.

Better Insight For A Better Outcome

Today, 20 million people in the United States are affected by this condition, yet many are not aware of how it affects our loved ones, leaving the patient and their family helpless as to how to improve their overall quality of life. Below are five common conceptions that those with or know someone with peripheral neuropathy should be aware of for better understanding this condition.

 1. Diet Can Exacerbate Symptoms

Your diet may either help or hurt your nerves. To improve symptoms, avoid foods with excess sugar, artificial sweeteners, and refined grains. These foods may irritate the nerves causing nerve pain. In fact, studies have shown that a diet consisting of low-fat and whole foods supplemented with exercise may have a positive impact on neuropathy in reducing pain symptoms.

 2. Symptoms Are More Complex Than Just Tingling

While pain and tingling are common and the easiest symptoms to recognize they are not the only ones. There are three types of peripheral nerves: sensory, autonomic and motor. Each can show different symptoms. Sensory nerve damage causes the frequent pain, tingling and numbness. Motor nerve damage may cause difficulty walking or picking up items, and moving the arms. Autonomic nerve damage affects more of your involuntary functions, like breathing, sweating, blood pressure and more.

 3. Diabetes Is the #1 Cause of Neuropathy

Diabetes is the leading cause of neuropathy today. Over 70% of diabetes patients develop symptoms. To avoid diabetes manage your blood sugar carefully. This can be a great way to prevent or even reverse the effect of diabetic neuropathy.

4. There Are Other Causes Besides Diabetes

While diabetes is the leading cause of peripheral neuropathy, other causes may include: alcoholism, traumatic injury, chemotherapy, as well as a vitamin B12 deficiency. It is well documented that it may be very difficult for the medical community to identify the exact cause of each patient’s peripheral neuropathy. For cases where the cause cannot be defined, doctors will diagnosis the patients with “idiopathic neuropathy”.

5. Certain Medications Can Damage Nerves

For those suffering from diabetes, drugs such as metformin have been shown to encourage damage to the nerves. This association has been linked in a recent study to vitamin B12 deficiency, which may result in neuropathy.

Peripheral neuropathy is a very serious condition that should be managed as soon as even the simplest symptoms arise. Talking to your doctor and following their specific treatment plan, as well as being equipped with better insight into this condition, may better equip you in combatting the symptoms associated with peripheral neuropathy allowing you to still live a healthy and high quality of life. What other things have you heard about peripheral neuropathy? Let us know!

Tags: peripheral neuropathy, diet, medications, diabetes, b12 deficiency, pain, tingling



  1. Allet L, Armand S, de Bie RA, Pataky Z, Aminian K, Hermann FR, et al. Gait alterations of diabetic patients while walking on different surfaces. Gait Posture. 2009; 29:488–493. [PubMed: 19138520]
  2. Hastings MK, Gelber JR, Isaac EJ, Bohnert KL, Strube MJ, Sinacore DR. Foot progression angle and medial loading in individuals with diabetes mellitus, peripheral neuropathy, and a foot ulcer. Gait Posture. 2010; 32:237–241. [PubMed: 20570153]
  3. Pecoraro RE, Reiber GE, Burgess EM. Pathways to diabetic limb amputation. Basis for prevention. Diabetes Care. 1990; 13:513–521. [PubMed: 2351029]
  4. Sawacha Z, Gabriella G, Cristoferi G, Guiotto A, Avogaro A, Cobelli C. Diabetic gait and posture abnormalities: a biomechanical investigation through three-dimensional gait analysis. Clin Biomech. 2009; 24:722–728.
  5. Shull PB, Shultz R, Silder A, Dragoo JL, Besier TF, Cutkosky MR, et al. Toe-in gait reduces the first peak knee adduction moment in patients with medial compartment knee osteoarthritis. J Biomech. 2013; 46:122–128. [PubMed: 23146322]
  6. Zimny S, Schatz H, Pfolhl M. The role of limited joint mobility in diabetic patients with anat-risk foot. Diabetes Care. 2004; 27:942–946. [PubMed: 15047653]

8 Ways For Effective Sleep Hygiene When Dealing With Chronic Pain


We dare you to find a person that has never had a restless night of sleep. We think you can agree with us that finding such a lucky person would be quite a daunting task. With that being said, we have all had the occasional night where we just can’t fall asleep. A night or two, although annoying, hardly causes us to become alarmed. Nonetheless, for those suffering from a chronic illness, a couple of nights without sleep can wreak havoc on pain symptoms as well as their overall quality of life. Unfortunately, it is simply not just a couple of nights that individuals with chronic pain have to deal with. Not getting a good night’s rest generally leads to exacerbated pain symptoms where hyperalgesia (intensified pain) may keep someone from falling asleep at night. Said another way, pain worsens sleep patterns and sleep disturbances worsen pain. It is worth noting that chronic pain patients are all too familiar with sleep disorders where more than 66% of patients experience problems. Such a rancorous cycle could lead to a chronic inability to fall asleep, which could result in insomnia or other sleep disorders.

What Exactly Is Insomnia?

Insomnia is a general clinical term that refers to the difficulty in initiating or maintaining sleep that occurs for at least three nights a week for up to 3 months in a given year. It may present as an independent problem (primary insomnia) or as part of a coexisting medical or psychiatric condition (secondary insomnia). Insomnia is known to cause clinically significant distress or impairment in social, occupational, educational, academic, behavioral, or other important areas of functioning; thus it is important to talk to your doctor as soon as possible if you find yourself meeting this criteria. Fortunately, in many cases insomnia can be reversible and can greatly reduce someone’s sleep-deprived pain symptoms. We will not go into too much detail but there are a number of treatments that can truncate symptoms of insomnia. However, it is very important to consult your physician to determine if the actual cause of your inability to sleep is from insomnia or from another sleep disorder that has yet to be ruled out. For example, sleep disorders caused by medication side effects, psychiatric disorder, or sleep apnea should all be considered as to why are not able to sleep.

Chronic Pain & Insomnia: A Catch-22

One form of treatment that we would like to discuss is the use of medications. Certain pain medications can in fact improve sleep and generally are prescribed for patients who have both a sleep disorder and a specific pain disorder. On the other hand, opioid pain medications can disrupt sleep and prevent patients from entering deep sleep after as little as one dose. Opioid pain medications can also cause sleep-related breathing disturbances. This is why it is crucial to consult with your doctor as to what the underlying cause is for your inability to sleep where a more precise treatment plan can be created.

Creating A Healthy Sleep Environment

Below are 8 ways that have been found to be effective in creating proper sleep hygiene where the first 6 are relatively easy to implement. We go into further detail about the last two in the hopes of furthering your understanding of these practices. As with any of these tips, please consult your doctor before implementing any of these.

  1. Use your bedroom only for sleeping. Avoid using your bedroom as an office, a place to eat, or a place to socialize.
  2. Only go to bed when you are sleepy.
  3. Watch caffeine and alcohol intake, especially after noon.
  4. Try to do physical activity earlier in the day.
  5. Try to wake up at the same time every day regardless of when you go to sleep the night before.
  6. Avoid naps during the day
  7. Cognitive Behavioral Therapy

As we mentioned above, medications are a very critical vehicle for alleviating symptoms of insomnia and pain. Nonetheless there does exist a therapy treatment that is just as effective as medications in the long-term and does jot have the side effects that may accompany medications. Cognitive behavioral therapy (CBT) is a form of treatment that has been shown to be highly effective in treating insomnia. CBT is comprised of a number of strategies that seeks to improve overall sleep quality as well as changing thought and behavior patterns that are assumed to interfere with sleep. CBT accomplishes this by helping patients control or eliminate negative thoughts and worries that keep them awake. Through CBT work there is an increased awareness of thoughts related to sleep and once controlled, they tend to decrease and it is easier for the patient to fall asleep. Numerous studies have shown that cognitive behavioral interventions are as effective as pharmacological treatments in the short term and more effective in the long term.

  1. Relaxation Therapy

Another strategy is relaxation training, which is used to reduce or eliminate muscle tension and distract one from racing thoughts. Relaxation therapy is useful for both sleep onset and sleep maintenance insomnia. Techniques include progressive muscle relaxation, guided imagery, biofeedback, and autogenic training; to name a few. Regardless of the type of relaxation strategy used, the treatment involves professional guidance and the teaching of these skills over a number of sessions.

Do your best to adopt one or any of these stress-management strategies to reduce the anxiety or other emotional disturbances associated with your lifestyle. Doing so will be your best bet in keeping sleep-deprived pain symptoms at bay. Again, we must stress to please make sure that you receive treatment for any medical, psychiatric, or other conditions that may interfere with your sleep. What tips have helped you create healthy sleep hygiene? Let us know!

Tags: alcohol, caffeine, CBT, chronic pain, insomnia, pain management, sleep, sleep hygiene


  1. Buysse DJ, Germain A, Moul DE, Franzen PL, Brar LK, Fletcher ME, et al. Efficacy of brief behavioral treatment for chronic insomnia in older adults. Arch Intern Med. 2011;171:887–95.
  2. Lichstein KL, Durrence HH, Riedel BW, Taylor DJ, Bush AJ. Epidemiology of sleep: Age, gender, and ethnicity. Mahwah, NJ: Erlbaum; 2002.
  3. McCurry SM, Logsdon RG, Teri L, Vitiello MV. Evidence-based psychological treatments for insomnia in older adults. Psychol Aging. 2007;22:18–27.
  4. Mellinger GD, Balter MB, Uhlenhuth EH. Insomnia and its treatment: Prevalence and correlates. Arch Gen Psychiatry. 1985;42:225–32.
  5. Morgenthaler T, Kramer M, Alessi C, Friedman L, Boehlecke B, Brown T, et al. Practice Parameters for the Psychological and Behavioral Treatment of Insomnia: An Update.An American Academy of Sleep Medicine Report. Sleep. 2006;29:1415–9.
  6. Morin CM, Azrin NH. Behavioral and cognitive treatments of geriatric insomnia. J Consult Clin Psychol. 1988;56:748–53.
  7. Morin CM, Bootzin RR, Buysse DJ, Edinger JD, Espie CA, Lichstein KL. Psychological and behavioral treatment of insomnia: Update of the recent evidence (1998-2004) Sleep. 2006;29:1398–1414.
  8. Morin CM, Kowatch RA, Barry T, Walton E. Cognitive-behavior therapy for late-life insomnia. J Consult Clin Psychol. 1993;61:137–46.
  9. Pigeon WR, Crabtree VM, Scherer MR. The future of behavioral sleep medicine. J Clin Sleep Med. 2007;3:73–9.
  10. Stepanski EJ, Rybarczyk B. Emerging research on the treatment and etiology of secondary or comorbid insomnia. Sleep Med Rev. 2006;10:7–18.

5 Ways To Prevent Golfer’s Elbow

What a great time to be in Arizona! With a high of 80° and sunny weather, it is the perfect time for Phoenicians and snowbirds to partake in the wonderful outdoor activities the Valley of the Sun has to offer; one of the more popular activities being golf. There is not a better place than Arizona in the winter to experience the plethora of picturesque and world-renowned courses. Nonetheless, the great weather or game of golf is not immune from injuries. An injury that we see on a regular basis is golfer’s elbow (i.e. medial epicondylitis). Here we would like to discuss what golfer’s elbow is and provide some stretching tips on how you can reduce the injury and pain associated with golfer’s elbow.

What Is Golfer’s Elbow?

To begin describing this type of injury, let’s begin by briefly going over the anatomy. Golfer’s elbow involves a tendon known as the common flexor tendon that connects the flexor forearm muscles to the inner (medial) side of the elbow bone (epicondyle). Constant repetition of bending the wrist, for example, as when holding and swinging a golf club, can lead to inflammation of the medial epicondyle. This repetitive motion and cumulative stress can cause the tendons at the inner side of the elbow to deteriorate. Generally, patients experience symptoms of pain and tenderness at the inner side of the elbow that increases during wrist flexion or grasping motions. The pain may radiate down the forearm and if not treated immediately, further micro-deterioration of the tendons could lead to severe pain, inability to play golf, and even surgery.

5 Ways To Prevent Golfer’s Elbow

Fortunately, there are a number of stretches and exercises that can treat and even prevent golfer’s elbow. We have compiled 3 exercises and 2 stretches that work to strengthen the forearm muscles in the hopes of preventing golfer’s elbow. Try to incorporate these stretches and exercises during your golf season (especially if pain does arise on the inside part of your elbow) as well as during the off-season.

  1. Wrist Curl

Place your forearm on your quadriceps with your palm facing the sky. Next hold a lightweight dumbbell in your hand. Very slowly extend your wrist as far as you can (your fingers will move towards the ground), followed by slowly curling the dumbbell moving towards your body. Your flexor forearm muscles should be completely flexed at this point. Do about 10 repetitions with one arm, and then repeat with the other arm.

  1. Reverse Wrist Curl

Place your forearm on your quadriceps with your palm facing the ground. Next, hold a lightweight dumbbell in your hand and very slowly drop your wrist as far as you can (your fingers will move towards the ground). Then, bring the dumbbell upwards towards the sky by contracting the muscles on the outside of your forearm. Your extensor forearm muscles should be completely extended at this point. Again, do about 10 repetitions with one arm, and then repeat with the other arm.

  1. Hand Grip & Squeeze

Simply take a tennis ball and alternate between squeezing and releasing the ball. Perform this for about 5 minutes at a time for each arm.

  1. Parallel Ulnar Nerve Floss

The ulnar nerve runs along side the medial epicondyle and can become “trapped” by constant inflammation and build-up of scar tissue. This floss (stretch) works to break-up the scar tissue, which may “entrap” the ulnar nerve and decrease inflammation. Start by curling your forearm to your biceps. Point your fingers towards your head where your palm is facing the sky. Your hand should be parallel with your shoulders. Gently take your other hand and place it on the pinky and ring finger of your bent arm. Gently push down on these two fingers while bending your neck in the opposite direction of the bent arm. Remember not to push too hard; aim for a gentle stretch. Hold the stretch for only 5 seconds, repeat 5 times and aim to stretch at least 3 times a day.

  1. Perpendicular Ulnar Nerve Floss

This floss technique is similar to the one above; only differing in the direction of the stretch. Straighten your arm in front of you with your palm facing outward. Have your arm about shoulder level and perpendicular to your shoulder. Again with the opposite hand, gently grab the pinky and ring finger of the straightened arm. Gently pull the two fingers towards you. Hold the position for 30 seconds and repeat 5 times. Aim to stretch at least 3 times a day.

These simple and yet effective exercises will go a long way in preventing serious problems associated with golfer’s elbow. Again, these techniques are all working to strengthen as well as loosen the muscle of your forearm. Although these are simple exercises that can be performed at your convenience, please consult your doctor before doing so. Only your doctor will be able to determine if medial epicondylitis is the cause of your pain and will recommend the best rehabilitation option for you. What stretches or exercises work best in keeping you on top of your golf game? Let us know!

Tags: golfer’s elbow, medial epicondylitis, stretches, exercises, pain management, chronic pain


  1. Bisset L, Beller E, Jull G, et al; Mobilisation with movement and exercise, corticosteroid injection, or wait and see for tennis elbow: randomised trial. BMJ. 2006 Sep 29
  2. Buchbinder R, Johnston RV, Barnsley L, et al; Surgery for lateral elbow pain. Cochrane Database Syst Rev. 2011 Mar 16;(3):CD003525. doi: 10.1002/14651858.CD003525.pub2.
  3. Coombes BK, Bisset L, Vicenzino B; Efficacy and safety of corticosteroid injections and other injections for management of tendinopathy: a systematic review of randomised controlled trials. Lancet. 2010 Nov 20;376(9754):1751-67. doi: 10.1016/S0140-6736(10)61160-9. Epub 2010 Oct 21.
  4. Luk JK, Tsang RC, Leung HB; Lateral epicondylalgia: midlife crisis of a tendon. Hong Kong Med J. 2014 Apr;20(2):145-51. doi: 10.12809/hkmj134110. Epub 2014 Feb 28.
  5. McCreesh K, Lewis J; Continuum model of tendon pathology – where are we now? Int J Exp Pathol. 2013 Aug;94(4):242-7. doi: 10.1111/iep.12029.
  6. Olaussen M, Holmedal O, Lindbaek M, et al; Treating lateral epicondylitis with corticosteroid injections or non-electrotherapeutical physiotherapy: a systematic review. BMJ Open. 2013 Oct 29;3(10):e003564. doi: 10.1136/bmjopen-2013-003564.
  7. Orchard J, Kountouris A; The management of tennis elbow. BMJ. 2011 May 10;342:d2687. doi: 10.1136/bmj.d2687.
  8. Pattanittum P, Turner T, Green S, et al; Non-steroidal anti-inflammatory drugs (NSAIDs) for treating lateral elbow pain in adults. Cochrane Database Syst Rev. 2013 May 31;5:CD003686. doi: 10.1002/14651858.CD003686.pub2.
  9. Petrella RJ, Cogliano A, Decaria J, et al; Management of Tennis Elbow with sodium hyaluronate periarticular injections. Sports Med Arthrosc Rehabil Ther Technol. 2010 Feb 2;2:4. doi:10.1186/1758-2555-2-4.
  10. Shiri R, Viikari-Juntura E; Lateral and medial epicondylitis: role of occupational factors. Best Pract Res Clin Rheumatol. 2011 Feb;25(1):43-57. doi: 10.1016/j.berh.2011.01.013.
  11. van Rijn RM, Huisstede BM, Koes BW, et al; Associations between work-related factors and specific disorders at the elbow: a systematic literature review. Rheumatology (Oxford). 2009 May;48(5):528-36. doi: 10.1093/rheumatology/kep013. Epub 2009 Feb 17.

4 Reasons Why A High-Protein Diet May Reduce Chronic Pain


It’s very simple to believe that a plethora of diseases and illness have their own recommended diets. For example, conditions like diabetes, obesity, atherosclerosis, hyperlipidemia all have their own recommended diets and parameters as to what nutritional changes will truncate symptoms of these conditions. In no way are we saying this is a bad thing; in fact, we support associations that disseminate these diets. However, what we do see as not being so common, are diets on how to truncate symptoms of chronic pain. In recent years the clinical/scientific research community has gathered a considerable amount of data that chronic pain, particularly the debilitating, severe form that requires opioid treatment, needs a “chronic pain” diet. Unfortunately, there has yet to be any official recommendation for a diet that may reduce symptoms of chronic pain. This is exactly what we would like to discuss.

It is well documented that the foundational principles of a diet for those suffering from chronic pain is a high-protein–intake diet with minimal amounts of carbohydrates. The goals of a high ratio of protein-to-carbohydrates are to promote weight loss, mental function, energy, and strength. It is also recommended that a dietary supplement (e.g. glucosamine chondroitin) be taken to assist regeneration of tissue and prevent osteopenia and osteoporosis.


Before we jump into this mechanism, we want to stress that the release and action of hormones is similar to a circular mechanism. For example, say you just ate a meal and you have increased the amount of sugar in your response. This signal will alert the pancreas to secrete a hormone known as insulin. The job of this hormone is to readily uptake glucose (sugar) in the blood and stores it in tissues. Normally, insulin is regulated by a negative feedback loop where once the sugar in the blood has dropped to a certain minimum, the pancreas will stop producing insulin to prevent the cardiovascular system from becoming hypoglycemic (low blood sugar). However, in unstable circumstances, insulin production will continue past the minimum point. Over a long period of insulin secretion, as well as combining with other anabolic effects, the body can be induced into a state of hypoglycemia.

Now that we got that out of the way, let’s be quick in giving some background as to why this high protein-to-carbohydrates ratio diet is physiologically and biochemically important for those suffering from chronic pain. Chronic pain no doubt puts quite a bit of stress on the body as well as inducing mental stress. When the body is in a state of stress, the adrenal glands (which sit on top of the kidneys) release a large amount of stressor hormones known as catecholamine and cortisol. Such excessive production of these hormones takes a toll on the body by causing the blood glucose levels to become unstable; levels may vary from hyper-(high) to hypoglycemia (blood sugar). Overtime, with so much overproduction of these hormones, the adrenal glands can become in a state of exhaustion where the net hormone–nutrition effect of uncontrolled pain is poor mental state, deficient protein intake, muscle wasting, weakness, and food intake consisting almost solely of carbohydrates (sugars and starches). Thus do to the nature of carbohydrates, overconsumption may lead to weight gain with an unstable release of insulin.

Nonetheless, pharmaceutical management (typically opioids) also has a profound effect on the hormone–nutrition system, compounding the necessity of a pain diet. Those individuals taking opioids typically prefer sugary foods (opioids can induce a state of hypoglycemia causing a “sugar desire effect” on the opioid receptors) and who often experience weight gain; there have been cases where some people have actually doubled their weight in only a matter of a few years from being on opioids. Therefore, the combination of stress from severe chronic pain and opioid management can cause unhinged glucose metabolism in patients and a potent desire to ingest primarily sugars and starches, with little protein or fat intake.

Why Is Protein So Critical?

It is worth noting that there have been studies that have shown that patients will experience an increased intensity of pain only after a few hours of eating a meal high in carbohydrates. It has been speculated that the increase in pain is caused by a sharp increase in insulin; along with the other two factors mentioned above can leave them in a state of hypoglycemia. Thus a major element of the diet recommended here is stabilization of blood sugars. So let’s now jump into some reasons as to why a high-protein intake diet may lead to the reduction of chronic pain symptoms!

  1. Protein Decreases Inflammation

Research has shown that foods high in protein (e.g. fish, cruciferous vegetables) contain high levels of anti-inflammatory mediators. Such agents promote a decrease in inflammation by reducing free radicals as well as immunological agents that are responsible for an inflammatory response.

  1. Protein Builds Muscle-Cartilage

All protein is simple a varying chain of 20 different amino acids. One of the main amino acids that makes up collagen is a nonpolar-hydrophobic amino acid known as proline. A high-protein diet can provide the body with a proper amount of proline that can be available for collagen regeneration, which is essential for the development of cartilage and intervertebral discs.

  1. Protein Balances The Insulin-To-Glucagon Ratio

Just like insulin, glucagon is secreted from specific cells in the pancreas. However, glucagon does the complete opposite job of insulin. After a long period without eating where blood sugar may be low, glucagon is released to mobilize sugar deposits (glycogen & amylopectin) thus increasing blood glucose levels. Also, glucagon is the only hormone that blocks glucose storage as fat. Eating a diet high in protein and low in carbohydrates will balance the ratio of glucagon-to-insulin. Such a diet may prevent a sharp increase in insulin, which prevents a blood sugar rebound by avoiding a sharp decrease in blood glucose (i.e. hypoglycemia that results in carbohydrate cravings and possible pain flares). A high-protein diet may also avoid excess sugar consumption which decreases the amount of excess glucose that might be stored as fat, thus avoiding weight gain.

  1. Endogenous Pain Relievers Are Protein Derivatives

Back to the amino acids! Again all proteins are composed of 20 variations of amino acids. Proteins a chemically digested beginning in the stomach and ending in the duodenum (first section of the small intestines where most absorption takes place). Three main enzymes: pepsin, secreted by the stomach; trypsin and chymotrypsin, secreted by the pancreas are responsible for breaking down proteins into their varying sorts of amino acids. This is important because out of the twenty amino acids that make up proteins, eight of them are known as essential amino acids (these are isoleucine, leucine, lysine, methionine, phenylalanine, threonine, tryptophan, and valine.) that the body cannot make, thus must be supplied through one’s diet. By eating a diet high in protein will ensure adequate levels of these eight amino acids where they can be absorbed into the blood system via the jejunum and ilium of the small intestines to the liver, exocrine/endocrine glands, and brain; providing the body with the “building blocks” of all compounds crucial for pain relief. Such compounds are known as epinephrine/norepinephrine (endorphins), dopamine, serotonin, and γ-aminobutyric acid (GABA). We must stress that it has yet to be identified as to how much protein someone with chronic pain needs to take in order to provide enough amino acid substrate for the production of these pain-controlling compounds.

So What Does The Diet Look Like?

The diet is actually very simple and can be easy to follow. After discussing with your healthcare provider as to how many calories and number of meals you are going to consume in a day, try to make sure that each meal is at least 50% comprised of protein. Also, ensure at most 30% fat and 20% carbohydrates. Try to avoid consuming sugary drinks. For example, juice, milk, regular sodas, and energy drinks are loaded with sugar. These drinks, as well as other high sugary foods, will cause a sharp increase in insulin and could potentially lead to a rebound effect where hypoglycemia may occur. By avoiding these drinks and foods we hope to reduce overall carbohydrate intake thus preventing hypoglycemia and weight gain. Let’s go back go reason #4 real quick. Although it has yet to be identified as to how much protein someone with chronic pain needs to take in order to provide enough amino acid substrate for the production of these pain-controlling compounds, given the other three reasons, as well as the chemical composition of these compounds, it is safe to say that 1 gram of protein per body weight is sufficient enough to provide adequate levels of amino acids. With that being said, please consult your doctor as to how much protein you should be consuming daily. Also we know that this number may sound high where historically “high protein as been known to cause liver/kidney failure”. But such a claim has been proven to be false or severely exaggerated. Always make sure to drink plenty of water with and between each meal. If you would like to discuss a diet specific for you, please come see us! Please call our office at (480) 222- PAIN (7246) to make an appointment.

Tags: diet, protein, carbohydrates, chronic pain, pain management, inflammation



  1. Cooper C, Atkinson EJ, Hensrud DD et al. Dietary protein intake and bone mass in women. Calcif Tissue Int 1996;58:320-325.
  2. Dawson-Hughes B, Harris SS, Rasmussen H et al. Effect of dietary protein supplements on calcium excretion in healthy older men and women. J Clin Endocrinol Metab 2004;89:1169-73.
  3. Geinoz G, Rapin CH, Rizzoli R et al. Relationship between bone mineral density and dietary intakes in the elderly. Osteoporos Int 1993;3:242-8.
  4. Ginty F. Dietary protein and bone health. Proc Nutr Soc 2003;62:867-76.
  5. Hill AJ, Blundell JE. Composition of the action of macronutrients on the expression of appetite in lean and obese human subjects. Ann N Y Acad Sci. 1990;580:529-31
  6. Hu FB, Stampfer MJ, Manson JA et al. Dietary protein and risk of ischemic heart disease in women. Am J Clin Nutr 1999;70:221-227.
  7. Kerstetter JE, Svastislee C, Caseria D et al. A threshold for low-protein-diet-induced elevations in parathyroid hormone. Am J Clin Nutr 2000;72:168-173.
  8. Klahr S, Levey AS, Beck GJ et al. The effects of dietary protein restriction and blood-pressure control on the progression of chronic renal failure. N Engl J Med 1994;330:877-884.
  9. Layman DK. Protein Quantity and Quality at Levels above the RDA Improves Adult Weight Loss. J Am Coll Nutr. 2004 Dec;23(6 Suppl):631S-6S.
  10. Layman DK, Baum JI. Dietary protein impact on glycemic control during weight loss. J Nutr. 2004 Apr;134(4):968S-73S.
  11. Layman DK, Boileau RA, Erickson DJ, Painter JE, Shiue H, Sather C, Christou DD. A reduced ratio of dietary carbohydrate to protein improves body composition and blood lipid profiles during weight loss in adult women. J Nutr. 2003 Feb;133(2):411-7.
  12. Mendellhall C, Moritz T, Roselle GA et al. A study of oral nutrition support with oxadrolone in malnourished patients with alcoholic hepatitis: results of a Department of Veterans Affairs Cooperative Study. Hepatology 1993;17:564-576.
  13. Mohanty P, Ghanim H, Hamouda W et al. Both lipid and protein intake stimulates increased generation of reactive oxygen species by polymorphonuclear leukocytes and mononuclear cells. Am J Clin Nutr 2002;75:767-772.
  14. Navder KP, Lieber CS. Nutrition and alcoholism. In: Bronner, F. ed. Nutritional Aspects and Clinical Management of ChronicDisorders and Diseases. Boca Raton, FL: CRC Press, 2003, pp. 307-320.
  15. Poortmans JR, Dellalieux O. Do regular high-protein diets have potential health risks on kidney function in athletes? Int J Sports Nutr 2000;10:28-38.
  16. Stubbs RJ, van Wyk MC, Johnstone AM, Barbron CG. Breakfasts high in protein, fat or carbohydrate: effect on within-day appetite and energy balance. Eur J Clin Nutr 1996;50:409-17
  17. Suzuki K, Kato A, Iwai M. Branched-chain amino acid treatment in patients with liver cirrhosis. Hepatol Res. 2004 Dec;30S:25-29.
  18. Walser M. Effects of protein intake on renal function and on the development of renal disease. In: The Role of Protein and Amino Acids in Sustaining and Enhancing Performance. Committee on Military Nutrition Research, Institute of Medicine. Washington, DC: National Academies Press, 1999, pp. 137-154.