Can what you eat change how much pain you feel?
The science of nutrition and chronic pain:
Chronic pain affects millions of Australians and is one of the leading causes of disability, reduced quality of life, and healthcare burden. While medications and physical therapies remain cornerstones of management, there is a growing and compelling body of evidence pointing to something many of us overlook every single day: what we eat.
This blog explores the science connecting nutrition and chronic pain, and what practical, evidence-based steps you can take to support your pain management through diet.
Why nutrition matters for chronic pain:
The relationship between nutrition and chronic pain is both important and complex. Dietary intake can directly influence the nervous, immune, and endocrine systems, all of which play key roles in how pain is experienced and processed.
Poor diet quality is one of the most significant and modifiable risk factors for chronic disease globally, and there is a clear association between suboptimal eating patterns and worsened pain outcomes. Chronic pain is also associated with elevated weight, multi-morbidity, and poor dietary patterns, which together create a cycle that can be difficult to break.
The good news? A systematic review and meta-analysis of 73 studies found that “nutrition interventions had a statistically significant effect on reducing pain severity” in adults with chronic non-cancer pain. Dietary interventions are not just supportive, they are genuinely therapeutic.
The role of inflammation
One of the key mechanisms linking diet and pain is “systemic inflammation” Chronic low-grade inflammation contributes to the sensitisation of pain pathways and is a shared feature of many painful conditions including osteoarthritis, rheumatoid arthritis, fibromyalgia, and low back pain.
The foods we eat can either fuel or dampen this inflammatory state.
Ultra-processed foods, added sugars, refined carbohydrates, and hydrogenated oils have been shown to promote inflammation and oxidative stress, both of which amplify pain experiences. Conversely, whole, nutrient-dense foods rich in antioxidants, fibre, and healthy fats can reduce inflammatory biomarkers and support pain modulation.
What dietary patterns have the best evidence?
The Mediterranean Diet
The Mediterranean diet is the most well-researched eating pattern for pain management. Characterised by high consumption of fruits, vegetables, legumes, wholegrains, olive oil, and fish, with moderate dairy and minimal red meat, it has been shown to:
- Reduce inflammatory markers such as C-reactive protein (CRP)
- Improve pain outcomes in osteoarthritis and rheumatoid arthritis
- Support weight management, reducing mechanical load on painful joints
A 2025 meta-analysis of randomised controlled trials found that the Mediterranean diet group experienced significant decreases in pain severity.
Plant-Based and Plant-Rich diets
Vegetarian, vegan, and flexitarian eating patterns have also demonstrated effectiveness in reducing pain experiences. These diets are naturally rich in antioxidants, fibre, and phytochemicals, which reduce oxidative stress and support gut and immune health. Multiple systematic reviews at evidence level 1b support the recommendation to eat predominantly plant-rich diets for conditions including arthritis and fibromyalgia.
High diet quality, generally.
Even without adopting a specific named diet, “improving overall diet quality” is associated with better pain outcomes. Eating more core foods, including fruits, vegetables, wholegrains, legumes and dairy or alternatives, and reducing discretionary foods is a meaningful and achievable starting point.
Key nutrients worth knowing about.
Omega-3 Fatty Acids
Found in oily fish (salmon, sardines, mackerel), flaxseeds, and walnuts, omega-3 fatty acids have well-established anti-inflammatory properties..
Polyphenols
Colourful fruits and vegetables are rich in polyphenols, compounds with potent antioxidant and anti-inflammatory activity. Functional foods including turmeric, ginger, green tea, and peppermint contain bioactive compounds with analgesic and anti-inflammatory properties that may enhance dietary interventions.
Vitamin D
Vitamin D deficiency is highly prevalent in people with chronic pain, particularly those with low back pain. While evidence for supplementation as a pain treatment is still emerging, maintaining adequate vitamin D levels through diet, sun exposure, and supplementation where appropriate is recommended as part of comprehensive pain management.
Vitamin B12
Emerging evidence supports vitamin B12 as a potential therapeutic agent for pain, likely through its role in nerve function and repair.
What to limit?
Just as important as what you add to your diet is what you reduce. Evidence consistently shows that the following increase inflammatory burden and worsen pain:
- Ultra-processed foods: packaged snacks, processed meats, soft drinks
- Added sugars and refined carbohydrates
- Hydrogenated and trans fat
- Excessive alcohol
Australian dietary guidelines already recommend limiting these foods for general health, and the evidence for chronic pain is fully aligned with this advice.
The gut-brain-pain connection:
Emerging research highlights the importance of the gut microbiome in pain modulation. A diet high in fibre, fermented foods, and diverse plant foods supports a healthy microbiome, which in turn influences immune function, systemic inflammation, and even central pain processing. This is an exciting area of evolving science.
Practical starting points
You don't need to overhaul your diet overnight.
Small, consistent changes make a meaningful difference.
Consider:
1. Fill half your plate with colourful vegetables at each meal
2. Choose oily fish (salmon, sardines, tuna) 2–3 times per week
3. Swap refined grains for wholegrains (brown rice, oats, wholegrain bread)
4. Add a handful of nuts or seeds daily
5. Use olive oil as your primary cooking fat
6. Reduce ultra-processed snack foods and sugary drinks
7. Incorporate anti-inflammatory spices such as turmeric and ginger into cooking
If you are struggling with motivation, limited mobility affecting food preparation, or have complex nutritional needs, ask your GP for a referral to an Accredited Practising Dietitian (APD) Dietitian-delivered dietary intervention has been shown to improve pain scores, quality of life, and dietary intake in chronic pain populations.
A whole-person approach:
Nutrition does not work in isolation. Pain management is most effective when nutrition is integrated into a “whole-person, multidisciplinary approach” alongside physical activity, sleep, psychological support, and appropriate medical care.
As physiotherapists, we are well placed to initiate conversations about diet quality, screen for nutritional risk factors, and refer patients to dietitian as part of an integrated care team. Evidence supports including a nutrition assessment early in chronic pain management.
The bottom line:
What you eat matters, and the science is catching up to what many patients and clinicians have long suspected. Following a predominantly plant-based or Mediterranean dietary pattern, reducing ultra-processed foods, and optimising key nutrients can meaningfully reduce pain and improve quality of life.
These changes are safe, evidence-based, and accessible, making nutrition one of the most empowering tools available in chronic pain management.
If you are managing chronic pain and would like guidance on how nutrition fits into your treatment plan, speak with your physiotherapist, GP, or an Accredited Practising Dietitian.
Written by Libby Oldfield
Specialist Women's, Mens and Pelvic Health Physiotherapist
(As awarded by the Australian College of Physiotherapy in 2010).
To book with Libby
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