Spasmodic Torticollis, Pain, Inflammation and Nutrition

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Pain
For the great majority of people suffering with Spasmodic Torticollis, there is some level of pain; for some it is an annoyance and for others the pain can be debilitating. One study revealed that 90% of the ST population suffers with pain (1). Most of the pain associated with ST is due to the tremendous strain on the neck and back muscles from the constant, unrelenting spasms and pulling.

Pain research has demonstrated that “pain processing” occurs at several levels of the nervous system. For example, in the periphery within the joints and muscles there are numerous sensory nerve fibers called nociceptors that sense injurious stimuli and inflammation. Consequently, it should not be a surprise that constant muscle spasms lead to constant pain.

Within the spinal cord, there are special cells known as glia and they play a role in nerve cell communication. The glial cells are excited by the excessive activity of the nociceptors, and this excitation causes the glial cells to release numerous biochemicals.

The pain processing system in the joints/muscles and spinal cord communicates in a biochemical language. The biochemicals that excite the pain system are the same ones associated with inflammation. Within joints and muscles, resident and circulating immune cells release inflammatory biochemicals that hyper excite the nociceptors. In the case of glial cells, they are known to release inflammatory biochemicals that lead to chronic excitation of the pain processing system in the spinal cord.

Research suggests that the best way to reduce the production of inflammatory biochemicals is with proper anti-inflammatory nutrition and regular exercise. For many STr’s, spasm and pain limits activity, which places an even more important emphasis on proper nutrition, and interestingly, the same foods that reduce pain and inflammation are the foods that help to make/keep us thin and lean.

Eating that promotes pain

The biggest issue for most individuals suffering with a weight problem is overeating. It is not a surprise to most that eating excess calories leads to weight gain; however, it is not well known that excess calorie consumption helps to promote a chronic inflammatory state that pervades the entire body.

Before farming and the industrialization of America, humans almost exclusively ate vegetation (fruits and vegetables) and animals that ate vegetation (wild game and fresh fish). Nuts were occasionally consumed and honey was sparsely consumed. Interestingly, current research has demonstrated that this pattern of eating is anti-inflammatory, disease-preventing, and therapeutic for various diseases depending on the level of progression (2-9).

A modern version of this historical pattern of eating is referred to as the “polymeal,” which includes omega-3 meats and fish, vegetables, fruits, nuts in moderation, dark chocolate in moderation, red wine in moderation, and spices such as garlic, ginger, turmeric, rosemary, basil, oregano, and others. Notice that grains, legumes (beans and peanuts), and dairy are missing from the list of anti-inflammatory foods; this is because grains, legumes, and dairy are pro-inflammatory compared with the polymeal foods. They represent relatively “new” foods for humans on an evolutionary scale (2) and several of their components are distinctly pro-inflammatory, such as lectins in grains and legumes, and gliadin in grains such as wheat (7).

If you are a typical American, then it is likely that you are a bit overweight. We need to appreciate that excess body fat does not develop from eating too much salad, other vegetables, and fruit. Consider for example that there is about 165 calories in 2 pounds of romaine lettuce. I know this because this calculation is easy to determine from various books, and because I buy 2 pound bags of romaine lettuce from Super Target. In contrast, we only need to eat 2 slices of bread to reach about 150 calories. Shifting your consumption of calories to fruits and vegetables will lead to the shedding of excess pounds and a significant reduction in inflammation.

The average American diet contains excessive amounts of pro-inflammatory calories from the following sources: sugar, omega-6 fatty acids, trans fatty acids, and saturated fatty acids. Each will be discussed in a bit more detail below.

The sugar issue is straight-forward; we find sugar in various beverages, desserts, snacks, and cereals. The average American consumes about 150 pounds of sugar per year from these foods (2). These excess calories lead to fat gain and can promote blood sugar problems such as pre-diabetes and diabetes.

Trans fats are bioengineered fats that no longer resemble the fats found in nature. We find them in margarine and most packaged foods, and their consumption leads to the immediate expression of inflammation in both men and woman, and the expression is worse in those with heart disease (10, 11).

Most readers have read/heard about omega-6 and omega-3 fatty acids. Omega-6’s are generally pro-inflammatory, while omega-3’s are anti-inflammatory. We need each type of fatty acid and the dietary ratio should be below 4:1, with the goal being 1:1. However excessive amounts of omega-6 fatty acids, with ratios exceeding 100:1, are found in commonly used oils such as corn, sunflower, peanut, soybean, cottonseed, and safflower oils, which are used in cooking, packaged food, salad dressings, and various sauces. While grains are not a high fat food, their omega-6:omega 3 ratios average about 20:1. In contrast, fruits and vegetables have rations below 4:1, and wild game, grass-fed meat, and fresh fish are typically below 4:1.

Excess saturated fat is a problem that most of us have heard about. We are typically told that the chief source of saturated fat in the American diet is meat, and this is partially correct. Lean meat has low levels of saturated fat, which is actually quite healthy. The problem with the meat consumed by most is that it is high fat meat. In fact, most are actually eating “obese” meat that is rich in both saturated fat and pro-inflammatory omega-6 fats, but low in anti-inflammatory omega-3s.

Around 1885, cattle raisers discovered how to fatten up a steer to over 1000 pounds by the age of 2 years, a practice that continues today. These cattle are overfed corn/grains and remain sedentary, so they quickly become obese and overloaded with saturated fat and omega-6 fatty acids. Obese meat from sedentary cattle has fat marbled within the muscles, while wild or pasture fed meat does not.

Clearly, our goal should be to eat grass-fed meat or wild game, which are low in fat and anti-inflammatory. If this is not an option for you, the modern alternative to wild game is the next best choice, which includes skinless poultry, fish, omega-3 eggs, lean chop meat, and lean cuts of red meat with the visible fat trimmed (12).

There are also metabolic advantages to eating lean meat, which is beneficial for those who are trying to lose body fat. Lean meat consumption can lower cholesterol and triglyceride levels, improve satiety levels, increase caloric expenditure, and improve insulin sensitivity (12).

Clearly our best option for reducing body fat and inflammation is to get most of our calories from fruits, vegetables, chicken, fish, and lean meat. The benefits of eating this way are often noticed within a week.

Summary

The goal of this article is to introduce readers to the topic of diet and inflammation, and to provide information about which foods promote or inhibit inflammation. Individuals suffering with ST are at risk for developing chronic pain, which may be helped by eating anti-inflammatory foods. STr’s are also at risk for weight gain, which can be prevented by eating low calorie, anti-inflammatory foods.

To learn more about how you can incorporate an anti-inflammatory nutritional approach to your life, please visit www.deflame.com, one of the most comprehensive websites devoted to reducing pain and inflammation with diet and nutritional supplements. At deflame.com you can download the Deflaming Guidelines PDF document and listen to the MP3 audio version, both of which outline how to reduce a chronic inflammatory state with diet and nutritional supplements. On the homepage, you can link to a page that describes the human pain system, which explains in more detail how eating pro-inflammatory foods can lead to the expression of pain.

David R. Seaman, DC, MS
Dr. Seaman is an associate professor at Palmer College of Chiropractic Florida, where he teaches clinical nutrition, neuroscience and complicated case presentations. He has written numerous articles and several chapters about the relationship between nutrition and inflammation, many of which can be accessed at deflame.com. He is also the author of the text, Clinical Nutrition for pain, inflammation and tissue healing.

References:
1. Chan J, Brin MF, Fahn S. Idiopathic cervical dystonia: clinical characteristics. Mov Disord. 1991;6:119-126.
2. Cordain L, Eaton SB, Sebastian A, Mann N, Lindeberg S, Watkins BA, O’Keefe JH, Brand-Miller J. Origins and evolution of the western diet: Health implications for the 21st century. Am J Clin Nutr. 2005;81:341-54.
3. Seaman DR. Nutritional considerations in the treatment of soft tissue injuries. In Hammer WI. Editor. Functional soft-tissue examination and treatment by manual methods. Boston: Jones & Bartlett; 2007: p.717-734
4. Seaman DR. Nutritional considerations for pain and inflammation. In Liebenson CL. Ed. Rehabilitation of the spine: a practitioner’s manual. Baltimore: Williams & Wilkins; 2006: p.728-740
5. Simopoulos AP. Essential fatty acids in health and chronic disease. Am J Clin Nutr 1999; 70(3 Suppl):560S-569S
6. Chung HY, Kim HJ, Kim JW, Yu BP. The inflammation hypothesis of aging: molecular modulation by calorie restriction. Ann NY Acad Sci 2001; 928:37-35
7. Cordain L. Cereal grains: humanity’s double edged sword. World Rev Nutr Diet 1999; 84:19-73
8. Hadjivassiliou M, Chattopadhyay AK, Davies-Jones GA, Gibson A, Gruenwald RA, Lobo AJ. Gluten sensitivity as a neurological illness. J Neurol Neurosurg Psychiatry. 2002; 72:560-63
9. Franco OH, Bonneux L, de Laet C, Peeters A, Steyerberg EW, Mackenbach JP. The Polymeal: a more natural, safer, and probably tastier (than the Polypill) strategy to reduce cardiovascular disease by more than 75%. Brit Med J 2004; 329:1447-50
10. Mozaffarian D, Pischon T, Hankinson SE et al. Dietary intake of trans fatty acids and systemic inflammation in women. Am J Clin Nutr. 2004; 79:606-12
11. Mozaffarian D, Rimm EB, King IB, Lawler RL, McDonald GB, Levy WC. Trans fatty acids and systemic inflammation in heart failure. Am J Clin Nutr. 2004; 80:1521-25
12. O’Keefe JH Jr, Cordain L. Cardiovascular disease resulting from a diet and lifestyle at odds with our Paleolithic genome: how to become a 21st-century hunter-gatherer. Mayo Clin Proc. 2004; 79(1):101-8.

Click here to see how one ST’r has greatly benefitted
from an anti-inflammatory diet.

My mom and I wanted to thank you for hosting such a great symposium this year. This was our third year and we are looking forward to next years. E. Mathews