A systematic review of diet, food, and rehabilitation interventions for chronic musculoskeletal pain in the international classification of functioning, disability, and health (ICF) model
Keywords:
chronic musculoskeletal pain, diet, foodAbstract
Background: To evaluate the effects of dietary modifications and specific food choices on chronic musculoskeletal pain management, using the International Classification of Functioning, Disability, and Health (ICF) model to examine their impact on body function, physical activities, and social participation.
Methods: This systematic review was conducted from January 2013 to January 2023. A comprehensive literature search across four databases (PubMed, Food Science & Technology Abstracts, ProQuest, and Scopus) yielded 7 randomized controlled trials that met the inclusion criteria. The outcomes measured included pain, inflammation, and quality of life. A Meta-analysis was also employed to explore the overall impact of dietary interventions on pain.
Results: Most studies showed significant improvements in pain levels following dietary intervention, with variations depending on the specific dietary modifications. The impact on inflammation, as measured by the Erythrocyte Sedimentation Rate and interleukin levels, presented mixed results. However, a positive effect on quality of life was observed in studies combining dietary interventions with physical therapy or exercise.
Conclusion: The results underscore the potential of integrated approaches to chronic musculoskeletal pain management but indicate that further research is needed to clarify the effects on inflammation and identify optimal dietary strategies for different pain conditions.
References
1. World Health Organization. Musculoskeletal health. Accessed September 10, 2023. Available from: https://www.who.int/news-room/fact-sheets/detail/musculoskeletal-conditions
2. Hernández-Lázaro H, Mingo-Gómez MT, Jiménez-del-Barrio S, et al. Researcher’s perspective on musculoskeletal conditions in primary care physiotherapy units through the International Classification of Functioning, Disability, and Health (ICF): A scoping review. Biomedicines. 2023;11(2):290. doi:10.3390/biomedicines11020290
3. Treede RD, Rief W, Barke A, et al. Chronic pain as a symptom or a disease: the IASP Classification of Chronic Pain for the International Classification of Diseases (ICD-11). Pain. 2019;160(1):19-27. doi:10.1097/j.pain.0000000000001384
4. Clauw DJ. Diagnosing and treating chronic musculoskeletal pain based on the underlying mechanism(s). Best Pract Res Clin Rheumatol. 2015;29(1):6-19. doi:10.1016/j.berh.2015.04.024
5. Staud R. Evidence for shared pain mechanisms in osteoarthritis, low back pain, and fibromyalgia. Curr Rheumatol Rep. 2011;13(6):513-520. doi:10.1007/s11926-011-0206-6
6. Puntillo F, Giglio M, Paladini A, et al. Pathophysiology of musculoskeletal pain: a narrative review. Ther Adv Musculoskelet Dis. 2021;13:1759720X21995067. doi:10.1177/1759720X21995067
7. Price TJ, Ray PR. Recent advances toward understanding the mysteries of the acute to chronic pain transition. Curr Opin Physiol. 2019;11:42-50. doi:10.1016/j.cophys.2019.05.015
8. Gamble J. Why nutrition matters in healthcare outcomes. Ochsner J. 2008;8(2):61-64.
9. Mendonça CR, Noll M, Castro MCR, Silveira EA. Effects of nutritional interventions in the control of musculoskeletal pain: An integrative review. Nutrients. 2020;12(10):3075. doi:10.3390/nu12103075
10. Brain K, Burrows TL, Rollo ME, et al. A systematic review and meta-analysis of nutrition interventions for chronic noncancer pain. J Hum Nutr Diet Off J Br Diet Assoc. 2019;32(2):198-225. doi:10.1111/jhn.12601
11. Page MJ, McKenzie JE, Bossuyt PM, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;n71. doi:10.1136/bmj.n71
12. Higgins JPT, Altman DG, Gøtzsche PC, et al. The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials. BMJ. 2011;343:d5928. doi:10.1136/bmj.d5928
13. Lozano-Plata LI, Vega-Morales D, Esquivel-Valerio JA, et al. Efficacy and safety of weekly vitamin D3 in patients with fibromyalgia: 12-week, double-blind, randomized, controlled placebo trial. Clin Rheumatol. 2021;40(8):3257-3264. doi:10.1007/s10067-021-05640-8
14. Guagnano MT, D’Angelo C, Caniglia D, et al. Improvement of inflammation and pain after three months’ exclusion diet in rheumatoid arthritis patients. Nutrients. 2021;13(10):3535. doi:10.3390/nu13103535
15. Messier SP, Mihalko SL, Legault C, et al. Effects of intensive diet and exercise on knee joint loads, inflammation, and clinical outcomes among overweight and obese adults with knee osteoarthritis: The IDEA Randomized Clinical Trial. JAMA. 2013;310(12):1263. doi:10.1001/jama.2013.277669
16. Torlak MS, Bagcaci S, Akpinar E, et al. The effect of intermittent diet and/or physical therapy in patients with chronic low back pain: A single-blinded randomized controlled trial. EXPLORE. 2022;18(1):76-81. doi:10.1016/j.explore.2020.08.003
17. Field R, Pourkazemi F, Rooney K. Effects of a low-carbohydrate ketogenic diet on reported pain, blood biomarkers and quality of life in patients with chronic pain: A pilot randomized clinical trial. Pain Med. 2022;23(2):326-338. doi:10.1093/pm/pnab278
18. Vadell AK, Bärebring L, Hulander E, Gjertsson I, Lindqvist HM, Winkvist A. Anti-inflammatory diet in rheumatoid arthritis (ADIRA)—a randomized, controlled crossover trial indicating dieffects on disease activity.
19. Du C, Smith A, Avalos M, et al. Blueberries improve pain, gait performance, and inflammation in individuals with symptomatic knee osteoarthritis. Nutrients. 2019;11(2):290. doi:10.3390/nu11020290
20. Delgado DA, Lambert BS, Boutris N, et al. Validation of digital visual analog scale pain scoring with a traditional paper-based visual analog scale in adults. JAACOS Glob Res Rev. 2018;2(3):e088. doi:10.5435/JAAOSGlobal-D-17-00088
21. Cleeland CS, Ryan KM. Pain assessment: global use of the Brief Pain Inventory. Ann Acad Med Singapore. 1994;23(2):129-138.
22. Bennett R. The Fibromyalgia Impact Questionnaire (FIQ): a review of its development, current version, operating characteristics and uses. Clin Exp Rheumatol. 2005;23(5 Suppl 39):S154-162.
23. Ware JE, Sherbourne CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care. 1992;30(6):473-483.
24. Ware J, Kosinski M, Keller SD. A 12-item short-form health survey: construction of scales and preliminary tests of reliability and validity. Med Care. 1996;34(3):220-233. doi:10.1097/00005650-199603000-00003
25. Salaffi F, Leardini G, Canesi B, et al. Reliability and validity of the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index in Italian patients with osteoarthritis of the knee. Osteoarthritis Cartilage. 2003;11(8):551-560. doi:10.1016/S1063-4584(03)00089-X
26. Mahoney FI, Barthel DW. Functional evaluation: the Barthel Index. Md State Med J. 1965;14:61-65.
27. Van Riel PLCM, Renskers L. The Disease Activity Score (DAS) and the Disease Activity Score using 28 joint counts (DAS28) in the management of rheumatoid arthritis. Clin Exp Rheumatol. 2016;34(5 Suppl 101):S40-S44.
28. Dragan S, Șerban MC, Damian G, et al. Dietary patterns and interventions to alleviate chronic pain. Nutrients. 2020;12(9):2510. doi:10.3390/nu12092510
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Zihao Du, Yukun Chen, Yuzhi Chen, Meryl Rosofsky
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Transfer of Copyright and Permission to Reproduce Parts of Published Papers.
Authors retain the copyright for their published work. No formal permission will be required to reproduce parts (tables or illustrations) of published papers, provided the source is quoted appropriately and reproduction has no commercial intent. Reproductions with commercial intent will require written permission and payment of royalties.
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
