Some people come to the clinic with what seems like a simple shoulder problem that should respond well to physical therapy, but then doesn’t. Ongoing shoulder pain may not be driven only by the original injury and on such occasions gut-derived autoimmune/inflammatory processes should be considered as a possible contributor.
Recently a patient presented with two sore shoulders, brought on by workers comp pre-return to work shoulder-strength testing. Ultrasounds showed evidence of bursitis, slight shoulder tendons wear and tear, pain in the front of both shoulders; extremely limited range of motion – especially of the left.
The patient received physical therapy for several weeks with minimal improvement. She was advised that the inflammatory processes in her shoulders may be being exacerbated by components in her diet. Initially, not keen to make suggested dietary changes and within one week, achieved almost full range of motion.
Why might dietary change help sometimes? The patient history showed a previous but unrelated work injury requiring years of pain medication. Long term intake of such medications may lead to compromised integrity (leakiness) of the intestinal lining. This allows immune stimulating proteins from foods such as grains and milk (even whole microbes) to leak across to where immune cells reside. Immune cells see such foreign proteins and microbes as signs of danger and become activated. They enter the blood stream, migrate to other sites of injury, and produce large amounts of inflammatory mediators that augment local inflammation increasing pain at those sites.
For this client, her strenuous shoulder-strength tests likely caused some local injury. Once such local shoulder inflammation began, it attracted circulating and activated gut-derived immune cells. These cells then exacerbated the local shoulder inflammation and prevented the shoulder tissues from moving from the inflammatory phase into the repair and resolution phase of the healing process.
In this case, dietary change likely reduced exposure of gut immune cells to immune stimulating proteins, resulting in a relatively quick reduction in shoulders pain. So, if you have unresolved shoulder (or neck) pain, among other causes, you may want to consider the impact of elements in your diet.
Article Written + Submitted by:
Andreas Klein Nutritionist + Remedial Therapist from Beautiful Health + Wellness
P: 0418 166 269