Treatment of Clients Experiencing Pain Disorders A Collaborative Approach to Care June 2, 2018 * Tex-CHIP Training Series

Role of Nutrition & Lifestyle in Prevention/Management of Pain Disorders

Understanding Provider Role in Treating Pain Disorders Each food choice either increases or decreases inflammation Assess diet pattern in patient Individualization Maintain or lose weight Restriction and/or Avoidances High Inflammatory Foods: Dairy Grains/Gluten Soy Refined Carbohydrates Saturated Fats Excess consumption omega-6s Monosodium glutamate (MSG) Excess consumption omega-6s can trigger the body to produce pro-inflammatory chemicals. These fatty acids are found in oils such corn, safflower, sunflower, grapeseed, soy, peanut, and vegetable; mayonnaise; and many salad dressings. Cytokines processed sugars trigger the release of inflammatory messengers called.

Considerations when Interacting with Clients Depression Multiple autoimmune diseases causing chronic inflammation and pain: lupus rheumatoid arthritis celiac disease psoriasis irritable bowl disease Weight gain (depression, coping mechanisms) Alcohol consumption Medication interactions B12 deficiency and metformin methotrexate – reduces absorption of folic acid , can altered taste, cause nausea, vomiting, diarrhea

Our Treatment Plan Healthcare Domain: Nutrition Provider: Dietitian Objective: Provide alleviation of presenting trauma symptoms as indicated by client report of: (a) Inflammation – internally or externally (b) Gastrointestinal irritation (c) Overweight/Obesity (d) Depression      Goals: a)  Identify food group(s) causing inflammation to patient b) Decrease consumption processed foods, increase consumption of vegetables and fruit (individualized goal for amount) c)  Reduce weight 7-10% if overweight or obese (BMI <30). Interventions: a)  Eliminate entire food group (i.e. dairy, gluten) focusing on one at a time for 3 weeks. Then reintroduce food group for 1-2 weeks. b)  Follow vegetarian, vegan or Mediterranean meal pattern.  c) Engage in physical activity 30 minutes each day.

Measuring Outcomes/ Success Identifying food group(s) that worsen symptoms successfully through elimination diet If chronic inflammatory disease, reduction of symptoms from diet Decrease in processed foods consumed Increase in vegetables and fruits consumed Weight loss (7-10%) Consistent exercise – 30 minutes every day

Communication from Counselors Report patient coping techniques (i.e. marijuana use, alcohol, sweets) Diet quality Living arrangements Mobility to shop/cook food Food security status/socio-economic