An Excerpt from The Pain Solution by Saloni Sharma, MD

If it came from a plant, eat it; if it was made in a plant, don’t.
— Michael Pollan

Myth: Orthopaedic pain is not affected by food choices.
Fact: Food programs the body for more or less pain and inflammation.
Relief-5R: Optimizing our fuel is part of a pain solution.

Food and orthopaedic pain may not seem linked. In fact, most orthopaedists recommend medications, injections, and surgery for pain relief, not a pain-fighting food plan. This approach ignores a major pain factor. The standard American diet (SAD) is full of foods that aggravate pain: added sugar, excess salt, unhealthy fats, and artificial ingredients. The SAD triggers painful inflammation. Processed foods, the crown jewels of the SAD, are found everywhere, from our workplaces and schools to convenience stores, fast-food restaurants, and hospitals. Even when we know they are not healthy, they trap us into wanting more. This is no accident. The food industry designs these highly processed foods to trigger the reward system in our brains, just like opioids! They want to trigger what they call a “bliss point,” an exact ratio of extra sugar, salt, and fat that gives us a high and creates cravings. This is sick.

The industry exploits more than just our sense of taste. An award-winning scientific study, dubbed the “sonic chip” study, revealed that the louder the crunch of a chip when we bite into it, the more fresh, crispy, and desirable we perceive it to be. This trickery hijacks the feel-good signals in the brain to make eating a processed chip feel like eating a crisp, ripe apple. Through no fault of our own, we are duped into craving these substances. Processed food is quick, cheap, and emotionally rewarding. Trillions of dollars a year are spent on advertising to keep us coming back for more. It seems nearly impossible to escape the processed-food trap on our own. It’s not because we lack willpower. It is because we are under a biological attack.

But armed with a plan for healthy refueling, we can break free. First, we must recognize that how we fuel our bodies determines how well we function. Our fuel and environment can build us up or break us down. They determine our inflammation and pain levels. Smart nutrition choices can help heal damage to our bodies and prevent future degeneration. Nourishing food activates natural pain-control mechanisms in the body and helps us more efficiently clean out wastes and harmful substances. It can reduce painful inflammation in our spine, joints, and muscles. Studies have shown that consuming real, unprocessed food reduces pain, inflammation, and cellular damage. Each food decision tips the balance toward or away from painful inflammation. Once freed from the hooks of processed food, we get to choose. We can quell and prevent pain with better food choices. Let’s dig in! We will start with an overview of the typical diet and its connection to chronic pain, look at easy ways to improve our food intake, and discover practical ways to add microboosts to our day.

My Refuel Experience
Everything I thought was rewarding me was poisoning me. A busy shift, a difficult morning, or a sluggish feeling called for a diet soda. The bubbles danced on my tongue and reenergized me — without sugar. A win, I thought. Little did I know that diet soda intake correlates with higher rates of inflammation, diabetes, and metabolic syndrome, that diet soda consumption is associated with a greater risk of kidney failure, or that both sugar-sweetened and diet soft drinks are linked with obesity. It gets worse. During the afternoon slump, I would gobble down processed cookies or candy and be puzzled in the evening when a food baby erupted. My treats — soda, processed food, and simple carbohydrates — were fueling destructive inflammation. I was unknowingly hurting myself.

It was not until I was pregnant that I began making connections between my diet and my health. When I developed gestational diabetes (diabetes of pregnancy), I was shocked, since I was at a healthy weight and exercised regularly. Through this diagnosis I came face to face with my family history of diabetes. I resolved to make lifestyle changes to manage my blood sugar, reduce inflammation, and ensure the safety of my growing bundle of joy.

For the first time in my life, I learned how to use nutritional labels. I found that my blood sugar was better controlled if I ate more fiber, adequate protein, and no fake, fat-free foods. Four times a day, I stabbed my fingertip to measure my blood sugar and discovered how it was affected by my food choices and activity level. An afternoon walk lowered my blood sugar enough that I could enjoy a fun-size candy bar afterward. At a New Year’s Day brunch, I learned I could eat a donut with two strips of bacon on top and not bump my blood sugar (though I don’t recommend it). How could I be a physician and know so little about this? I knew I couldn’t be the only one.

Saloni Sharma, MD, LAc, is double board-certified in pain management and rehabilitation medicine. She is the medical director and founder of the Orthopaedic Integrative Health Center at Rothman Orthopaedics and has treated thousands of patients. She is also cochair of Pain Management and Spine Rehabilitation for the American Academy of Physical Medicine and Rehabilitation. A popular speaker at Google and an award-winning clinical assistant professor at Thomas Jefferson University Hospital, she lives near Philadelphia. More information at

Excerpted from the book The Pain Solution: 5 Steps to Relieve and Prevent Back Pain, Muscle Pain, and Joint Pain. Copyright ©2022 by Saloni Sharma, MD. Printed with permission from New World Library.