Did you know that today is World Chocolate Day? I didn’t, until yesterday! July 7 “marks the introduction of the food to Europe in 1550 – until this point, chocolate was only known to indigenous communities in Mexico and parts of central and south America.” (1)
That sounds like a good excuse – uh, I mean reason! – to celebrate my favourite food. So last night I checked my baking supplies and recipes, to find something that I could bake today… something with dark chocolate as the star ingredient. The winner? Banana-chocolate muffins, with “extra dark” chocolate chips; with thanks to my dear friend Susie, for sending me this recipe last year.
Delicious and healthier than commercial energy bars, these muffins make an excellent cycling snack. Having relatively healthy cycling snacks is important for me for a few reasons. First off, my husband does a lot of cycling (up to 10,000 km a year, or about 6200 miles), and he needs a lot of high-energy fuel to keep him going on his 100 km (62 mile) rides. Using various fitness monitors and tools, we’ve estimated that he burns off an average of 3,500 calories on his longer rides.
He really does need extra calories when he’s cycling, but he often feels bloated or sluggish after eating commercial energy bars or products. They also tend to be very sweet, which isn’t something that he appreciates on a long ride, as the sugary taste makes him thirstier than usual. That’s not great when you’re limited to a few refillable bottles of water for a 100-km or 62-mile outing.
Although I don’t bike nearly as much as he does, cycling is an important part of my pain and symptom management plan – along with other forms of aerobic or cardio exercise. Since 2016 I’ve been living with a rare autoimmune and neuro-inflammatory disease, which causes a long list of symptoms. These include a mild cognitive impairment (MCI) and occasional full-body autoimmune fatigue.
What my disease is best known for, though, is severe pain. Its name is Complex Regional Pain Syndrome (CPRS), although it used to be called Reflex Sympathetic Dystrophy (RSD). The pain symptoms are usually limited to a specific area of the body, often one of the limbs; a hand and arm, or a foot and leg. In my case, it’s the right hand and lower arm that are affected.
Every now and then my hand and wrist will twitch or spasm without warning, and I have a chronic pain ‘trifecta’ of;
- Allodynia, or skin pain and sensitivity, from my fingertips to just above my elbow
- joint pain, in my wrist and in each joint of every finger
- neuropathic pain, from between my shoulder and elbow down to my fingertips.
The neuropathic pain can feel as though my hand and arm are on fire, or suffering from frostbite from extreme cold temperatures, or as though I’m being stung by a swarm of wasps, or … well, I’m sure you get the idea. All these different types of pain can even occur all at the same time, to varying degrees, at any given moment. Given that researchers don’t yet know what causes CRPS, there are no truly effective treatments for it:
Because there is no cure for CRPS, treatment is aimed at relieving painful symptoms.
Doctors may prescribe topical analgesics, antidepressants, corticosteroids, and opioids to relieve pain.
However, no single drug or combination of drugs has produced consistent long-lasting improvement in symptoms.” (2)
This is where my personal pain management plan comes in. There are things that ‘might’ help with CRPS pain, that I can do myself – for myself. This includes exercise, which has been repeatedly shown by research to provide at least some improvement of pain symptoms. Earlier this year, for example, England’s National Institute for Health and Care Excellence (NICE) published a new guidance document stating that:
Evidence from many studies showed that exercise reduced pain (23 studies) and improved quality of life (22 studies) compared with usual care in people with chronic primary pain” (3)
Basically, that’s what my cycling does for me; it seems to temporarily reduce my pain symptoms, often quite significantly. But only if I ride without using my right hand, so I ride mostly with only my left hand on the handlebars. It looks rather odd, but this technique works for me – if I use my fairly heavy commuter bike. At this point, I’ve given away my road or racing-style bicycle.
During the non-freezing months I bike outside as much as possible, then when our winter weather hits in Montreal I switch to a stationary bike and treadmill… In addition to walking and snowshoeing outside, in a forest not far from my home. I used to love cross-country skiing as well, but I’ve yet to find a way to use the poles properly with just one hand – without constantly knocking myself over to one side!
Now let’s get back to those delicious chocolate-banana muffins. I already mentioned that they make good cycling snacks because they don’t trigger thirst as much as commercial energy bars and foods do. The other reason it’s important for me to bake healthy-ish homemade snacks is that I’m trying to avoid as many inflammatory foods and ingredients as possible.
Although research “hasn’t clearly proven that diet impacts pain — or that particular foods do or don’t cause inflammation and pain… steering away from certain types of food helps to reduce inflammation for some people”. (4)
Chronic pain is, in part, thought to be the result of oxidative stress and inflammation, and clinical research has indicated links between these conditions and diet.
Thus, dietary interventions are a particularly promising therapeutic treatment for chronic pain, with numerous studies suggesting that diet has a noticeable effect on pain as far down as the cellular level.” (5)
In general, it has been recommended that people living with chronic pain:
avoid trans fats entirely, and steer clear of foods with added vegetable oils or lots of added sugar, or that are highly processed.” (4)
On that note, during the three-day virtual conference of the Pain Society of Alberta in October 2020, Dr. John Pereira commented that dietary improvements can benefit more than chronic pain: “Better overall nutrition could lower inflammation, reduce pain and improve overall quality of life”. (6)
He went on to note that recent research has shown that inflammation can worsen pain, and that inflammation throughout a person’s body can be exacerbated – or worsened – by (6):
- highly-processed foods
- high levels of sugars in food
- poor sleep
- stress
- levels of physical activity that are unsuited to one’s overall health or specific medical condition
These are two approaches to pain management that I can take by myself – and for myself; exercising to the best of my abilities, and trying to focus my diet as much as possible on anti-inflammatory foods. Do I always succeed with this? Of course not! But by setting a joint goal of exercising several times a week and trying to eat mostly anti-inflammatory foods, I do a lot better at this than if I wasn’t trying at all.
And that about sums up my approach to my personal pain management plan = Doing the best I can!
I’ve also been learning to paint – and to draw – since the end of January, as a new facet of my personal pain management plan. I’ll be posting more about that soon. You can also read about some of my art-adventures in my Art so far post from last month.
If there’s something that you think might help you, whether in dealing with pain or other challenges, why not give it a try? If it doesn’t work out, then you’ll know that it’s not for you. But maybe it will work out, and maybe it will help. I may not be very good at painting (yet?), but I’m really enjoying it – so it that sense, it is a success!
As always, thanks so much for stopping by. Stay safe, keep well, and be sure to do something today that’s just for you – just for fun.
References
(1) Eva Waite-Taylor & Sarah Young. World Chocolate Day 2021: The treats you need to celebrate, from vegan bars to hampers. The Independent. Newspaper (website). England. Online. Accessed 07 Jul 2021:
https://www.independent.co.uk/extras/indybest/food-drink/chocolate/world-chocolate-day-2021-fairtrade-vegan-bars-truffles-b1879492.html
(2) National Institute of Neurological Disorders and Stroke (NINDS). NINDS Disorders: Complex Regional Pain Syndrome. Society for Neuroscience; BrainFacts (website). Online. Accessed 07 Jul 2021:
https://www.brainfacts.org/diseases-and-disorders/neurological-disorders-az/diseases-a-to-z-from-ninds/complex-regional-pain-syndrome
(3) Chronic pain (primary and secondary) in over 16s: assessment of all chronic pain and management of chronic primary pain. NICE guideline (NG193). 07 April 2021. Accessed 07 Jul 2021:
https://www.nice.org.uk/guidance/ng193/chapter/Recommendations#managing-chronic-primary-pain
(4) Cleveland Clinic. How to Change Your Diet to Lessen Your Chronic Pain. Cleveland Clinic Website. 09 Nov 2018. Online. Accessed 07 Jul 2021:
https://health.clevelandclinic.org/how-to-change-your-diet-to-lessen-your-chronic-pain/
(5) AS Kaushik, LI Strath, RE Sorge. Dietary Interventions for Treatment of Chronic Pain: Oxidative Stress and Inflammation. Pain Therapy. 2020;9(2):487-498. doi:10.1007/s40122-020-00200-5. Online. Accessed 07 Jul 2021:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7648781/
(6) J Pereira. Conference presentation: What’s New in Pain. Alberta Pain Society. 14th Annual Pain Society of Alberta Conference. 16 Oct 2020. Website:
https://www.painab.ca/2020virtualconference