Keto and Joint Pain: Can the Ketogenic Diet Help?
Navigating your day with creaking, achy, and painful joints is challenging. According to the National Poll on Healthy Aging by the University of Michigan, around 70% of older adults reported currently experiencing joint pain, and these numbers are also climbing in people of all ages. [1]
If you’re dealing with joint pain, you’re probably interested in finding some relief. You know the ketogenic diet has been proven beneficial for a range of ailments and disorders, from epilepsy to Alzheimer’s and beyond. So, what about joint pain? Can ditching the sugar and heavy carbs and welcoming in the healthy fats improve joint pain too? Let’s look at keto and joint pain, and whether this way of eating can improve symptoms.
What Causes Joint Pain?
Joint pain can be caused or worsened by a range of factors, including:
- Underlying viruses
- Uric acid crystals (gout)
- Infections
- Food allergies
- Previous joint injuries
- Sprains and strains
- Toxicity
- Heavy physical activity
- Overuse or lack of use of muscles
Arthritis essentially means inflammation of the joints, and inflammation can be especially painful. Inflammatory arthritic conditions (including autoimmune diseases) could be associated with genetics, bacteria, and environmental toxins.
Keto and Joint Pain: Ways the Ketogenic Diet Can Help
It’s definitely possible for the ketogenic diet to improve joint pain and to lower inflammation. Here are just some of the ways that going low-carb could soothe those sore joints.
1. Promotes Weight Loss
Chronic pain is associated with obesity. Joints become more stressed trying to carry excess body weight, resulting in wear over time. [2]
A ketogenic diet is one of the most effective for weight loss because your body’s metabolism switches from burning sugar for fuel to burning fat instead. Becoming a fat burner and consuming dietary fat and protein keeps you feeling fuller longer, so you’re less likely to give in to cravings.
A diet high in sugar and carbs contributes to weight gain and insulin resistance, so it makes sense that a diet low in sugar and carbs contributes to weight loss. High blood sugar and insulin resistance are associated with increased body fat, particularly in the abdominal area. [3]
Metabolic syndrome and obesity have also been linked to a higher risk of developing gout. Gout is a painful arthritic condition affecting the joints. Research concludes that excess sugar consumption hikes up serum uric acid levels. Excess sugar consumption includes foods and beverages with high amounts of fructose (think high-fructose corn syrup found in countless foods today, from salad dressings to candy and soda). [4] Elevated insulin levels from a sugar-loaded diet can also raise uric acid levels.
2. Lowers Inflammation and Oxidative Stress
A ketogenic diet has also been proven to lower inflammation, which is a leading driver of chronic pain and a range of diseases, including autoimmune disease and inflammatory arthritis. Research suggests a keto diet could provide relief for chronic joint pain, neuropathic pain, and inflammatory pain. [5]
For example, one study examined participants with type 2 diabetes who were experiencing knee pain. Those on the keto diet had significant improvement in knee pain and function as well as reduced inflammatory markers and weight loss from their abdominal area. [6]
Another smaller 2019 study followed 21 adults with knee pain for 12 weeks as they adhered to three different diets: control (no change) diet, low-fat, and low-carb. Those on the low-carb diet experienced improvements in knee pain and function, lower inflammation, and weight loss. [7]
Studies reveal a keto diet tends to decrease oxidative stress and inflammation and stabilize your blood sugar and hormones. Less oxidative stress and less inflammation mean less pain. [8] [9] On a keto diet, most people consume more healthy fats and anti-inflammatory, antioxidant-rich foods, such as bone broth, green tea, leafy greens, and berries.
3. Improves Mitochondria and Gut Bacteria
Gut bacteria and the mitochondria could play a role in chronic pain and arthritis. For example, cartilage from people with osteoarthritis showed more significant mitochondrial dysfunction and oxidative damage compared to healthy cartilage from people without any pain or arthritis.
Studies are mounting that highlight the way a ketogenic diet benefits the mitochondria and gut bacteria. Eating too much sugar and starch kills off much of the good, healthy bacteria in your microbiome, but if you’re following a keto diet, you won’t be eating all that harmful sugar. [10] Eating a diverse range of healthy keto-friendly whole foods and fermented foods nourishes your gut bacteria.
4. Increases Anti-inflammatory Omega-3 Fatty Acids
Omega-3 fatty acid supplements and fatty fish like mackerel and sardines have been proven to reduce joint pain, swelling, stiffness, and inflammation in those with arthritis. [11] If you’re keto, hopefully, you’re likely eating more healthy fat in general, including omega-3s.
5. Increases Production of Pain-Relieving Adenosine
Adenosine is a neurotransmitter with an anti-inflammatory effect. Water fasting, exercise, and ketogenic diets might have pain-relieving effects due to increased adenosine production [12]
Other studies also show a reduction in pain and biomarkers of inflammation, such as C reactive protein (hs-CRP). [13] High levels of C-reactive protein are a common problem in people suffering from chronic pain.
Has going keto helped your joint pain? Tell us about it in the comments!
References
University of Michigan National Poll on Healthy Aging. Arthritis and Joint Pain. Arthritis and Joint Pain | National Poll on Healthy Aging (healthyagingpoll.org)
Okifuji, A., & Hare, B. D. (2015). The association between chronic pain and obesity. J Pain Res, DOI:10.2147/JPR.S55598
Gokulakrishnan, K., Deepa, M., Monickaraj, F., & Mohan, V. (2011). Relationship of body fat with insulin resistance and cardiometabolic risk factors among normal glucose-tolerant subjects. J Postgrad Med, DOI: 10.4103/0022-3859.85200
Choi, H. K., Willett, W., & Curhan, G. (2010). Fructose-rich beverages and risk of gout in women. JAMA, DOI: 10.1001/jama.2010.1638
Ruskin, D. The effects of ketogenic diets on inflammation and chronic pain. National Institutes of Health, The Effects of Ketogenic Diets on Inflammation and Chronic Pain - David Ruskin (grantome.com)
Lyman, K. S., Athinarayanan, S. J., McKenzie, A. L., Pearson, C. L., Adams, R. N…Andrawis, J. P. (2022). Continuous care intervention with carbohydrate restriction improves physical function of the knees among patients with type 2 diabetes: A non-randomized study. BMC Musculoskelet Disord, DOI: 10.1186/s12891-022-05258-0
Strath, L. J., Jones, C. D., George, A. P., Lukens, S. L., Morrison, S. A., Soleymani, T…Sorge, R. E. (2019). The effect of low-carbohydrate and low-fat diets on pain individuals with knee osteoarthritis. Pain Medicine, https://doi.org/10.1093/pm/pnz022
Ciaffi, J., Mitselman, D., Mancarella, L., Brusi, V., Lisi, L., Ruscitti, P…Ursini, F. (2021). The effect of ketogenic diet on inflammatory arthritis and cardiovascular health in rheumatic conditions: A mini review. Rheumatology, https://doi.org/10.3389/fmed.2021.792846
Kong, G., Wang, J., Li, R., Huang, Z., & Wang, L. (2022). Ketogenic diet ameliorates inflammation by inhibiting the NLRP3 inflammasome in osteoarthritis. Arthritis Research and Therapy, Ketogenic diet ameliorates inflammation by inhibiting the NLRP3 inflammasome in osteoarthritis | Arthritis Research & Therapy | Full Text (biomedcentral.com)
Vidali, S., Aminzadeh, S., Lambert, B., Rutherford, T., Sperl, W., Kofler, B., & Feichtinger. (2015). Mitochondria: The ketogenic diet: A metabolism based therapy. Int J Biochem Cell Biol, DOI: 10.1016/j.biocel.2015.01.022
Lankinen, M., Schwab, U., Erkkila, A., Seppanen-Laakso, T., Hannila, M-L., Mussalo, H…Oresic, M. (2009). Fatty fish intake decreases lipids related to inflammation and insulin signaling: A lipidomics approach. PLoS One, https://doi.org/10.1371/journal.pone.0005258
Goldman, N., Chen, M., Fujita, T., Xu, Q., Peng, W…Nedergaard, M. (2010). Adenosine A1 receptors mediate local anti-nociceptive effects of acupuncture. Nat Neurosci, DOI: 10.1038/nn.2562
Field, R., Physio, M., Pourkazemi, F., & Rooney, K. (2022). 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 Medicine, https://doi.org/10.1093/pm/pnab278
