A Little Omega-3 Could Reduce Your Pain and Fatigue
Omega-3 fatty acid (FA) supplements can benefit your joints and cardiovascular system, but what about the pain of fibromyalgia? A small, one-month study involving 12 fibromyalgia patients showed improvements in tender point pain counts, chest expansion (e.g., less muscle tightness), and perceived fatigue levels.1 Even total cholesterol dropped with the supplementation of 1,500 mg per day of the combined two key omega-3 FAs: eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA).
Vegetable oils are not a source of EPA or DHA. Fish oils that have been processed and encapsulated increase the concentration of these two essential omega-3 FAs. The manner in which omega-3 FAs work to relieve fibromyalgia or neuropathic-type pain is not clear. However, a recent case series report on the use of omega-3 FAs to substantially reduce the neuropathic pain and restore function in five patients (one with fibromyalgia), is quite impressive.2
While omega-3 FAs are known to exert anti-inflammatory effects, which can then lead to pain relief, inflammation is not generally present in patients with neuropathic or fibromyalgia pain. The Canadian research team that published the case series suggests that EPA and DHA could possibly work by reducing the release of pain-promoting cytokine substance from the white blood cells. These cytokines are suspected to play a major role in the production of neuropathic and fibromyalgia pain.
Two of the patients in the case series had cervical neck pain due to injuries sustained from a motor vehicle accident (a common occurrence in fibro). A third patient was an auto mechanic with carpal tunnel syndrome due to repetitive strain of his job, another was a nurse with an arm injury from lifting patients that developed into fibromyalgia, and the fifth subject was a burn patient. All five patients had tried lots of therapies before being placed on EPA/DHA in amounts from 2,400 mg to 7,200 mg per day.
Prior to supplementing with the omega-3 FA, the fibromyalgia patient could barely do household chores, such as vacuuming the carpet, and her pain was 8 on a scale of 0 to 10 (where 0 is no pain and 10 is worst possible pain). After taking the EPA/DHA for seven months, her function and grip strength were much improved and she rated her pain 3 on the scale.
Both cervical neck pain patients took 4,800 mg per day of EPA/DHA, and after eight months muscle strength, grip strength, and function were restored. One returned to ice hockey and the other resumed actively working out in the gym. In fact, the latter patient boosted his daily dose to 7,200 mg and noticed “sharper brain function and feeling clear-headed.” The mechanic took 3,000 mg of EPA/DHA per day and after eight months was back to full-time work. The burn patient initially took 2,400 mg of EPA/DHA and slowly increased to high-dose omega-3 FAs. After several months his pain was reduced in half.
All of these patients had serious pain, but after many months of omega-3 FA therapy, their pain levels slowly came down and their function returned. This is only a small sampling of patients, and the study lacks a control group for comparison so the results are strongly biased in favor of the patient feeling better. However, some of the parameters for patient improvement represented objective measures, and the increased physical functioning of these patients after many months of omega-3 FA supplementation was quite dramatic.
“It is important to recommend a high-quality brand of omega-3,” writes the authors. “A product with a higher concentration of EPA/DHA per serving is advisable over a similar product with a lower concentration,” they add, because fish oils may contain heavy metal impurities(such a mercury) and it is best to limit the number of capsules needed per day. With regards to purity, the authors recommend the website www.ifosprogram.com, which lists omega-3 products that have been independently tested for contaminants. Click on the Consumer Report tab for free information. If you are diabetic or trying to loose weight, beware that each capsule will likely contain about 10 calories.
Other recommendations provided by the research team to help ensure greater success with treating your pain:
- Patients should not expect quick results, but rather anticipate giving the omega-3 FAs a six-month trial.
- If you experience stomach difficulties or nausea from taking omega-3, try freezing the capsules and/or search for a brand that is enteric-coated.
- Digestion is improved when omega-3 FAs are taken with food. It is also best to split the dosage up to take with several meals instead of ingesting the supplements all at once.
- Do not take omega-6 or omega-9 FAs. The typical North American diet is already loaded with plenty of omega-6, and they tend to promote (not relieve) inflammation.
- Reduce intake of foods high in the pain-promoting substance, arachidonic acid, which is high in red meat and fried foods.
- Be sure your diet contains plenty amounts of vitamin B6, magnesium and zinc. Also avoid excessive intake of trans-FAs and caffeine.
- Judicious courses of anti-inflammatory drugs, such as Celebrex (celecoxib) may help boost the effectiveness of omega-3.
- For severe pain cases, omega-3 FAs may be combined with Lyrica (pregabalin) or Cymbalta (duloxetine).
- Long-lasting lifestyle changes need to be adopted to ensure long-term pain relief. This includes physical activity, stress reduction, keeping a regular sleep schedule, and eating a healthy diet.
- People who take high-dose omega-3 (7,000 mg and up) require special routine laboratory testing, and all patients should consult their physician before initiating a new supplement.
- Ozgocmen S, et al. Int J Clin Pharmacol Ther 38:362-3, 2000.
- Ko GD, et al. Clin J Pain 26:168-72, 2010.