5 Nutrients to Support Healing from Back Pain and Back Surgery

Using food and nutrients to help the body heal is a common practice, and many studies suggest that this field of medicine – called immunonutrition – can aid in healing.¹Guyer RD, Siddiqui S, Zigler JE, Ohnmeiss DD, Blumenthal SL, Sachs BL, Hochschuler SH, Rashbaum RF. Lumbar spinal arthroplasty: analysis of one center's twenty best and twenty worst clinical outcomes. Spine (Phila Pa 1976). 2008 Nov 1;33(23):2566-9. doi: 10.1097/BRS.0b013e318185941a. PubMed PMID: 18941428.^,2Chow et al. Immunonutrition: Role in Wound Healing and Tissue Regeneration. Advances in Wound Care. 2014; 46-53.^,3Bharadwaj. Should perioperative immunonutrition for elective surgery be the current standard of care? Oxford Gastroenterology Report. 2016; 1-9^,4Parrish. Immunonutrition - Fact, Fancy or Folly? Nutrition issues in Gastroenterology, series 38. Practical Gastroenterology. 2006.

Certain nutrients are essential to the immune system. Without them, the body’s ability to heal and recover is reduced. Nutrients commonly used in immunonutrition recommendations include arginine, glutamine, Omega-3, nucleotides, and antioxidants, which are all found naturally in certain foods as well as in nutritional supplements.

Research supports that the following five nutrients play an important role in healing from injury, such as a herniated disc or degenerative disc disease, and from back or neck surgery.

5 Essential Nutrients for Back Pain Healing

These essential nutrients include, but are not limited to, the following:

1. Arginine

Arginine is an amino acid the body produces in limited amounts during periods of growth, illness, or injury. Research suggest that taking arginine supplements may increase the body’s ability to fight infections.⁵Rosenthal MD, Carrott PW, Patel J, Kiraly L, Martindale RG. Parenteral or Enteral Arginine Supplementation Safety and Efficacy. J Nutr. 2016 Dec;146(12):2594S-2600S. Epub 2016 Nov 9. Review. PubMed PMID: 27934650.^,6Patel JJ, Miller KR, Rosenthal C, Rosenthal MD. When Is It Appropriate to Use Arginine in Critical Illness? Nutr Clin Pract. 2016 Aug;31(4):438-44. doi: 10.1177/0884533616652576. Epub 2016 Jun 1. Review. PubMed PMID: 27252277.

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Arginine is found naturally in nuts and seeds, legumes, and meats, particularly turkey meat.

2. Glutamine

Like arginine, glutamine is an amino acid the body produces in limited amounts. It is involved in the biological processes that control cell growth and repair. Some clinical studies suggest that glutamine supplementation might help decrease the risk of infections and reduce number of days patients must stay in the hospital after a major surgery or illness.⁷Mundi MS, Shah M, Hurt RT. When Is It Appropriate to Use Glutamine in Critical Illness? Nutr Clin Pract. 2016 Aug;31(4):445-50. doi: 10.1177/0884533616651318. Epub 2016 May 31. Review. PubMed PMID: 27246308.^,8McRae MP. Therapeutic benefits of glutamine: An umbrella review of meta-analyses. Biomed Rep. 2017 May;6(5):576-584. doi: 10.3892/br.2017.885. Epub 2017 Apr 5. PubMed PMID: 28529738; PubMed Central PMCID: PMC5431459.

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Lists of glutamine-rich foods vary, but research suggests beef, eggs, white rice, tofu, and corn are rich in glutamine.⁹Lenders CM, Liu S, Wilmore DW, et al. Evaluation of a novel food composition database that includes glutamine and other amino acids derived from gene sequencing data. Eur J Clin Nutr. 2009;63(12):1433-9.

3. Omega-3 Fatty Acids

Omega-3 fatty acids naturally reduce the body’s inflammatory response. Inflammation can be necessary during healing, but too much inflammation or chronic inflammation can be destructive. Supplementing with omega-3 is thought to help decrease chronic inflammation. Since inflammation is a common contributor to back pain, it follows that decreased inflammation will likely decrease back pain.

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Omega-3s are found in many foods, including salmon, eggs, walnuts, and flaxseed, as well as leafy green vegetables, like spinach.

4. Nucleotides

Every cell in the human body contains molecules called nucleotides, which help make-up and maintain DNA and RNA. DNA and RNA production is necessary for cell repair and regrowth.

When the body is coping with a stressful health event, such as a problem in the lower back or neck, it needs more nucleotides than usual. The body regularly produces and recycles nucleotides in addition to absorbing them through food.

Since all cells contain nucleotides, all natural plant- and animal-based food sources contain nucleotides.

5. Antioxidants

Antioxidants help maintain and restore healthy tissues by reducing oxidative stress in the body. Oxidative stress is associated with chronic inflammation, and inflammation is a common contributor to back pain.

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Examples of antioxidants include beta-carotene, selenium, vitamin A, and vitamin C. Antioxidant-rich foods include leafy greens and other vegetables, fresh and (additive-free) frozen fruits, nuts, seeds, and whole grains.

Immunonutrition Now and in the Future

It is generally agreed that maintaining a healthy, nutrient-rich diet helps maintain health and reduce the risk of infection and disease, and many scientific studies demonstrate the role of specific nutrients in recovering from injury or surgery. However, many of the studies conducted to date are relatively small or have been funded by companies that manufacture nutritional formulas.¹⁰Roehl, K. Immunonutrition in 2016: Benefit, Harm, or Neither? Nutritional Issues in Gastroenterology, Series #154, Practical Gastroenterology Journal. August 2016. https://med.virginia.edu/ginutrition/wp-content/uploads/sites/199/2014/06/Parrish-August-16.pdf Accessed March 7, 2019.^,11Howes N, Atkinson C, Thomas S, Lewis SJ. Immunonutrition for patients undergoing surgery for head and neck cancer. Cochrane Database Syst Rev. 2018 Aug 30;8:CD010954. doi: 10.1002/14651858.CD010954.pub2. PubMed PMID: 30160300.

Research in immunonutrition is ongoing. Over time, researchers may discover certain combination of nutrients are more effective than others, or that nutrient supplements are only effective for certain patients, such as patients undergoing treatment for a spinal tumor.

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In the meantime, many doctors may recommend immunonutrition because there is high likelihood of potentially significant benefits and little to no significant risk of side effects.