Doctors believe the next breakthrough in pain relief could lie in food and drink. HELEN FOSTER reports
Next time you visit the doctor you may be surprised to discover that he doesn't write you out a prescription. He packs you off to the greengrocers instead. New research from America suggests that food and drink can fend off disease just as well as pills or potions. Suffering from migraine? Drink a cup of coffee. Troubled with backache? Try a fat- free diet. In desperate need of pain relief? There are some experts who go so far as to claim that a spicy curry could help.

Dr Neal Barnard is the driving force behind the new findings. He initially became interested in how food affects our health when he worked as an autopsy assistant and saw how poor diet led to heart disease. Since then he's worked on numerous clinical trials, research papers and best-selling books. He's investigated the way diet affects cancer, heart disease and the ageing process. Now Dr Barnard has turned his attentions to something that millions of us suffer from every day - pain.

"Foods can fight pain," he explains. "Sound scientific research from some of the world's most respected medical institutions is showing this and I believe that in many cases chronic pain conditions like arthritis or migraine can be relieved in as little as two weeks of dietary control."

The key to understanding his theories lies in the way that pain develops in the body. First an injury or another trigger causes inflammation (reddening, swelling etc). This in turn sends signals via the nerve endings to the brain, which translates them into pain. "Food can be used to block pain at any one of these four points," says Dr Barnard. "I'm not saying that it's a cure-all. If you're doing DIY and you hit your thumb, that is not the time to munch a turnip. You need painkillers and you need them now. But if you have a chronic pain condition that's affecting your life every day, diet could be the solution you're looking for."

Barnard's approach differs depending on what type of pain you have. For conditions like migraine, arthritis and digestive pains the key is to identify trigger foods and eliminate them. "People are aware that red wine and chocolate are common causes for migraine but there are actually 12 possible trigger foods (dairy products, chocolate, eggs, citrus fruits, meat, wheat, nuts and peanuts, tomatoes, onions, corn, apples, bananas). I call them 'the dirty dozen'."

In studies he's discovered that up to 90 per cent of people who eliminate their trigger can reduce - or even stop - their migraines. In terms of other conditions, arthritis sufferers should be cautious of dairy products, citrus fruits and wheat and those with digestive problems should look at fatty foods, dairy products and wheat.

To find your trigger you should cut suspect foods out completely for two weeks. At the end of this, you should introduce a lot of one trigger food for two days and see if symptoms reappear. If they don't then that food doesn't affect you and you can keep eating it - if they do, you've found a trigger.

Other foods change our perception of pain. "Sugar certainly does," says Barnard. "It causes a glucose spike that alters the brain chemistry. Research studies show we feel pain more intensely after we've ingested sugar." Conversely, complex carbohydrates like wholegrains can actually decrease the amount of pain we feel.

According to Barnard, they don't cause the same reaction - instead they increase the concentration of the painkilling amino acid called tryptophan in the brain. Spicy foods are also powerful pain fighters, blocking the abilities of the nerves to transmit pain signals.

But perhaps the most surprising link is that between food and back pain. Barnard believes that heart attacks and back pain could be caused by the same thing. A team of researchers in Finland has discovered that many people with back pain also suffer from blocked arteries around the spine, reducing the flow of blood and leading to the degeneration of the discs which cause the problem. A similar blockage is what causes heart failure and chest pain. So how can food help? "By altering your diet you can reduce further damage and pain and possibly even reverse arterial furring. The same low fat, high fibre diet used to treat heart patients can ease back pain."

Dr Wolfgang Hamann, senior lecturer in pain management at Guys and St Thomas' hospitals, backs up Barnard's claims. "There is definitely a link between food and pain conditions like migraine so there may be a link with others," he says. "Because the pain process involves a complex interplay between chemical monitors in the nervous system, it's possible some foodstuffs mimic those chemicals."

So that's that then, no fat, no sugar, no meat and not even an orange to cheer you up should that be your particular trigger - but Barnard believes we shouldn't panic. There are a lot of foods that are unlikely to aggravate pain while at the same time they may even soothe symptoms. Rice, ginger, green and yellow vegetables and cooked, non citrus fruits are all safe options. And remember, if a food doesn't trigger your problem there's no reason why you should avoid it. Just use your common sense.

'Foods That Fight Pain' is published by Bantum, pounds 7.99.


Philip Hayden

37, BT marketing manager

Problem: Severe RSI

Diet: 'Lots of carbohydrates (brown bread, white pasta etc), fruit and vegetables. I eat meat or poultry 10 times a week.'

Dr Barnard: 'Vitamin B6 may help. Potatoes, avocados and bananas are rich in vitamin B6 but the dose used in research is 50-150 milligrams per day which you'll need a supplement to reach. Don't go over 150mg as this can aggravate nerve damage. Cut down on meat and poultry. Protein depletes vitamin B6.'

Jane Murphy

31, journalist

Problem: Migraines

Diet: 'I eat a lot of carbohydrates - half a loaf of bread at once sometimes. I get protein mainly from seeds, beans and nuts. I occasionally eat chocolate.'

Dr Barnard: 'Jane should try elimination because her diet contains a lot of trigger foods. She should also avoid fatty foods premenstrually. Finally, a note on coffee. New information shows that two cups of strong coffee taken just as migraine strikes can help some sufferers.'

Jane Davis

29, teleworker

Problem: Menstrual pain

Diet: 'I eat a lot of carbohydrates and vegetables, but I also eat red meat and am addicted to Indian food. I don't eat cakes or biscuits but I like chocolate.'

Dr Barnard: 'For the next two cycles (two months) Jane should try to avoid all animal products and keep vegetable oils to a bare minimum. A recent study showed that a diet including this dramatic reduction in fat greatly reduces the hormone swings that lead to menstrual pain.'