Living With Chronic Pain

Can Probiotics Decrease Inflammation and Pain?

It’s almost impossible to turn on the television or read a magazine without seeing ads for products with probiotics – so-called “good bacteria,” yeast or other living microorganisms in foods or supplements. They are touted to have health benefits, including for arthritis. Demand for these products is only growing; the global market for probiotics is over 30 billion dollars! So the real question is- do they work and really decrease pain?

Everybody has a unique collection of microbes that inhabits their body (in the gut, on the skin and in the mouth, for instance). These communities are altered over time by diet, environment, medications and experiences. And scientists are learning that they affect many aspects of our functioning. “There is more recognition that gut microbes play a bigger role in our health than we once thought,” explains Katherine Zeratsky, a registered dietician at Mayo Clinic. “All of the beneficial bacteria help keep the bad bacteria in check, and that’s good for your overall health.”

Probiotics and Arthritis

Probiotics may be especially important in those with inflammatory types of pain since the beneficial bacteria appear to reduce common biomarkers of inflammation, including C-reactive protein- a common laboratory finding in those with inflammatory diseases.
Studies have shown that people with inflammatory arthritis have inflammation of the intestinal tract. This results in increased intestinal permeability, which then enables certain bacteria to cross the intestinal barrier, get into the bloodstream and trigger an inflammatory response. A healthy diet helps keep the intestinal barrier strong and the immune system in top fighting condition. Probiotics are present in, or added to, such foods as some yogurts, kefir, sauerkraut, tempeh, kimchi and kombucha. Probiotic dietary supplements are available in capsule, powder, tablet and other forms.

Bacteria in the gut, known as the gut microbiome, could be the culprit behind arthritis and joint pain that plagues people who are obese. Osteoarthritis, a common side effect of obesity, is the greatest cause of disability in the US, affecting 31 million people. Sometimes called “wear and tear” arthritis, osteoarthritis in people who are obese was long assumed to simply be a consequence of undue stress on joints. But researchers at the University of Rochester Medical Center provide the first evidence that bacteria in the gut – governed by diet – could be the key driving force behind osteoarthritis.

The scientists found that obese mice had more harmful bacteria in their guts compared to lean mice, which caused inflammation throughout their bodies, leading to very rapid joint deterioration. While a common prebiotic supplement did not help the mice shed weight, it completely reversed the other symptoms, making the guts and joints of obese mice indistinguishable from lean mice.

The team fed mice a high fat diet akin to a Western “cheeseburger and milkshake” diet. Just 12 weeks of the high fat diet made mice obese and diabetic, nearly doubling their body fat percentage compared to mice fed a low fat, healthy diet. Their colons were dominated by pro-inflammatory bacteria, and almost completely lacked certain beneficial, probiotic bacteria, like the common yogurt additive Bifidobacteria.

The changes in the gut microbiomes of the mice coincided with signs of body-wide inflammation, including in their knees, where the researchers induced osteoarthritis with a meniscal tear, a common athletic injury known to cause osteoarthritis. Compared to lean mice, osteoarthritis progressed much more quickly in the obese mice, with nearly all of their cartilage disappearing within 12 weeks of the tear. Cartilage is both a cushion and lubricant, supporting friction-free joint movements. When you lose that, it’s bone on bone, rock on rock. It’s the end of the line and you have to replace the whole joint.

Surprisingly, the effects of obesity on gut bacteria, inflammation, and osteoarthritis were completely prevented when the high fat diet of obese mice was supplemented with a common prebiotic, called oligofructose. The knee cartilage of obese mice who ate the oligofructose supplement was indistinguishable from that of the lean mice.

Prebiotics like oligofructose cannot be digested by rodents or humans, but they are welcome treats for certain types of beneficial gut bacteria, like Bifidobacteria. Colonies of those bacteria chowed down and grew, taking over the guts of obese mice and crowding out bad actors, like pro-inflammatory bacteria. This, in turn, decreased systemic inflammation and slowed cartilage breakdown in the mice’s osteoarthritic knees.

Before You Head to the Vitamin Shop

Though there are parallels between mouse and human microbiomes, the bacteria that protected mice from obesity-related osteoarthritis may differ from the bacteria that could help humans. There are no treatments that can slow progression of osteoarthritis – and definitely nothing reverses it,” said Eric Schott, Ph.D., postdoctoral fellow at URMC and soon-to-be clinical research scientist at Solarea Bio, Inc. “But this study sets the stage to develop therapies that target the microbiome and may actually treat the disease.”

As For Humans

In a 2014 study published in the journal Nutrition, 46 patients with rheumatoid arthritis (RA) were divided into two groups. One group received daily supplements containing Lactobacilluscasei and the other group received a placebo. After an eight-week period, several markers of inflammation were significantly lower in the probiotic group, leading researchers to state that, although further studies are needed to confirm the results, these conclusions may lead to the use of probiotics as an adjunct therapy for patients with RA.
In another study, patients with a variety of arthritic conditions who took the probiotic bacteria B. infantis for eight weeks had lower levels of inflammation compared with those who took a placebo. And healthy people who took probiotics also saw a reduction in inflammation compared with those who took a placebo. The results suggest that probiotics may lower levels of inflammation, regardless of the affliction.

Probiotics are thought to promote health by giving a boost to the good bacteria that live in the gut (the so-called gut microbiota). In fact, some of the bacteria that are present in our bodies are also available as probiotics, including certain strains of Lactobacillus and Bifidobacterium. While definitive connections between the gut microbiome and arthritis have yet to be discovered, you can adopt a diet that promotes a balanced and diverse level of gut bacteria by adding :

Fermented foods

Sauerkraut, kimchi, miso, tempeh, fermented tofu, pickles, and pickled items such as pickled beets, radish, garlic, and cucumbers. Probiotic bacteria predigest these foods during fermentation, making nutrients easier to absorb. The probiotic bacteria then join your gut microbiome when you eat these foods.


Diets rich in lactose-containing food ie fat-free milk, yogurt, and the like; are usually very beneficial for their bacterial content.

Probiotic Supplements

Since there’s no oversight on supplements there is no guarantee they contain the same strains of probiotics that have been proven clinically effective. A recent report from ConsumerLab found that 30 percent of probiotic supplements did not contain the amounts of helpful organisms touted on their labels.

If you want to make sure that contents are as advertised, look for a U.S. Pharmacopeial Convention (USP) verification label which indicates that an independent third party has verified the ingredients – and ask your doctor before starting any supplements. They may interact with your medications or produce other unintended effects. Your doctor also may be able to give you some guidance on the best way to take them.

There is no one-size-fits-all probiotic supplement. What works for one person may not work for the next. Try one for a month and see how you feel. If you don’t get any relief or if you are getting a bad reaction, discontinue and try another kind.

High-Fiber Foods

Fresh fruit and veggies and whole grains protect against infection and prevent bacteria from eating your stomach lining.

Anti-inflammatory Foods

While there is no one specific food plan to follow, foods rich in omega-3-fatty acids can help

  • Cold-water fatty fish like salmon, trout, and fresh tuna
  • Walnuts
  • Flaxseed, soybean, and canola oils
  • Beans
  • Grass-fed beef

A healthy diet that helps us to lose weight, improves health overall and balances our gut flora is a win-win all around. If it lessens our pain as well, why not give it a try?


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