Living With Chronic Pain

Hydration and Pain

We are 70% water. We can go weeks without food, but only days days without water. Staying hydrated is imperative to making sure the body functions properly. And don’t think it’s only important when we exercise or spend time in the Arizona heat. Every day we lose nearly 10 cups of water a day by breathing, sweating and urinating. If we don’t replenish every few hours our organs, muscles, tissues and brains begin to die. It’s estimated 75% of us are dehydrated regularly. By the time you feel thirsty it’s already too late. Yellow urine? Another sign your body is hoarding water. 

New research shows it even affects our pain levels. In one study, participants were asked to attend two tests. One test was administered after participants drank their normal amount of water, and in the other test, after forgoing all fluids for 24 hours. On both visits their feet were immersed in ice cold water. The more dehydrated they were, the more intense they felt pain, whereas those well hydrated didn’t note any change in pain levels. They also found it made people hyperventilate or breathe faster and more shallow, reducing brain blood flow and caused the sympathetic nervous system to kick into a fight or flight mode. This set off a whole cascade of events, surging cortisol into the body, tensing muscles, increasing inflammation, blood pressure and heart rate. 

Another study showed common pain killers like aspirin, acetaminophen, or narcotics may be less effective in a dehydrated state. Analgesics are water soluble agents that require enzyme catalyzed changes in their chemical structure to function. And the combination of dehydration and certain medications that already impair kidney and gastrointestinal function can be exacerbated with dehydration.

Pain and dehydration are also linked physiologically:

Acts as a lubricant.  Synovial fluid resides between joints, acting as a lubricant that cushions and protects them as they move. Water is critical to its formation. Without it inflammation and ultimate damage such as osteoarthritis can occur. 
Impacts cartilage. This is the flexible connective tissue that keeps joints mobile by coating the surfaces of bones and keeps them from scraping on each other. It’s the life source for bones carrying all necessary nutrients between cells. 80% of cartilage is water. Think of it like a sponge. Without a constant hydration it becomes dry and brittle.
Decreases inflammation. Waste products from natural metabolic processes are flushed through the liver and kidneys and eliminated via urine. Dehydration allows toxins to build up in the system which can lead to widespread inflammation and accumulation of substances like uric acid which can cause gouty attacks or calcium for kidney stones. It also alters fluid balance which worsens friction, causing inflammation in joints.
Muscle cramps. Muscles require significant amounts of water and electrolyte to function. They are extremely sensitive to any losses. Even mild deficiencies can lead to spasms or involuntary spasms. Dehydration also allows toxic buildups in the muscles such as lactic acid, causing inflammation and pain.
Back pain. There are 23 vertebrae in the spine. Between each is a disc space that act as shock absorbers. They lose water throughout the day. If it’s not replenished, it shrinks and loses some of its ability to protect and support the spine’s mobility and posture, leading to damage and pain over time.
Headaches. Dehydration leads to a decrease in blood volume and flow. When the brain is affected, headaches result.

Most of us require 64 ounces or 2 liters a day of pure water. Sure there’s water in soda, coffee, and other drinks, but they have other ingredients that can actually act as a diuretic and counter their water content. I keep a 20-ounce travel mug next to me all the time to remind me to finish three a day. Weather, activity level, diet, medications and underlying renal, electrolyte imbalance and heart disease can impact those recommended numbers as well. Ask your healthcare provider for more details.
Too often we think popping a pill or adding a supplement will help our pain. But it may actually all come down to something so much easier to take in- pure water. 


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