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Omega-3s for Pain and Inflammation

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Claire Georgiou  ●   3 min read  


Omega-3 fats contain two naturally occurring essential fatty acids (EFAs), eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). Many inflammation-based health concerns can be reduced and modulated with an increased intake of omega-3 fatty acids in the diet or via supplements. These EFAs stimulate the body’s anti-inflammatory processes, helping relieve joint pain and other inflammation-based pain in the body in much the same way as non-steroidal anti-inflammatory drugs (NSAIDs), but without the side effects.

Omega-3 fatty acids are generally deficient in western diets as there tends to be an over-consumption of processed foods, displacing the omega-3 rich ingredients in the diet. The ratio of omega-3 to -6 should ideally be 1:1, but in the western diet it is estimated to be 1:15[1] A low intake of omega-3 fatty acids may be a contributing factor in the increased incidence of inflammatory diseases around the globe.[1]

Omega-3 EFAs exert their action upon key proteins involved in the inflammation process. Anti-inflammatory mechanisms of omega-3 include the ability of EPA to prevent pro-inflammatory arachidonic acid (AA) production. Cyclo-oxygenase-2, an enzyme involved in the inflammatory cascade, is also inhibited by EPA. This is the same mechanism of action of a number of popular NSAIDs.[2] Eicosanoids produced from AA directly compete with EPA for the same G-coupled receptors, so the higher the EPA intake the higher the likelihood of EPA binding and reducing inflammation.[2]

An already substantial body of evidence supports the need to significantly increase the dietary intake of omega-3 fatty acids to optimise metabolic health, reduce rates of chronic inflammatory conditions, and improve overall mortality rates.[3]

EPA and DHA may reduce the development of atherosclerosis, or arterial plaques, via their ability to reduce concentrations of pro-inflammatory cytokines that can lead to atrial wall adhesions and plaques that cause atherosclerosis and heart disease.[4] These powerful anti-inflammatory compounds reduce cardiovascular injury as well as the risk of developing cardiovascular diseases.[4]

Omega-3 EFAs have been demonstrated and proven to successfully minimise joint pain associated with a range of inflammatory conditions. A number of placebo-controlled studies comparing NSAIDs such as ibuprofen, an analgesic commonly used for pain, and omega-3 EFAs have shown equivalent results for pain relief.[5,6]

While fish oils are becoming markedly more popular as a form of pain relief for arthritis and joint conditions, the mechanisms by which fish oil induces relief have wide-reaching effects. A meta-analysis of 17 randomised, controlled trials assessing the pain-relieving effects of omega-3 PUFAs in patients found that omega-3 PUFAs are a successful treatment for joint pain associated with rheumatoid arthritis, inflammatory bowel disease, and dysmenorrhoea.[3] Fish oil supplementation for pain relief was also shown to be a much safer alternative to NSAIDs for reducing pain associated with arthritis. By comparison, long-term NSAID use can have significant side effects.[6]

Autoimmune conditions are a multifactorial disease with inflammation as a key component of the disease state. EPA and DHA from fish oil have potential to confer a benefit in autoimmune conditions via immune-modulating activity.[1] A number of randomised, placebo-controlled clinical trials in patients with autoimmune conditions including rheumatoid arthritis, Crohn’s disease, psoriasis, and others, found a decrease in inflammatory activity and a reduction in the need for anti-inflammatory medication.[1]

Taking omega-3 rich fish oil supplements regularly has the benefit of supporting and reducing:

  1. Joint and muscle pain.
  2. Inflammatory neurological diseases such as Alzheimer’s and dementia.
  3. Osteoarthritis.
  4. Autoimmune diseases such as rheumatoid arthritis, MS, lupus, inflammatory bowel disease and other autoimmune diseases.
  5. Inflammation associated with reproductive health such as dysmenorrhoea.
  6. Protects against cardiovascular disease and renal disease due to its anti-inflammatory and anti-hypertensive effects.[7]

References

  1. Simopolous AP. The importance of the ratio of omega-6/omega-3 essential fatty acids. Biomed Pharmacother 2002;56(8):365-379. [Abstract]
     
  2. Laye S, Nadjar A, Joffre C, et al. Anti-inflammatory effects of omega-3 fatty acids in the brain: physiological mechanisms and relevance to pharmacology. Pharmacological Reviews 2018;70(1),12-38. [Full text]
     
  3. Goldberg RJ, Katz J. A meta-analysis of the analgesic effects of omega-3 polyunsaturated fatty acid supplementation for inflammatory joint pain. Pain 2007;129:210-223. [Abstract]
     
  4. De Caterina R, Madonna R, Massaro M. Effects of omega-3 fatty acids on cytokines and adhesion molecules. Curr Atheroscler Rep 2004;6:485-491. [Full text]
     
  5. Zainal Z, Longman AJ, Hurst S, et al. Relative efficacies of omega-3 polyunsaturated fatty acids in reducing expression of key proteins in a model system for studying osteoarthritis. Osteoarthritis Cartilage. 2009;17(7):896-905. [Full text]
     
  6. Maroon JC, Bost JW. Omega-3 fatty acids (fish oil) as an anti-inflammatory: an alternative to nonsteroidal anti-inflammatory drugs for discogenic pain. Surg Neurol 2006;65(4):326-331. [Abstract]
     
  7. Zivkovic AM, Telis N et al. Dietary omega-3 fatty acids aid in the modulation of inflammation and metabolic health. Calif Agric (Berkeley). 2011; 65(3):106-111. [Full text]

 


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The information provided on FX Medicine is for educational and informational purposes only. The information provided on this site is not, nor is it intended to be, a substitute for professional advice or care. Please seek the advice of a qualified health care professional in the event something you have read here raises questions or concerns regarding your health.

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Claire Georgiou
Claire Georgiou is an Australian Naturopath, Nutritionist and Herbalist. Claire has completed a Bachelor of Health Science (C.Med) and an Advanced Diploma of Naturopathy, Herbal Medicine and Nutrition.