The Gut-Pain Connection You Should Know About

Physical Therapist and Nutrition Specialist By Joe Tatta, DPT, CNS
Physical Therapist and Nutrition Specialist
Joe Tatta, DPT, CNS is a doctor of physical therapy, board certified nutrition specialist, and functional medicine practitioner specializing in treating persistent pain caused by lifestyle-related musculoskeletal, metabolic, and autoimmune health issues. He received his doctor of physical therapy degree from Arcadia University and currently lives in New York, NY.
Medical review by Marvin Singh, M.D.
Integrative Gastroenterologist
Dr. Marvin Singh is an Integrative Gastroenterologist in San Diego, California. He is trained and board certified in Internal Medicine and Gastroenterology/Hepatology.
The Gut-Pain Connection You Should Know About

Hippocrates, the father of modern medicine, said all healing begins in the gut. And scientists continue to prove him correct as they unravel how a healthy gut microbiome plays a role in weight loss, disease prevention, and much more. As we know, diet plays a crucial role in maintaining a healthy gut environment and dysbiosis, or a gut-flora imbalance, ramps up inflammation, and triggers many illnesses including inflammatory bowel disease.

As a doctor of physical therapy, gut health provides insight into why my patients (especially overweight or obese patients) develop osteoarthritis in non-weight-bearing joints like the wrist, by pointing to a problem with systemic inflammation. And while my patients understand how an out-of-whack gut affects digestion, they don’t always make the connection between gut health and joint pain or other problems like headaches, mood swings, eczema, weight gain, or fatigue that often accompany pain.

Gut problems can trigger pain.

How does this work? First, consider that fact that your gut maintains a solid barrier between your digestive tract and your internal environment, allowing important nutrients to pass through while keeping out everything else. Maintaining the integrity of the gut is a one-cell-thick barrier that forms a tight junction, which keeps out foreign invaders like bacteria, toxins, and large undigested food particles. When these tight junctions are injured, that barrier becomes inflamed and porous; bacteria, toxins, and undigested food particles start slipping through. We call these foreign invaders antigens, or foreign substances that trigger an immune response. A double whammy ensues: You’re not getting optimal nutrients while foreign invaders barge through, a condition called intestinal permeability or leaky gut.


This connection has everything to do with inflammation.

Your immune system responds with antibodies, which attack and destroy these antigens. When an antibody binds with an antigen, an immune complex occurs. Persistent leaky gut ramps up these immune complexes; they circulate around your body and deposit into various tissues and organs including—you guessed it—skeletal muscles and joints, creating more inflammation. Leaky gut also contributes to autoimmune diseases, or immune responses against specific tissues that create damage and loss of function. When that happens in your joints, inflammation creates pain, swelling, and stiffness. While multifactorial, researchers link leaky gut with rheumatoid arthritis as bacterial products slip through your gut lining and deposit in your joints, creating an immune reaction.

You can reduce pain by healing the gut.

When my patients heal their leaky gut, they finally put out the fire that feeds inflammation. That healing calms their immune system, has the potential to impact autoimmune diseases like rheumatoid arthritis, and decreases pain. I have seen people reduce their symptoms naturally, without drugs or surgery. Beyond focusing on a whole-foods diet that eliminates food intolerances, I’ve found these seven strategies to optimize gut health to reverse pain:


1. Step up your fiber.

Studies show that sufficient dietary fiber might be your best strategy to maintain a healthy microbiome. Among its benefits, fiber helps pull toxins from your gut for elimination.

2. Eat more anti-inflammatory foods.

Omega-3 fatty acids have anti-inflammatory properties and help alleviate pain. If wild-caught fish isn’t part of your diet, take a high-quality fish oil supplement with about 3,000 milligrams of EPA and DHA.


3. Repopulate smartly.

Probiotics help re-establish a balanced gut microbiome. Fermented foods including coconut yogurt, kefir, and sauerkraut are good sources of probiotics, but if you don’t regularly eat them, look for a professional multistrain probiotic supplement with billions of microorganisms. Spore based probiotics also have been shown to reduce LPS (lipopolysaccharides) that are elevated in leaky gut.

4. Get sufficient vitamin D.

Researchers link vitamin D deficiencies with various problems including inflammation, leaky gut, and autoimmune diseases including rheumatoid arthritis and chronic pain. Ask your doctor for a 25-hydroxy vitamin D test and work with him or her to achieve and maintain optimal ranges.


5. Ditch the gluten.

If you have joint pain or other types of pain, gluten's gotta go. Gliadin is the protein found in wheat, rye, and barley many people are sensitive to or that causes an outright autoimmune reaction. Your immune system sees gluten as the enemy and will unleash weapons to attack it, causing inflammation in your gut, joints, and other areas of the body.

6. Avoid GMOs.

Eliminating genetically modified foods (GMOs) becomes crucial for healing your leaky gut since GMOs damage your digestive tract and may be one of the causes of your leaky gut in the first place.


7. Nix nightshades.

Colorful bell peppers, tomatoes, potatoes, and eggplants provide nutrients and phytonutrients, but they can be a problem for patients with leaky gut, autoimmune disease, or osteoarthritis. Nightshades contain glycoalkyloids, which can create gut problems.

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