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Muscle Pain and Tenderness, Chronic 

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Muscle pain in celiac disease and gluten sensitivityWhat Is Chronic Muscle Pain And Tenderness?

Muscle pain and tenderness, also called myalgia, is a disorder of muscle tissue.

Muscle pain that is ongoing or chronic can result from a variety of disorders, infections, overuse, injury, as an unwanted effect of certain medications, toxic substances, celiac disease, and certain nutritional deficiencies.

What Is Muscle Pain and Tenderness In Celiac Disease and/or Gluten Sensitivity?

  •  Relationship between muscle pain and celiac disease. Muscle pain and tenderness are well-recognized classic features of multiple vitamin and mineral deficiencies in celiac disease.
  • Relationship between muscle pain and vitamin D deficiency. A cross-sectional study involving 153 consecutive patients who admitted to the presence of chronic nonspecific musculoskeletal pain during a comprehensive sleep evaluation at a specialist sleep medicine clinic showed that vitamin D deficiency was prevalent in patients with sleep disorders and chronic nonspecific musculoskeletal pain.1
  • Relationship between muscle pain and magnesium deficiency. In muscle contraction, the mineral potassium moves from inside muscle fibers out into the fluid surrounding them while the mineral sodium moves from the fluid surrounding cells into the muscle fibers. This exchange is reversed when muscle fibers relax. Calcium acts as the catalyst for contraction. Magnesium acts as the catalyst for relaxation. With a magnesium deficit, muscles cannot properly relax, causing weakness, spasm and pain.
  • Relationship between muscle pain and associated disorders. Myalgia can also be a symptom of associated disorders in celiac disease that include the following: chronic fatigue syndrome, neuropathy, hemochromatosis, osteomalcia, multiple sclerosis, sarcoidosis, systemic lupus erythematosis, Addison’s disease (adrenal insufficiency), hypothyroidism, Grave’s disease (hyperthyroidism), polymyositis, and fibromyalgia.

How Prevalent Is Muscle Pain And Tenderness In Celiac Disease and/or Gluten Sensitivity?

Muscle pain and tenderness are common in patients with untreated celiac disease.

What Are The Symptoms Of Muscle Pain And Tenderness?

canstockphoto6718654Muscle pain and tenderness are marked by these symptoms:

  • Painful sensation when pressed, and while using affected muscles or at rest.
  • Pain is more pronounced after exercise.

How Do Muscle Pain And Tenderness Develop In Celiac Disease and/or Gluten Sensitivity?

Do Muscle Pain And Tenderness Respond To Gluten-Free Diet?

Yes. Muscle pain and tenderness improves on a strict gluten free diet containing deficient nutrients.

6 Steps To Improve Muscle pain And Tenderness In Celiac Disease and/or Gluten Sensitivity:

Treatment. This condition responds to the complete elimination of gluten, which is the required treatment that improves both muscle and gut health.

  • Gut health is the foundation to restore ALL health. Restored health will enable you to maintain a strict gluten free diet, just as other life tasks will be easier.
  • A strict gluten free diet means removing 100% of wheat, barley, rye and oats from the diet.
  • Cutting out bread and other obvious sources of gluten is not good enough for recovery. Even 1/8th teaspoon of flour or bread crumb is enough to sustain the inflammation that is damaging your small intestine, causing increased permeability (leaky gut) and allowing undigested gluten to enter your body where it can damage structures and function, and instigate immune inflammatory responses.

Correct Your Individual Nutritional Needs.

Recovery. You should begin to feel better within a week and notice more energy as inflammation subsides and the  absorbing cells that make up the surface lining of your small intestine are better able to function.

  • Intestinal lining cells are replaced every 5 days. The healing process is like sunburn where the damaged surface layer of skin sloughs off and is replaced with new normal cells.
  • Leaky gut normally resolves in two month after starting a gluten free diet and brings about a big improvement in health. Improvement in intestinal permeability precedes morphometric recovery (cell appearance and structure) of the small intestine in celiac disease.3
  • The intestinal lining may take up to a year to heal.
  • 2 Reduce Inflammation. Foods to Eat and Foods Not to Eat:

Because gluten is inflammatory, eliminate OTHER inflammatory foods from your diet to reduce an additive effect to gluten. At the same time, try to eat foods that reduce inflammation (anti-inflammatory).

Here Are Major Inflammatory Food Types That Reduce Healing:

  • Damaging Foods. In susceptible persons, includes corn, dairy (cow), and soy. Lactose, the sugar in any animal milk disrupts intestinal permeability causing leaky gut.4
  • Allergenic Foods. Includes foods that trigger the immune sytem to produce IgE antibodies. Allergy testing is the usual way to discover these offending foods.
  • Shelf Stable Processed Foods. Includes any that contain additives and preservatives. Look for them on the nutrition label of the box or package. Additives and preservatives also disrupt intestinal permeability causing leaky gut.4
  • Fats. Limit deep fried foods, trans-fats, saturated fats (animal fat/butter), and EXCESSIVE omega-6 fatty acid oils like corn oil. Rancid fats, sodium caprate (a medium chain fat), and sucrose monester fatty acid (a food grade surfactant) induce significant disruption of the intestinal barrier that causes leaky gut.4.
  • Excessive Refined White Flours (bran layer removed). Includes products made from them such as cookies, bread, cakes, pies. Bran contains the vitamins and minerals that metabolize grains and slows the otherwise rapid entry of sugar from their digestion into the bloodstream. Also disrupt intestinal permeability causing leaky gut.4
  • Refined Sugars.  Includes white sugar, corn fructose and high fructose corn syrup.
  • Certain Spices. Includes paprika and cayenne pepper which disrupt intestinal permeability causing leaky gut.4
  • Alcohol and Caffeine. Disrupt intestinal permeability causing leaky gut.4

Here Are Important Anti-Inflammatory Food Types to Promote Health:

  • Fruits. Contain ample amounts of vitamins, minerals and phytochemicals which are naturally occuring components in plants that detoxify toxins, carcinogens (reducing the risk by 50%) and mutagens.
  • Non-Starchy Vegetables. Support intestinal integrity and provide ample amounts of vitamins, minerals and phytochemicals. Includes lettuce, kale, onion, broccoli, garlic, and others.
  • High Quality Complex Carbohydrates. Provide vitamins, minerals, and fiber while boosting serotonin levels to help you relax and feel calm. Includes whole grains, legumes, and root vegetables such as carrots, parsnips, sweet potatoes, turnips, red beets, and others.
  • Antioxidants. Protect the body from inflammatory oxidant molecules that continually occur and help us handle stress and reduce irritability. Includes vitamin C-containing foods such as lemon, grapefruit, apricot, Brussels sprouts and strawberries, and others. Also, includes vitamin E-containing foods such as nuts, seeds, avocado, olive oil, and others. Cocoa is good, too.
  • Omega-3 Fatty Acids. Balance opposing omega-6 fatty acids and bad fats. Fish sources includes tuna, salmon, cod, and others. Plants sources include flax, chia seeds, canola oil, and others.
  • Probiotics. Supply normal microbes needed for colon health and health of the body such as these fermented foods: yogurt, kefir, and unpasteurized apple cider vinegar.
  • Prebiotics/ High Fiber Foods.  Food with fiber keeps our population of colonic microbes healthy.
  • Protective Herbs and Spices.  See below #6 below for examples.
  • 3 Information Sheet You Can Take to Your Doctor or Other Health Professional:

Click here.

  • 4 Manage Your Medications Safely:

Certain medications deplete nutrients including thiamin, vitamin C, vitamin E, vitamin K, vitamin B3, vitamin B6, vitamin B12, magnesium or selenium any of which can cause muscle pain and tenderness. Ask your doctor or pharmacist about this possible adverse effect if you are taking any of the drugs listed below. Do not stop prescribed medications without supervision.

 This is not a complete listing.

ANTACIDS / ULCER MEDICATIONS

ANTI-DEPRESSANTS

  • Adapin®, Aventyl®, Elavil®, Pamelor®, and others deplete Coenzyme Q10, Vitamin B12.

ANTIBIOTICS disrupt intestinal permeability which complicates celiac disease.

ANTI-INFLAMMATORIES disrupt intestinal permeability which complicates celiac disease.

ANTICONVULSANTS

ANTIVIRAL AGENTS

  • Zidovudine (Retrovir®, AZT and other related drugs) deplete Vitamin B12.
  • Foscanet depletes Magnesium. 

CARDIOVASCULAR DRUGS

CHOLESTEROL DRUGS

DIABETIC DRUGS 

DIURETICS

FEMALE HORMONES disrupt intestinal permeability which complicate celiac disease.

MAJOR TRANQUILIZERS  

  • Thorazine®, Mellaril®, Prolixin®, Serentil® and others deplete Vitamin B12.
  • 5Nutritional Supplements To Help Correct Deficiencies:

The type and quantity of nutritional supplements that may be needed depend on which nutrients are deficient.

  • Multivitamin/mineral combination once a day is useful to improve overall nutrient levels. This is a safe dose, but always check with your doctor to avoid interactions with medications.
  • B vitamins as prescribed to replenish low stores.
  • Vitamin B12 as prescribed following blood test for status.
  • Vitamin D as prescribed following blood test for status.
  • Vitamin E as prescribed following blood test for status.
  • Vitamin K as prescribed following blood test for status.
  • Chelated magnesium  as prescribed but do not take at same time as calcium because they compete for absorption.
  • Selenium as prescribed but do not take at same time as calcium because they compete for absorption.

Storage Note: Store container tightly sealed, away from heat, moisture and direct light to avoid loss of potency. That is, in a safe kitchen cabinet – not in the bathroom or on the kitchen table.

  • 6Manage Natural Remedies: 

Hydration:

  • Eight glasses of water are recommended per day unless there is a contraindication such as kidney or heart disease. The Institute of Medicine recommends approximately 2.7 liters (91 ounces) of total water, from all beverages and foods, each day for women and 3.7 liters (125 ounces) daily of total water for men.
  • If you are thirsty, drink water. Add fresh, squeezed lemon to water. Lemon is anti-inflammatory, alkalizing and provides vitamin C.
  • Hydration Test: Urine should be pale yellow. Fingertips should be plump, without pruning but this may not be reliable when fingers are swollen with edema. Lips should be plump, without puckering. The feeling of thirst can be unreliable.
  • What is wrong with soda, coffee, tea, and alcohol? These drinks are dehydrating, increase acid, and deplete nutrients.

Carminatives. The following  anti-inflammatory plant sources called carminitives help heal the digestive tract. They also tone the digestive muscles which improves peristalsis, thus aiding in the expulsion of gas from the stomach and intestine to relieve digestive colic and gastric discomfort.

Carminative Food Remedies:

  • Raspberry.
  • Carrot is also a cleansing digestive tonic.
  • Grape is also bile stimulating and a cleansing remedy for sluggish digestion and laxative.
  • Redbeets also stimulate and improve digestion and are easily digested.
  • Cabbage also stimulates and improves digestion and is also a liver decongestant.
  • Lettuce also stimulates and improves digestion and is also an alterative, meaning it improves the function of organs involved with the digestion and excretion of waste products to bring about a gradual change.
  • Potatoes are antispasmodic (due to atropine like properties) and a liver remedy.

Carminative Herb Remedies:

  • Sage is also a digestive, astringent, bile stimulant and energy tonic that heals the mucosa.  Drink as tea or use in cooking.
  • Chamomile, lemon balm, and fennel, (as a tea) also help relieve nervous tension.
  • Parsley also relieves indigestion.
  • Rosemary as a tea and in cooking also is a nervous system tonic for stress and fatigue, bile stimulant, and can relieve headaches and indigestion.
  • Thyme is also soothing remedy useful for stimulating digestion of rich, fatty foods.

Carminative Spice Remedies:

  • Cloves are also antispasmodic.
  • Nutmeg is also useful for indigestion.
  • Ginger.

Exercise Helps:

Exercise improves circulation and rids the body of toxins.

Note: Exercise is important, but the amount and type of exercise undertaken depends on your health. Your first priority is to heal.

What Do Medical Research Studies Tell About Muscle Pain And Tenderness In Celiac Disease and/or Gluten Sensitivity?

RESEARCH STUDIES

“Nonspecific pain is a marker for hypovitaminosis D in patients undergoing evaluation for sleep disorders: a pilot study.“ This cross-sectional study investigated the hypothesis that serum vitamin D levels are abnormally low in sleep clinic patients admitting to chronic nonspecific musculoskeletal pain and assessed the associated risk factors. A secondary purpose was to identify a clinical biomarker for vitamin D deficiency. This study showed that vitamin D deficiency was prevalent in patients with sleep disorders and chronic nonspecific musculoskeletal pain.

Researchers enrolled 153 consecutive patients who admitted to the presence of chronic nonspecific musculoskeletal pain during a comprehensive sleep evaluation at a specialist sleep medicine clinic within an academic center. Venous blood sampling was performed for determination of serum 25-hydroxyvitamin D.

The mean serum 25-hydroxyvitamin D level was 19.8 ± 11.1, with 54% of the study population having vitamin D deficiency. This mean 25-hydroxyvitamin D level was lower than that observed historically in healthy controls, and was either similar or lower than in all but one representative historical cohort formed on the basis of chronic nonspecific musculoskeletal pain.1

CASE REPORTS

“Neutrophilic myositis as a manifestation of celiac disease: a case report.” This case report describes diagnosis of celiac disease in a 42-year-old white man who presented with recurrent attacks of muscle pain and swelling. Clinically, he looked like he had severe pyogenic infection. He failed to respond to multiple courses of wide-spectrum antibiotics. Repeated cultures from muscle lesions and from the blood were negative. Hospital course was very hectic and life threatening at times. Upon further questioning, the patient gave a history of frequent loose-bowel movements for many years. A duodenal biopsy with villous blunting and positive antigliadin antibodies confirmed the diagnosis of celiac disease. The patient had complete recovery and remained in remission on a gluten-free diet.6

 

  1. McCarty DE, Reddy A, Keigley Q, Kim PY, Cohen S, Marino AA. Nonspecific pain is a marker for hypovitaminosis D in patients undergoing evaluation for sleep disorders: a pilot study. Nat Sci Sleep. 2013 Mar 9;5:37-42. doi: 10.2147/NSS.S42641. Print 2013. [↩] [↩]
  2. Krause’s Food, Nutrition, & Diet Therapy. 10th Edition. Kathleen Mahan, Sylvia Escott-Stump. 2000. W.B. Saunders Company. [↩]
  3. Cummins AG, Thompson FM, Butler RN, et al. Improvement in intestinal permeability precedes morphometric recovery of the small intestine in coeliac disease. Clinical Science. Apr 2001;100(4):379-86. [↩]
  4. Farhadi A, Banan A, Fields J, Keshavarzian A. Intestinal barrier: an interface between health and disease. Journal of Gastroenterology and Hepatology. 2003;18:479-91. [↩] [↩] [↩] [↩] [↩] [↩]
  5. Akinloye O1, Adebayo TO, Oguntibeju OO, Oparinde DP, Ogunyemi EO. Effects of contraceptives on serum trace elements, calcium and phosphorus levels. West Indian Med J. 2011 Jun;60(3):308-15. [↩]
  6. Alawneh K, Ashley C, Carlson JA. Neutrophilic myositis as a manifestation of celiac disease: a case report. Clin Rheumatol. 2008 Jun;27 Suppl 1:S11-3. doi: 10.1007/s10067-007-0801-0. [↩]

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