This week I had a patient in my office and she insisted to me that PT does not actually stand for "physical therapy".  No, she said, PT definitely stands for "personal torturer".  ​

She said it with a good-hearted smile on her face and I certainly ask my patients to inform me of pain so that I can avoid doing anything with the patient actually hurts.  But I understand that

Sometimes physical therapy... well, it just isn't terribly fun for everyone.  

Shocking, I know.

So, if I can give my patients a simple way to quickly reduce their pain that requires minimal effort, I'm sure my patients will be overjoyed to learn that I'm on board with that.

The problem is that most physical therapists fall into a trap.  And I admit, I'm not immune to it as well.  You see when a patient walks into our office immediately the gears in our heads start churning.  We see this mechanical puzzle that needs to be fixed.  

Sometimes, we can just as easily change a non-mechanical part of the patients problem and it has an even bigger impact on the patient!  So here are the 3 most important dietary considerations when patients have  experienced chronic myofascial pain.

1.  Iron-

Signs of Iron Deficiency include muscle achiness, chronic tiredness, exaggerated fatigue with exercise and a feeling of coldness.  

It is well-known that iron is required for generation of energy.  With a severe iron deficiency, the muscle are exposed to an oxygen-related energy crisis in the presence of mechanical stresses. 

Low Ferritin levels are associated with vegans, bowel cancer, excessive menstrual iron loss and non-steroidal anti-inflammatory drugs.  

Between 9-16% of females are iron deficient.

The first stage of iron depletion is serum ferritin levels of < 20 ng/ml.  The final stage of iron depletion is <10 ng/ml and is referred to as anemic.  At this time the bone marrow stores of iron aren't detectable.

2.  Vitamin D- 

Signs of Vitamin D Deficiency include osteoporosis and reduced muscle mass or weakness.  Most common in areas of the world without seasonal sunlight and can lead to chronic non-specific musculoskeletal pain.

In a study by Pionikoff, GA and JM Quigley- 90% individuals with musculoskeletal pain had vitamin D levels < 20ng/ml and 28% had less than 8 ng/ml.

3.  Vitamin B12- 

Signs of vitamin B12 deficiency can include cognitive dysfunction, degeneration of the spinal cord, peripheral neuropathy and widespread myalgia. 

A study by Gerwin found that 16% of patients with chronic myofascial pain had insufficient levels of B12.

Patients with levels < 350 pg/ml may be clinically symptomatic.


So to conclude, if you have had chronic muscular pain, weakness or fatigue, I would recommend having these nutritional levels evaluated by a medical professional.  It could be the thing that finally gives you a reprieve from your "personal torturer".