When it comes to chronic neuromusculoskeletal pain, especially with an osteoarthritis degenerative component, a routine question I find myself fielding is what kind of nutritional supplements may be beneficial along with patient's chiropractic treatment plans.

As always, there is not a single pat answer. There are several reasons for that:

– the mechanism by which patients develop chronic pain and the biochemistry of the individual problem is variable. As such, each patient needs to assess their own likely biochemical imbalances and use therapeutic agents directed at that problem

– some common imbalances include systemic inflammatory tendencies (which in turn can be along various chemical pathways, from essential fatty acid imbalances, to activated complement cascade, to neuroendocrine abnormalities etc.), oxidative stress from imbalance and free radical with poor bodily reserves of antioxidants, decreased peripheral blood flow to soft tissues with inadequate tissue oxygen perfusion, nutritional deficiencies from dietary patterns and certain medications, hormone imbalances and deficiencies (especially cortisol, estrogen, and thyroid hormones), just to name a few.

– Some common agents used to rectify abnormal biochemistry include high-grade curcumin, botanical anti-inflammatories in the white willow family, CBD products, omega-3 fatty acids, capsaicin

One product that has not been receiving a lot of attention for its potential application in the area of neuromusculoskeletal pain, in particular osteoarthritic pain, is black cumin seed oil. It's known to be a pretty potent antioxidant and a botanical anti-inflammatory but a lot of the research has focused on non-neuromusculoskeletal applications, such as autoimmune thyroid, and asthma. I think that black cumin seed oil is definitely an agent we need to start incorporating more frequently in anti-inflammatory protocols for chronic pain, but it is probably going to be more effective when it's not used as a standalone product but combined with other agents, especially botanical anti-inflammatories like white willow in curcumin. Its safety profile is remarkably safe, and in particular it has few absolute medication contraindications, although the dosage may need to be adjusted and gradually increased with certain medications.

Here's an interesting piece of research on black cumin seed oil for knee osteoarthritis, incidentally with an extremely well-designed study ( triple arm, double blind randomized control trial)

https://onlinelibrary.wiley.com/doi/10.1002/fsn3.3708?utm_source=klaviyo&utm_medium=email&utm_campaign=%28Email%20-%20Chris%20Kresser%20General%20News%29%20Chris%E2%80%99s%20Friday%20Favorites&utm_term=new%20triple-blind%20randomized%20controlled%20trial&utm_content=new%20triple-blind%20randomized%20controlled%20trial&_kx=ZpXBDTeEF9QJhwDqQXXrImrT_HpFsBz1ZlYMbsx_Vq0%3D.my75y6