Accurate Education -Dietary Phytonutrients for Pain – Diagnosis-Based

Anti-Inflammatory Diet:

Dietary Phytonutrients for Pain – A diagnosis based approach

Plant-based nutrients to reduce oxidative stress and inflammation

Plant-based nutrients, or phytonutrients, are natural compounds found in fruits & vegetables, that play vital roles in one’s health and well being but offer important benefits in the management of acute and chronic pain. This section mimics the information found on Plant-based Nutrients (Phytonutrients), but is organized around specific pain related diagnoses.

See:

• Plant-based Nutrients (Phytonutrients
  

  For more information, see: clevelandclinic.org

• Anti-Inflammatory Diet
• Omega Fatty Acids

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Definitions and Terms Related to Pain

Page Links:

1. Osteoarthritis
2. Rheumatoid Arthritis
3. Migraines Headaches
4. Sciatica
5. Peripheral Neuropathy
6. Multiple Sclerosis
7. Central Sensitization
8. Systemic Inflammation
9. Alzheimer’s Disease
10. Spinal Cord Injury
11. Brain Trauma (Including Stroke)
12. Practical Recommendations

Dietary Plant-based Nutrients (Phytonutrients) for Pain

Diagnoses and Phytonutrient Interventions

Below, each diagnosis is addressed with tailored polyphenol recommendations, focusing on their antioxidant, anti-inflammatory, and neuroprotective benefits. Food sources, daily intake recommendations, and mechanisms are drawn from Rudrapal et al. (2022), Manach et al. (2004), Hollman & Katan (1999), Middleton et al. (2000), Jin et al. (2020), Xu et al. (2006), Javadi et al. (2017), Hussain et al. (2016), and Islam et al. (2025).

1. Osteoarthritis

Pathophysiology: Oxidative stress and inflammation (e.g., elevated CRP, IL-6) drive cartilage degradation and joint pain, with ROS causing lipid peroxidation and matrix metalloproteinase (MMP) activation (Rudrapal et al., 2022).

Polyphenol Interventions:

• Curcumin:

  • Food Sources: Turmeric (100–200 mg/g in dried root), curry powders, mango ginger; enhance with black pepper (piperine).
  • Recommended Intake: 500–1,500 mg/day (supplement with piperine); 1 tsp turmeric (~2 g) provides ~200–400 mg. Cost: ~$2.20/day (Thorne Advanced Nutrients, 150 mg/4 capsules).
  • Mechanisms: Inhibits NF-κB and COX-2, reducing IL-1β and IL-6; neutralizes ROS (•OH, peroxynitrite), protecting cartilage (Daily et al., 2016; Pragasam, 2012).
  • Benefits: RCTs (500–1,000 mg/day) show 30–40% pain reduction (web:21).

 

• Quercetin

• • Food Sources: Red onions (20–30 mg/100 g, highly bioavailable glycosides), apples, kale, berries (Hollman & Katan, 1999).
  • Recommended Intake: 500–1,000 mg/day (supplement); 1 medium red onion provides ~10–30 mg. Cost: ~$0.80–$2.20/day (Thorne, 50 mg/4 capsules; Life Extension, 5 mg/2 capsules).
  • Mechanisms: Inhibits NF-κB, AP-1, lipoxygenase, and NOS, reducing joint inflammation and cartilage breakdown (Javadi et al., 2017; Middleton et al., 2000).
  • Benefits: RCT (500 mg/day) reduces pain/stiffness (Javadi et al., 2017).

• EGCG:

  • Food Sources: Green tea (50–100 mg/cup, 240 mL), matcha; avoid milk to enhance absorption (Hollman & Katan, 1999).
  • Recommended Intake: 300–800 mg/day (supplement); 2–3 cups green tea; avoid >1,000 mg/day due to hepatotoxicity risks (Islam et al., 2025).
  • Mechanisms: Inhibits COX-2, NF-κB, AP-1, and NOS, reducing IL-1β and TNF-α; scavenges ROS, protecting cartilage (Jin et al., 2020; Islam et al., 2025).
  • Benefits: RCT (800 mg/day) reduces joint pain (Islam et al., 2025).

• Apigenin:

  • Food Sources: Parsley (215 mg/100 g), chamomile tea (2.5–5 mg/cup), celery.
  • Recommended Intake: 5–50 mg/day (supplement); 1–2 cups chamomile tea. Cost: ~$0.80/day (Life Extension, 25 mg/2 capsules).
  • Mechanisms: Inhibits NF-κB, IL-6, COX-2; scavenges ROS, protecting cartilage (Hussain et al., 2016).
  • Benefits: Preclinical data support joint pain reduction (web:5).
    Practical Notes: Combine curcumin with meals (e.g., curries), berries in smoothies, green tea (no milk), and parsley in salads. Monitor pain (NRS) and inflammation (CRP, ESR) after 4–12 weeks. Avoid with blood thinners.

2. Rheumatoid Arthritis

Pathophysiology: Autoimmune-driven inflammation and ROS (e.g., •OH) increase cytokines (IL-6, TNF-α) and joint damage, amplifying pain (Rudrapal et al., 2022).

Polyphenol Interventions:

 

• Resveratrol:

• • Food Sources: Red grapes, red wine (1–10 mg/L), blueberries, dark chocolate.
  • Recommended Intake: 100–500 mg/day (supplement); 1–2 glasses red wine (150 mL) provides ~1–5 mg. Cost: ~$2.20/day (Thorne, 25 mg/4 capsules).
  • Mechanisms: Inhibits COX-1 and IL-6, reducing joint swelling; scavenges ROS, protecting synovial tissue (Khojah et al., 2018; Meng et al., 2021).
  • Benefits: Preclinical data support reduced joint tenderness (web:8).

• EGCG:

  • Food Sources: Green tea (50–100 mg/cup), matcha; avoid milk (Hollman & Katan, 1999).
  • Recommended Intake: 300–800 mg/day (supplement); 2–3 cups green tea; avoid >1,000 mg/day (Islam et al., 2025).
  • Mechanisms: Inhibits COX-2, NF-κB, and TNF-α, reducing joint inflammation; scavenges ROS, limiting tissue damage (Jin et al., 2020; Islam et al., 2025).
  • Benefits: RCT (800 mg/day) reduces joint pain (Islam et al., 2025).

• Quercetin:

  • Food Sources: Red onions (20–30 mg/100 g), apples, kale, berries (Hollman & Katan, 1999).
  • Recommended Intake: 500–1,000 mg/day (supplement); 1 medium red onion provides ~10–30 mg. Cost: ~$0.80–$2.20/day (Thorne, Life Extension).
  • Mechanisms: Inhibits NF-κB, lipoxygenase, and IL-6, reducing leukotriene production and joint inflammation (Javadi et al., 2017; Hollman & Katan, 1999).
  • Benefits: RCT (500 mg/day) reduces morning stiffness (Javadi et al., 2017).

• Apigenin:

  • Food Sources: Parsley, chamomile tea, celery.
  • Recommended Intake: 5–50 mg/day; 1–2 cups chamomile tea. Cost: ~$0.80/day (Life Extension).
  • Mechanisms: Inhibits NF-κB, IL-6, COX-2; scavenges ROS, reducing inflammation (Hussain et al., 2016).
  • Benefits: Preclinical data support joint pain reduction (web:5).
    Practical Notes: Encourage green tea (no milk) and onions. Supplements may reduce morning stiffness. Monitor ESR and pain scores after 4–12 weeks.

3. Migraines and Headaches

Pathophysiology: Neuroinflammation and oxidative stress (e.g., ROS-induced lipid peroxidation) trigger cortical spreading depression and pain pathways (Rudrapal et al., 2022).

Polyphenol Interventions:

• EGCG:

  • Food Sources: Green tea (50–100 mg/cup), matcha; avoid milk (Hollman & Katan, 1999).
  • Recommended Intake: 300–800 mg/day (supplement); 2–3 cups green tea; avoid >1,000 mg/day (Islam et al., 2025).
  • Mechanisms: Inhibits COX-2, NF-κB, reducing neuroinflammation; scavenges ROS; modulates GABA/serotonin, inhibiting LPS-induced astrocyte activation (Jin et al., 2020; Islam et al., 2025).
  • Benefits: Preclinical data suggest migraine relief via GABA/serotonin modulation (Islam et al., 2025).

• Quercetin:

  • Food Sources: Red onions (20–30 mg/100 g), apples, kale, berries (Hollman & Katan, 1999).
  • Recommended Intake: 500–1,000 mg/day; 1 medium red onion provides ~10–30 mg. Cost: ~$0.80–$2.20/day (Thorne, Life Extension).
  • Mechanisms: Inhibits NF-κB, lipoxygenase, and histamine release via mast cell stabilization, reducing neuroinflammation (Javadi et al., 2017; Middleton et al., 2000).
  • Benefits: Preclinical data reduce migraine severity (web:16).

• Apigenin:

  • Food Sources: Parsley, chamomile tea (2.5–5 mg/cup), celery.
  • Recommended Intake: 5–50 mg/day; 1–2 cups chamomile tea. Cost: ~$0.80/day (Life Extension).
  • Mechanisms: Inhibits NF-κB, IL-6, COX-2; modulates 5-HT1A receptors, reducing neuroinflammation (Hussain et al., 2016).
  • Benefits: RCT (chamomile gel) reduces migraine pain (web:5).
    Practical Notes: Include green tea (no milk), chamomile tea, and onions in diets. Quercetin/apigenin supplements may reduce migraine frequency. Track headache frequency and NRS scores after 4–12 weeks.

4. Sciatica

Pathophysiology: Nerve compression and ROS-driven oxidative damage amplify neuropathic pain and central sensitization (Rudrapal et al., 2022).

Polyphenol Interventions:

• Curcumin:

  • Food Sources: Turmeric, curry powders, mango ginger; enhance with piperine.
  • Recommended Intake: 500–1,500 mg/day (supplement); 1 tsp turmeric provides ~200–400 mg. Cost: ~$2.20/day (Thorne).
  • Mechanisms: Inhibits NF-κB and COX-2, reducing neuropathic inflammation; scavenges ROS, protecting nerve cells (Daily et al., 2016).
  • Benefits: Preclinical data reduce neuropathic pain (web:21).

• Resveratrol:

  • Food Sources: Red grapes, red wine, blueberries, dark chocolate.
  • Recommended Intake: 100–500 mg/day (supplement); 1–2 glasses red wine provides ~1–5 mg. Cost: ~$2.20/day (Thorne).
  • Mechanisms: Scavenges ROS, reducing neuronal oxidative damage; inhibits IL-6, alleviating neuropathic pain (Meng et al., 2021).
  • Benefits: Preclinical data support pain reduction (web:8).

• Quercetin:

  • Food Sources: Red onions, apples, kale, berries (Hollman & Katan, 1999).
  • Recommended Intake: 500–1,000 mg/day; 1 medium red onion provides ~10–30 mg. Cost: ~$0.80–$2.20/day (Thorne, Life Extension).
  • Mechanisms: Inhibits NF-κB and lipoxygenase, reducing neuropathic inflammation; scavenges ROS, protecting nerve tissue (Javadi et al., 2017).
  • Benefits: Preclinical data reduce allodynia (Javadi et al., 2017).
    Practical Notes: Use curcumin in cooking and red onions in salads. Monitor DN4 scores for neuropathic pain after 4–12 weeks.

5. Peripheral Neuropathy

Pathophysiology: Oxidative stress damages peripheral nerves, increasing neuropathic pain and central sensitization (Rudrapal et al., 2022).

Polyphenol Interventions:

• Resveratrol:

  • Food Sources: Red grapes, red wine, blueberries, dark chocolate.
  • Recommended Intake: 100–500 mg/day; 1–2 glasses red wine provides ~1–5 mg. Cost: ~$2.20/day (Thorne).
  • Mechanisms: Scavenges ROS, protecting nerve cells; inhibits IL-6, reducing neuropathic inflammation (Meng et al., 2021).
  • Benefits: Preclinical data support pain reduction (web:8).

• EGCG:

  • Food Sources: Green tea, matcha; avoid milk (Hollman & Katan, 1999).
  • Recommended Intake: 300–800 mg/day; 2–3 cups green tea; avoid >1,000 mg/day (Islam et al., 2025).
  • Mechanisms: Scavenges ROS, reducing neuronal damage; inhibits COX-2, NF-κB, JAK/STAT; promotes autophagy, supporting nerve repair (Jin et al., 2020; Islam et al., 2025).
  • Benefits: Preclinical (50 mg/kg) reduces allodynia; RCTs (600–800 mg/day) reduce MS-related neuropathy (Islam et al., 2025).

 

• Quercetin

• • Food Sources: Red onions, apples, kale, berries (Hollman & Katan, 1999).
  • Recommended Intake: 500–1,000 mg/day; 1 medium red onion provides ~10–30 mg. Cost: ~$0.80–$2.20/day (Thorne, Life Extension).
  • Mechanisms: Inhibits NF-κB and lipoxygenase, reducing neuropathic inflammation; scavenges ROS, protecting nerves (Javadi et al., 2017).
  • Benefits: Preclinical data reduce allodynia (Javadi et al., 2017).

• Apigenin:

  • Food Sources: Parsley, chamomile tea, celery.
  • Recommended Intake: 5–50 mg/day; 1–2 cups chamomile tea. Cost: ~$0.80/day (Life Extension).
  • Mechanisms: Inhibits NF-κB, IL-6, COX-2; scavenges ROS, protecting nerves (Hussain et al., 2016).
  • Benefits: Preclinical data reduce neuropathic pain (web:5).
    Practical Notes: Encourage green tea (no milk) and onion-based dishes. Monitor DN4 and pain scores after 4–12 weeks.

6. Multiple Sclerosis

Pathophysiology: Oxidative stress and inflammation damage myelin, exacerbating neuropathic pain and central sensitization (Rudrapal et al., 2022).

Polyphenol Interventions:

• EGCG:

  • Food Sources: Green tea, matcha; avoid milk (Hollman & Katan, 1999).
  • Recommended Intake: 300–800 mg/day; 2–3 cups green tea; avoid >1,000 mg/day (Islam et al., 2025).
  • Mechanisms: Scavenges ROS, protecting myelin; inhibits COX-2, NF-κB, JAK/STAT, and LPS-induced astrocyte activation; promotes autophagy and mitochondrial function; activates Nrf2, paralleling VUMERITY (Jin et al., 2020; Islam et al., 2025).
  • Benefits: RCTs (600–800 mg/day) reduce biomarkers, improve cognition; reduce MS-related neuropathic pain (Islam et al., 2025).

• Quercetin:

  • Food Sources: Red onions, apples, kale, berries (Hollman & Katan, 1999).
  • Recommended Intake: 500–1,000 mg/day; 1 medium red onion provides ~10–30 mg. Cost: ~$0.80–$2.20/day (Thorne, Life Extension).
  • Mechanisms: Inhibits NF-κB, lipoxygenase, and IL-6, reducing neuroinflammation; scavenges ROS, protecting myelin; activates Nrf2 (Javadi et al., 2017).
  • Benefits: Preclinical data reduce neuroinflammation (web:16).
    Practical Notes: Include green tea (no milk) and onions. Monitor relapse rates, DN4, and neurological symptoms after 4–12 weeks. Consult doctor for MS drug interactions.

7. Central Sensitization

Pathophysiology: Chronic oxidative stress and inflammation amplify pain signaling, increasing pain perception across conditions (Rudrapal et al., 2022).

Polyphenol Interventions:

• Curcumin:

  • Food Sources: Turmeric, curry powders, mango ginger; enhance with piperine.
  • Recommended Intake: 500–1,500 mg/day; 1 tsp turmeric provides ~200–400 mg. Cost: ~$2.20/day (Thorne).
  • Mechanisms: Inhibits NF-κB and COX-2, reducing central inflammation; scavenges ROS, limiting pain amplification (Daily et al., 2016).
  • Benefits: Preclinical data reduce pain amplification (web:21).

 

• EGCG:

• • Food Sources: Green tea, matcha; avoid milk (Hollman & Katan, 1999).
  • Recommended Intake: 300–800 mg/day; 2–3 cups green tea; avoid >1,000 mg/day (Islam et al., 2025).
  • Mechanisms: Inhibits COX-2, NF-κB, JAK/STAT, and LPS-induced astrocyte activation; promotes autophagy, reducing pain amplification (Jin et al., 2020; Islam et al., 2025).
  • Benefits: Preclinical data reduce central sensitization (Islam et al., 2025).

• Apigenin:

  • Food Sources: Parsley, chamomile tea, celery.
  • Recommended Intake: 5–50 mg/day; 1–2 cups chamomile tea. Cost: ~$0.80/day (Life Extension).
  • Mechanisms: Inhibits NF-κB, IL-6, COX-2; modulates 5-HT1A receptors, reducing pain signaling (Hussain et al., 2016).
  • Benefits: Preclinical data support reduced pain perception (web:5).
    Practical Notes: Use turmeric in cooking and chamomile tea. Monitor NRS and patient-reported pain perception after 4–12 weeks.

8. Systemic Inflammation

Pathophysiology: Elevated ROS and cytokines (e.g., IL-6, TNF-α, CRP) drive widespread inflammation, exacerbating pain across conditions (Rudrapal et al., 2022).

Polyphenol Interventions:

• Resveratrol:

  • Food Sources: Red grapes, red wine, blueberries, dark chocolate.
  • Recommended Intake: 100–500 mg/day; 1–2 glasses red wine provides ~1–5 mg. Cost: ~$2.20/day (Thorne).
  • Mechanisms: Inhibits COX-1 and IL-6, reducing systemic inflammation; scavenges ROS (Meng et al., 2021).
  • Benefits: Preclinical data reduce inflammation markers (web:8).

• Quercetin:

  • Food Sources: Red onions, apples, kale, berries (Hollman & Katan, 1999).
  • Recommended Intake: 500–1,000 mg/day; 1 medium red onion provides ~10–30 mg. Cost: ~$0.80–$2.20/day (Thorne, Life Extension).
  • Mechanisms: Inhibits NF-κB, lipoxygenase, and IL-6, reducing systemic inflammation; scavenges ROS; activates Nrf2 (Javadi et al., 2017).
  • Benefits: Preclinical data reduce CRP, IL-6 (web:16).

• Apigenin:

  • Food Sources: Parsley, chamomile tea, celery.
  • Recommended Intake: 5–50 mg/day; 1–2 cups chamomile tea. Cost: ~$0.80/day (Life Extension).
  • Mechanisms: Inhibits NF-κB, IL-6, COX-2; scavenges ROS (Hussain et al., 2016).
  • Benefits: Preclinical data reduce systemic inflammation (web:5).
    Practical Notes: Encourage onions and chamomile tea in diets. Monitor CRP and ESR levels after 4–12 weeks.

9. Alzheimer’s Disease

Pathophysiology: Oxidative stress, amyloid-beta (Aβ) accumulation, and neuroinflammation drive neuronal loss and pain, exacerbating cognitive decline and central sensitization (Rudrapal et al., 2022; Islam et al., 2025).

Polyphenol Interventions:

• EGCG:

  • Food Sources: Green tea, matcha; avoid milk (Hollman & Katan, 1999).
  • Recommended Intake: 300–800 mg/day; 2–3 cups green tea; avoid >1,000 mg/day (Islam et al., 2025).
  • Mechanisms: Reduces Aβ deposits (60% in frontal cortex, 52% in hippocampus) and microglial activation (18% in cortex, 28% in hippocampus); inhibits LPS-induced astrocyte activation; promotes autophagy and mitochondrial function; scavenges ROS; activates Nrf2 (Xu et al., 2006; Islam et al., 2025).
  • Benefits: RCT (600 mg/day, 12 months) reduces Aβ plaques, improves cognition (Islam et al., 2025).

• Quercetin:

  • Food Sources: Red onions, apples, kale, berries (Hollman & Katan, 1999).
  • Recommended Intake: 500–1,000 mg/day; 1 medium red onion provides ~10–30 mg. Cost: ~$0.80–$2.20/day (Thorne, Life Extension).
  • Mechanisms: Inhibits NF-κB and lipoxygenase, reducing neuroinflammation; scavenges ROS, protecting neurons (Javadi et al., 2017; Middleton et al., 2000).
  • Benefits: Preclinical data reduce Aβ-induced inflammation (web:16).

• Resveratrol:

  • Food Sources: Red grapes, red wine, blueberries, dark chocolate.
  • Recommended Intake: 100–500 mg/day; 1–2 glasses red wine provides ~1–5 mg. Cost: ~$2.20/day (Thorne).
  • Mechanisms: Inhibits NF-κB and IL-6, reducing neuroinflammation; scavenges ROS; modulates SIRT1, reducing Aβ aggregation (Meng et al., 2021; Rahman et al., 2020).
  • Benefits: RCT (500 mg/day) reduces Aβ aggregation (web:8).

 

• Apigenin

  • Food Sources: Parsley, chamomile tea, celery.
  • Recommended Intake: 5–50 mg/day; 1–2 cups chamomile tea. Cost: ~$0.80/day (Life Extension).
  • Mechanisms: Inhibits NF-κB, IL-6, COX-2; increases NAD+ via CD38 inhibition; scavenges ROS (Hussain et al., 2016).
  • Benefits: Clinical data support neuroprotection (web:9).
    Practical Notes: Encourage green tea (no milk), berries, and parsley. Monitor NRS, DN4, and cognitive scores (e.g., MMSE) after 4–12 weeks.

10. Spinal Cord Injury

Pathophysiology: Oxidative stress and inflammation cause secondary neuronal damage, amplifying neuropathic pain and central sensitization (Rudrapal et al., 2022).

Polyphenol Interventions:

• EGCG:

  • Food Sources: Green tea, matcha; avoid milk (Hollman & Katan, 1999).
  • Recommended Intake: 300–800 mg/day; 2–3 cups green tea; avoid >1,000 mg/day (Islam et al., 2025).
  • Mechanisms: Scavenges ROS, reducing neuronal damage; inhibits COX-2, NF-κB, JAK/STAT; promotes autophagy and mitochondrial function (Xu et al., 2006; Islam et al., 2025).
  • Benefits: Preclinical data reduce neuropathic pain and neuronal loss (Islam et al., 2025).

 

• Quercetin

• • Food Sources: Red onions, apples, kale, berries (Hollman & Katan, 1999).
  • Recommended Intake: 500–1,000 mg/day; 1 medium red onion provides ~10–30 mg. Cost: ~$0.80–$2.20/day (Thorne, Life Extension).
  • Mechanisms: Inhibits NF-κB and lipoxygenase, reducing neuroinflammation; scavenges ROS, protecting neurons (Javadi et al., 2017; Middleton et al., 2000).
  • Benefits: Preclinical data reduce neuropathic pain (web:16).

• Resveratrol:

  • Food Sources: Red grapes, red wine, blueberries, dark chocolate.
  • Recommended Intake: 100–500 mg/day; 1–2 glasses red wine provides ~1–5 mg. Cost: ~$2.20/day (Thorne).
  • Mechanisms: Scavenges ROS, reducing oxidative damage; inhibits IL-6 and NF-κB, alleviating neuropathic inflammation (Meng et al., 2021).
  • Benefits: Preclinical data support neuroprotection (web:8).
    Practical Notes: Include green tea (no milk) and red onions in diets. Monitor DN4 and pain scores after 4–12 weeks.

11. Brain Trauma (Including Stroke)

Pathophysiology: Oxidative stress and inflammation cause neuronal damage, leading to neuropathic pain and central sensitization (Rudrapal et al., 2022).

Polyphenol Interventions:

• EGCG:

  • Food Sources: Green tea, matcha; avoid milk (Hollman & Katan, 1999).
  • Recommended Intake: 300–800 mg/day; 2–3 cups green tea; avoid >1,000 mg/day (Islam et al., 2025).
  • Mechanisms: Scavenges ROS, reducing neuronal damage; inhibits COX-2, NF-κB, JAK/STAT; promotes autophagy and mitochondrial function; reduces infarct volume via caspase-3/PARP inhibition (Xu et al., 2006; Islam et al., 2025).
  • Benefits: Preclinical (50 mg/kg) reduces infarct volume and neurological deficits (Islam et al., 2025).

 

• Quercetin

• • Food Sources: Red onions, apples, kale, berries (Hollman & Katan, 1999).
  • Recommended Intake: 500–1,000 mg/day; 1 medium red onion provides ~10–30 mg. Cost: ~$0.80–$2.20/day (Thorne, Life Extension).
  • Mechanisms: Inhibits NF-κB, lipoxygenase, and NOS, reducing neuroinflammation; scavenges ROS, protecting neurons (Javadi et al., 2017; Middleton et al., 2000).
  • Benefits: Preclinical data reduce neuronal damage (web:16).

• Resveratrol:

  • Food Sources: Red grapes, red wine, blueberries, dark chocolate.
  • Recommended Intake: 100–500 mg/day; 1–2 glasses red wine provides ~1–5 mg. Cost: ~$2.20/day (Thorne).
  • Mechanisms: Scavenges ROS, reducing oxidative damage; inhibits IL-6 and NF-κB; modulates SIRT1, supporting neuroprotection (Meng et al., 2021; Rahman et al., 2020).
  • Benefits: Preclinical data support neuroprotection (web:8).

 

• Apigenin

  • Food Sources: Parsley, chamomile tea, celery.
  • Recommended Intake: 5–50 mg/day; 1–2 cups chamomile tea. Cost: ~$0.80/day (Life Extension).
  • Mechanisms: Inhibits NF-κB, IL-6, COX-2; increases NAD+ via CD38 inhibition; scavenges ROS (Hussain et al., 2016).
  • Benefits: Preclinical data support neuroprotection (web:9).
    Practical Notes: Encourage green tea (no milk), berries, and parsley. Monitor DN4, NRS, and neurological symptoms after 4–12 weeks.

Practical Recommendations

• Dietary Incorporation: Aim for 2–3 servings/day: 1 cup berries, 1 medium red onion (quercetin), 2–3 cups green tea (no milk for EGCG), 1 tsp turmeric, 5 g parsley (apigenin). Enhance bioavailability with healthy fats (e.g., olive oil, avocado) or piperine (black pepper). Avoid milk with green tea to maximize EGCG absorption (Hollman & Katan, 1999).
• Supplementation: Use liposomal or nanoformulated supplements for better absorption (e.g., Thorne Advanced Nutrients for curcumin, quercetin, EGCG, resveratrol, ~$2.20/day; Life Extension Two-Per-Day for quercetin, apigenin, ~$0.80/day). Start with lower doses (e.g., EGCG 300 mg/day) and adjust with doctor guidance (Islam et al., 2025).

Conclusion

Dietary polyphenols like curcumin, quercetin, EGCG, apigenin, and resveratrol offer targeted benefits for pain management and neuroprotection across osteoarthritis, rheumatoid arthritis, migraines, sciatica, peripheral neuropathy, multiple sclerosis, central sensitization, systemic inflammation, Alzheimer’s, spinal cord injury, and stroke.

By addressing oxidative stress, inflammation, and neuronal damage through mechanisms like NF-κB, COX-2, JAK/STAT inhibition, Nrf2 activation (paralleling Vumerity), Aβ reduction, and autophagy promotion, these compounds reduce pain and improve outcomes. Tailored dietary and supplement strategies, combined with regular monitoring, ensure effective integration into pain management plans.

References

• Islam MR, et al. Epigallocatechin 3-gallate-induced neuroprotection in neurodegenerative diseases. Mol Cell Biochem. 2025;480:3363–3383. doi:10.1007/s11010-025-05211-4.
• VUMERITY® efficacy. https://www.vumerity.com/en_us/home/about/efficacy.html.
• Hussain T, et al. Oxidative Stress and Inflammation: What Polyphenols Can Do for Us? Oxid Med Cell Longev. 2016;2016:7432797. doi:10.1155/2016/7432797.
• Javadi F, et al. The Effect of Quercetin on Inflammatory Factors and Clinical Symptoms in Women with Rheumatoid Arthritis. J Am Coll Nutr. 2017;36(1):9-15. doi:10.1080/07315724.2016.1140096.
• Manach C, et al. Polyphenols: food sources and bioavailability. Am J Clin Nutr. 2004;79(5):727-747.
• Hollman & Katan, 1999; Middleton et al., 2000; Rudrapal et al., 2022; Daily et al., 2016; Jin et al., 2020; Xu et al., 2006; web:5, 7, 8, 9, 15, 16, 21, 24.
• Islam et al. (2025) and VUMERITY website, retained core sources (Hussain et al., 2016; Javadi et al., 2017; Manach et al., 2004)

Emphasis on Education

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