You have felt great for months or even years when you gave up eating meat. You developed some low back pain awhile back and it’s not going away or it keeps coming back. You have tried physiotherapy, massage therapy, chiropractic care, and acupuncture with no luck. Even your yoga practice is longer helping it. In fact, you are no longer able to do intense exercise because you get sore and it takes you longer to recover. Could it be that your lower back pain is due to something more than a problem with the muscle, joint, or nerve? Could it be related to being on a vegan or vegetarian diet?
There are many reasons why people switch to a vegan or vegetarian diet. Some do it because of the negative impact that confinement animal feeding operations (CAFO) have on the environment. Some do it because of ethical or religious purposes. I respect these choices and appreciate anyone that thinks deeply about the impact their decisions will have on a social and spiritual level.
However, there are many people who choose to go on a vegan or vegetarian diet because they believe it is healthier for you than an omnivore diet (eating meat and plants in the diet). I was lead to believe the same thing in the nutrition courses taught to us at chiropractic college in the 90’s. We were told eating red meat creates inflammation (swelling) and causes your arteries to clog up. So I limited my intake of meat for along time without questioning this mainstream belief. The fact is, red meat has a lot of health benefits and does not cause inflammation or clog up your arteries to increase your risk of heart disease. Animal proteins are also more easily digested and absorbed by humans than plant proteins.
One of the issues I see with a lot of my long-term vegan and vegetarian patients is that they are prone to chronic recurrent low back pain and other joint and muscle pain syndromes. They also have problems recovering from injuries. At least part of the reason is because they aren’t eating enough protein on a daily basis. The other reason is because they may not be getting enough omega-3 fatty acids in their diet.
Protein deficiency and low back pain
Protein is used by your body to build your structure and to add support and strength to your body (muscles, tendons, bone, ligaments, connective tissue). It’s the “glue” that holds your body parts together. Protein is also important as a building block for immunoglobulins (immune system), neurotransmitters (chemicals messengers for your nerves and brain), and some hormones.
If you’re deficient in protein, all of the tissues that hold you spine together weaken. All of your muscles and where they attach into the bones become weak. The ligaments that hold your joints together become weak. Your spine can become unstable, prone to misalignments, and prone to sprain and strain injuries. Chronic low back pain is the result. You won’t be able to recover as quickly from an injury because you won’t be able to repair tissue as well.
Three main reasons you can become protein deficient
- Protein in plant-based diets is absorbed poorly
Plant-based diets will focus on vegetables, fruits, nuts, seeds, legumes and grains (refined and unrefined). Vegetables, fruits, nuts, and seeds are good sources of micronutrients (vitamins and minerals) but humans don’t absorb the little protein that are in these foods very well. Legumes and grains are poor sources of protein compared to animal protein. They also contain antinutrients (i.e. phytic acid, trypsin inhibitors) that reduce our ability to absorb protein. Whether it’s soy, lentils, kidney beans, wheat, or corn, these antinutrients have been shown to reduce digestion and absorption of amino acids (the smaller parts of protein) in these foods by as much as 50%. (1)
Vegans and vegetarians also avoid eating organ meats, meats, fish and shellfish, all of which are the most nutrient dense foods you can eat. (2)
The table below is from the Food and Agricultural Organization of the United Nations World Health Organization. They created a way to measure protein quality based on how complete or incomplete the protein is in each food (amino acid profile) and how well the protein in each food is digested and absorbed. It’s called the protein digestibility-corrected amino acid score (PDCAAS).
PDCAAS has been the preferred way to measure protein quality in scientific studies since 1989. (3) You will notice soybeans are high on the list, but this measure does not take into consideration the antinutrients that interfere with the digestion and absorption of protein as noted above. If you take this into consideration, the scores for soy protein, other legumes, and grains would be a lot lower.
Vegans and vegetarians are prone to a number of nutrient deficiencies including vitamin B12, vitamin A and D, calcium, iron, zinc, and the long chain fatty-acids EPA and DHA. (4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16)
Based on the PDDCAAS and antinutrient consideration there is a good chance that vegans and vegetarians would be more prone to protein deficiency than omnivores.
There is a good chance vegans and vegetarians are more prone to protein deficiency than omnivores. Protein deficiency may be one of the causes of chronic low back pain and other pain syndromes.
- You’re not consuming enough protein each day.
This could be an important cause of protein deficiency in vegans, vegetarians, and omnivores for that matter. But how much daily protein intake is optimal for a human being? There’s a lot of different answers regarding this topic. So what authority figure do you trust? If you want to dive deep into this subject, Registered Dietician Diana Rogers does a great job at sorting out the confusion in this article.
How much protein you should eat each day depends on your age, height, weight, activity level, and other health circumstances. The optimal range of protein can range from 10% to 35% of your total daily caloric intake. For men, based on a 2600 calorie diet this would range from 65 – 230 grams of protein per day. For women, based on a 2000 calorie diet this would range from 50 – 176 grams of protein per day.
Let’s say you determined you need to eat 2000 calories per day. A well balanced amount of daily protein you would likely need would be about 20% of that. This equates into 100 grams of protein per day or about 12 – 16 oz of meat per day. For meat eaters, a piece of meat that is about the size of the palm of your hand would be about 4-6 oz. For plant food, lentils are probably the most desirable source of protein because they’re the least processed, non-soy option. You’d have to eat 1.5 cups of lentils, which is 337 calories, in order to get the same amount of protein that you can get from 3.5oz of fish, at about 1/3 the calories. (17)
How much protein do you need?
If you’re generally healthy or you are pregnant aim for 10-20% of your calories to come from protein. If you need to lose weight, have blood sugar problems, want to put on muscle mass then aim for 20-35% of your calories to come from protein.
Here’s a calorie calculator to figure out how many calories you need per day: exrx.net
Once you figure that out, multiply that number by the percentage of protein you want to consume per day, and then divide that number by 4 to get the number of grams of protein you should be eating per day.
You can use an app like myfitnesspal to track your daily protein intake. Keep in mind if you eat plant based protein, the protein you actually absorb may be up to 50% less than what the app calculates.
- You’re not digesting protein well.
If you have low stomach acid, heartburn/GERD, IBS, or any other underlying gut problem, you won’t be able to break down protein into amino acids as well for proper absorption.
Thorough lab testing with a health practitioner would be necessary to determine the underlying cause of your gut problem.
Essential Fatty Acid Deficiency (AA and EPA), Inflammation, and Low Back Pain
What if your chronic recurrent low back pain is due to chronic inflammation (swelling)?
Inflammation is necessary to fight off sickness and to start the healing process when you are injured. Inflammation in your joints and muscles will irritate your nerves and cause pain. As you heal, your body decreases inflammation and pain. If your body can’t decrease inflammation, your low back pain will become chronic. A well balanced diet between the essential fatty acids arachidonic acid (AA) and eicosapentaenoic acid (EPA) are important for decreasing inflammation and pain.
An essential nutrient means we require the nutrient from our diet so our body functions properly. Omega-6 (i.e. arachidonic acid or AA) and omega-3 fatty acids (i.e. EPA) are essential fatty acids we get from eating animals and seafood. They work together to keep inflammation (swelling) at a healthy and stable level. High blood levels of both AA and long chain omega-3 fatty acids are associated with low levels of inflammatory markers in the blood. (18, 19)
The balance between omega-3 fatty acids and omega-6 fatty acids is key in keeping inflammation in control. If our food intake of omega-3 fatty acids is low (i.e. not enough cold water fatty fish, shellfish, or grass fed beef) in our diet, our tissue levels of AA go up. If we have high doses of omega-3 fats (i.e. too much fish oil supplements) our AA levels go down. Neither is helpful to control inflammation. (20)
Plant foods contain omega-6 (linoleic acid or LA) and omega-3 (alpha-linolenic acid or ALA) fatty acids. Both of these are considered essential fatty acids. ALA from plant foods (i.e. walnuts and flax) can be converted into EPA, but the conversion is poor in humans: 5-10% for EPA. (19) Vegetarians have 30% lower levels of EPA and DHA (another omega-3 fatty acid) than omnivores (meat eaters), while vegans have 50% lower EPA and nearly 60% lower DHA. (20)
Because vegetarians have 30% lower levels of EPA than omnivores (meat eaters), and vegans have 50% lower EPA, vegans and vegetarians are more likely to develop chronic inflammation and pain.
Solutions for Vegans and Vegetarians
- Switching back to an omnivore diet
The obvious solution to solve protein and EPA deficiency would be to switch back slowly to a whole food diet which includes animal meat and seafood. I say slowly, because if you haven’t ate meat or seafood in a long time, your digestive system won’t be used to eating it and you might get sick.
I would recommend you start eating homemade bone broths and supplementing with collagen powders (a protein for building connective tissue). You can also try a high quality beef isolate protein powder called PurePaleo Protein powder.
While you are on this recovery diet I would recommend you support your digestive system by supplementing with Betaine hydrochloric acid with pepsin and digestive enzymes. This will help you digest animal protein and absorb it easier.
You could try to eat small amounts shellfish and cold water fatty fish (wild salmon, mackerel, herring, anchovies) to get EPA. Eventually, you want to eat 12-16 ounces per week of shellfish or cold water fatty fish. If you can’t handle this I would suggest you supplement with cod liver oil and wild salmon oil.
Eventually, you should be able to retrain your digestive system to handle eating meat and seafood regularly.
- Getting enough protein and EPA with a vegan or vegetarian diet
I realize not everyone is going to switch to an omnivore diet due to a variety of reasons. So here are some solutions for vegans and vegetarians to get more protein and EPA.
Most vegetarians and vegans will need to supplement with microalgae like Algae Omega from Nordic Naturals in order to get enough EPA and DHA (another important essential fatty acid). Plant-based omega-3 fats like flaxseed and walnuts will not provide enough EPA and DHA in most cases.
For protein requirements you can include non GMO tofu, tempeh, spirulina, and sprouted legumes. Keep in mind, when getting your protein sources from plant food, your body may only be digesting and absorbing 50% of the protein. So you have to compensate for this by eating more.
Because vegans and vegetarians are prone to other nutritional deficiencies I have included a handout here for you to help ensure you are getting adequate intake of essential nutrients. Denise Minger provides some excellent tips for vegans.
Summary
Vegans and vegetarians are prone to nutritional deficiencies like protein and EPA. Getting good amounts of protein and the essential fatty acid EPA is crucial in resolving chronic low back pain.
If you have been a long-term vegan or vegetarian and have chronic recurrent low back (or any other type of chronic pain), I would recommend you figure out if you could be lacking in protein and EPA. If you are, take the steps I have suggested to see if it resolves your issue.
Come on, Something is not right !
Tell me, why the exact opposite has happenned to me.
I am no nutritionist or doctor, but I can tell you 12 years of a very bad back ( lower ) being an avid meat eater and all ( i did eat my veges too )
and I start a vegan diet 2 years ago , minus all of my back issues I have ever had.
and I mean ALL of the issues i have had.
Real life experience here. You can’t tell me that maybe this is an unussual circumstance…. bla bla bla. It’s not going to change my view.
You cannot tell me that waking up nearly every morning for 12 years with uncertainty
if i could actually get out of bed without my back pains and maybe walk upright normally .
I have seen everone about my back. Come on , no one could really help me.
Sorry, A very disturbing and dissapointing article for me to read.
Hi there,
I expect fully there will be people challenged by this article. I know full well when someone challenges my core beliefs it can stir me up inside. So I understand why you feel the article is disturbing and disappointing for you.
First the article, is meant for longer-term vegans and vegetarians (definitely beyond 2 years) who may be getting recurrent back pain to other recurrent joint pain. It gives them a common cause of recurrent pain and a potential solution…which is to increase their protein and omega-3 fatty acid intake. As mentioned in the article, there are people who are going to be unwilling to switch back to an omnivore diet and I fully expect that and respect their path. This is why I provided some strategies for them on how they can increase their protein intake without eating meat. And also, how to increase their omega-3 fatty acid intake.
You have been vegan only for a short period of time (2 years). I fully acknowledge that many new vegans and vegetarians feel very good when they first start this diet (as also indicated in the beginning of my article). First and foremost, I congratulate you for feeling better…that’s the most important thing here for you. Many vegans and vegetarians are more health conscious, in general, than a typical meat eater. So good for you. I also acknowledge that there are outliers out there who are long-term vegans that seem to do pretty well with their health. And I also know, that many long-term vegans crash at some point because of the nutritional deficiencies they can develop. In the latter case, this article will mean more for them.
Thanks for your comments and challenging me.
I agree. I felt great as a vegetarian for the first years then around 8-15 years my body started falling apart. Added some meat a few times a week to my diet and I’m healing much faster.
I was a meat eater for many years and exactly as you described is what happened to me, I felt better than ever for 6 years then as I hit my late 30s started to notice reoccurring back pain as well as other ailments , I decided to start eating meat again and these have all but cleared up, I eat meat once or twice a week and it’s made a huge difference to my life .
Another great share. Thanks for sharing Harry as your story could help other people that are having the same issue.
Dr. Collins
Yes I fully agree with this article. I hve been on a strict began diet for 1and hakf years. I just quit 3days ago becaise it @!#$@ up my life. Initially I felt very good and energetic. Then I twisted my knee whilst doing yoga. Actually the instructor pushed me. And it has been a year and it hasn’t healed despite seeing an orthopedic surgeon. He says my knee is badly inflammed. So you explain why a vegan diet cannot resolve my inflammation. When I was an omnoviore, it will take me maximum 2weeks tonrecover from sprains and back pain. So screw vegan diet which gave me more issues and suffering.I haven’t been able to travel and exercise due to this knee pain.
I am in the same boat. It really messed up my joints and switching back to a balanced diet is the way to go.
I have been vegan just over a year and don’t want to quit due to ethical reasons but this is already happening to me so how do i stay vegan and fix it, its widespread from my shoulders to kidney area. Thanks. Ps 5 ft tall.slow metabolism so more than 1k of cals whether animal or not makes me gain weight.
Hi Sue,
1000 calories per day is very low for an adult. Low calorie intake for long periods of time will cause high levels of the stress hormone cortisol. If your cortisol is high for long periods of time (or out of balance), this will do two things related to your comments: weight gain and pain. Cortisol is needed to shut off inflammation (swelling) in your body. The cells in your body won’t respond as well when you have high levels of cortisol over a long period of time. Pain can be the result. Read this: https://drcollins.ca/weight-loss-tips-hidden-causes-weight-loss-resistance/
Make sure you click on the links and handout link I left in the Vegan article to help you get more nutrients.
The weight gain concern you have can be due to a lot of things so make sure you read the link I left you above.
Ultimately, you may need some professional guidance and potentially more in depth lab testing to navigate you through this Sue.
Hope this helps you a little.
Dr. Collins
Came across this article while searching for “fatigue and joint pain on a vegan diet”.
Much to my relief (and dismay) this appears to be my issue.
I have been on a vegan/occasionally vegetarian diet for a little over a year. I felt amazing for about 6 months. My aching fingers, neck, hips all felt so much better. I haven’t been diagnosed, but I do feel I have the beginnings of some form of arthritis. But now, a full year+ later, I feel awful much of the time. I have the neck stiffness/aching again, my elbow joints are killing me, my hips/lower back hurt and I generally feel terrible.
I am very careful about eating a well-rounded diet. I cook from scratch, eat fresh organic produce, exercise almost everyday (yoga or bike riding or resistance/weights, gardening, low-impact calesthenics). I am 52 and am in perimenopause. I assume that’s what it is…I haven’t had a menstrual cycle for almost a year…maybe that’s from being on a vegan diet, too. I’ve heard that can happen. I also have the menopause tummy issue. No amount of exercise or calorie restriction helps. I am not a stressed out person. I am a stay at home “homemaker”, a job I absolutely love.
I have contemplated many times, over the past few months, that I need to change my diet to a more inclusive one. The ethical part keeps me from doing it, though. Damn that Forks over Knives Documentary!
I’m fine with the logic of consuming animal protein, it’s the emotional part that gets to me. I have been eating a few scrambled eggs over the past week (from my organically fed, free roaming backyard chickens). Not sure that’s enough to turn things around.
Maybe I just have arthritis, and coupled with menopause it’s all coincidental and not diet related at all.
Thanks for this article.
R
Thanks for the comments and sharing.
I realized one of my links didn’t work. Here is a missing link for you from Denise Minger’s website regarding tips for vegans: Tips for Vegans
As well, you might be interested in her Forks over Knives critique: Forks over knives critique
I just came across this article as I was googling “can a vegan diet cause chronic pain” . I am in a similar life stage as you and also a homemaker and have similar stress level. Started FOK eating approximately two months ago. Incredibly my sciatic pain disappeared the first week so I stuck with it. But now my entire body aches and hurts almost constantly.
This article may be my lifesaver as I was beginning to think it was fibromyalgia or something worse. So this morning I added an egg to my breakfast.. I always eat organic and will try adding some quality meats and see if that fixes my pain. I am a very healthy person otherwise and just didn’t understand what was happening.
I was wondering if you had an update and how things are going for you now?
Lisa
I am very happy with your article.
I began a vegetarian lifestyle (with quite a lot of dairy products) in 2012. But my body slowly weakened .. I needed more and more physical therapy, but normal treatments caused damage from which I hardly recuperated.. A soft touch was all I could handle. Some of the damage was to my muscles, but also my nerves were hurt. I have tinnitus since 2013 (neck manipulation) and in 2014 I got a spinal cord injury in my neck, which causes the right side of my body to burn (whilst I cannot sense temperature ) whenever my posture is poor. And boy, did my posture deteriorate while being a vegetarian! Just straightening myself , under guidance of a physical therapist caused the spinal cord injury!
I began to use supplements late 2013: the vitamin B’s,D, taurine and magnesium to decrease my tinnitus. As a nice side effect it stopped the cramps in my calves and “Tibialis anterior” (they preferred cramping simultaneously; That is the worst pain I ever had). In 2014 I also got metatarsalgia, so I also needed orthotics. Without them I couldn’t walk anymore.
I lost my job in 2015 because of all this and summer 2017 I had to sell my house and move to a rented house. THis drained my last bits of energy. By March this year I did not even get out of bed unless there was something pressing going on.
Only during Xmas 2017 I had felt fine for a week or 2. I was too tired to cook both vegetarian meals and a meat-meals for my son, so I ate what he ate… I regained enough energy to… start making vegetarian meals again… and I began to deteriorate again.
The doctor never even inquired if I was a vegetarian for I have high levels of Vitamin B12. MRI’s show no damage in my brain or neck (my cartilage shows about 20 years younger than I am 🙂 , no wear and tear!)
Reading about L-carnitine as supplement in case of nerve damage made me think … “carni” means meat! I decided to eat meat for a month to see what would happen.
This happened:
* In a few days I became more energetic. Now I hardly ever spent time lying down during the day
* My posture is so much better and my trigger point pain attacks rarely flare up now
* Since last week I no longer use the orthotics
THe nerve problems however are not on the mend yet. But… it wouldn’t surprise me if that would take a year or 2.
I prefer red meat and skipping this for one or two days (still not liking to eat animals) means I’m beginning to feel tired again.
I am definitely going to check out articles about the AA and EPA you mentioned.
I will not take omega-oil supplements (or seed) however, for the vitamin E that is added makes my tinnitus totally unbearable. I cannot even hear people speak after consuming things rich in vitamin E.
Some people may be able to handle vegetarian or vegan diets, but some of us just can’t. . So the article is true for a part of the non-meat eaters . THank you for writing it, dr Dean Collins !
You are most welcome Jo. Thank you for your comments.
Hello
Thank you for your article which is interesting but you are making big generalisations based on small and targeted specific information and research.
1. As a Chiropractic you will know that there are numerous reasons for lower back pain. And most of the times (in excess of 80%?) the cause cannot be identified. So how can you make such a big generalisation on the cause of it?
2. You made no reference to research that supports your association of lower levels of EPA and lower back pain. Is this a big generalisation based on your personal experience with no scientific research behind it?
3. In your experience, is lower back pain incidence in vegetarians/vegans higher than those on an omnivore diet? Or have you seen any research suggesting the incidence is higher in vegans/vegetarias? If not, then l, doesn’t your article apply to everyone really?
4. Research I seen has shown that the incidence of low back pain is 2 to 4 times higher in western societies than it is in Africa and South East Asia. Populations in these areas with lower incidence of low back pain, have higher activity jobs (mainly farming) and have diets rich in plants and low to very low consumption of meat. They also enjoy lower incidence in diabetes, heart disease and cancer.
5. Would be interested in knowing what is your view and advise on someone (on a omnivore diet super rich in EPA) who is experiencing chronic lower back pain – There are millions of them. Is this advise also applicable to vegans?
Perhaps a good recommendation for point number 5, based on point number 4, is for them to eat more vegetables/fruit and do more exercise?
Regardless of omnivore/vegetarian/vegan people need to do regular exercise and eat balanced diet.
Regards
Ant
Hi Ant,
Thank you for your thoughtful introspection. My responses to your inquiries and comments are as follows:
Yes I am aware there are numerous causes of low back pain and are often multifactorial. Articles are focussed purposely when I write them, otherwise I would be writing a book. This one is geared towards vegans and vegetarians who may be having issues with recurrent or consistent low back pain. I am simply offering two potential reasons why many of my vegan and vegetarian patients (and potentially other vegan and vegetarians) are getting recurrent back pain. And I’m offering a couple of solutions they may want to try to solve it so they carry on with life more comfortably. These solutions can apply to omnivores as well, and I have referred to that in the article.
Some of my articles are indeed observational. After many years of practice, I feel that holds some merit and it may even spur some research in the future. This article has some of my observations blended with scientific facts.
I’m not saying vegans and vegetarians get more low back pain than omnivores at all. What I’m suggesting is that if a vegan or vegetarian has recurrent low back pain, despite trying a variety of physical therapies to resolve it, they may want to up their protein and essential fatty acid consumption. The protein and essential fatty acid deficiency would pertain to vegans and vegetarians more than omnivores.
And I agree with you if people were more active and less sedentary they would have less low back pain. I have written other articles on this subject manner and relay this message to my patients everyday. I’m a big proponent of standing desks and treadmill desks as an example.
I’m not sure of your reference to less LBP in South East Asia and Africa. It makes sense especially if they are more active than western societies. Eating fruits and vegetable are important as well. I do know that LBP in Africa is now rising and is up to 62% of the adult population. But these scientific reviews did not study smaller subset of populations that you are eluding to. So you’re probably right with respect to the farming communities.
You may want to read about the healthy user bias. I was always under the impression for the longest time that vegan and vegetarians were healthier the omnivores. Some observational studies suggest this for sure. Vegetarians will adopt healthier behaviours than ominvores. They smoke and drink less, eat more fruits and vegetables, and are more likely to get exercise. Omnivores are more likely to do the opposite and engage in unhealthy behaviours . But is it the meat that causes the omnivore to get heart disease, cancer, or low back pain (or multiple joint pains for that matter) or the hamburger or hot dog bun? Likely the bun…AND eating more sugar, industrial seed oils, less fruits and vegetables, being overweight from eating too many refined flours and sugar, not moving enough, etc.
Hard to be 100% sure based on observational studies. There was a control study done in the UK that showed vegetarians and omnivores who shopped at health food stores lived longer than the general population. There was no difference in the survival rates, or heart disease and cancer between the health conscious omnivore and vegetarians however.
Eating a “balanced diet” is a loose term as people have their own ideas what a balanced diet looks like. My general advice for people is to eat whole foods (things that move above the ground and things that grow in the ground), avoid refined foods in packages, and move lots.
Regards,
Dr. Collins
Hi, why on the hand out is spirulina not mentioned as advised supplement for vegans. I thought this is one of the ost important to cover protein in vegan diet.
Sorry for the tardy reply Mo. We moved our office this past month and I have been playing catch up.
The handout lists how to attain important “micronutrients” when on a vegan or vegetarian. However, now that you mentioned it I will upgrade it and include a protein section.
Spirulina, does have a high percentage of protein in it, but you have to consume it as a powder or tablet/capsule. So you have to consume lots of it to get a lot of protein. For example, i tablespoon of spirulina powder only gives you about 4 grams of protein.
I have been a vegan for one year, and have no lateral meniscus, have had a lot of knee and back operations. I have been unable to bend my knee without pain, I am in constant pain and I can no longer do the activities that I used to do. It just dawned on me that, since there are no coincidences, that it could be the fact that I became vegan. I read your article and it is making me sad to realise that I will have to start reintroducing animal products in my diet. However, I can not take the pain anymore. Thanks for the article.
You’re welcome Linda. I hope you can solve your problem.
Dr. Collins
Hello dr.collins, I’ve been following vegan diets for the past few months and all my joints and back are paining so much. When i move my knee i hear a twitching sound which i didn’t hear before in my whole life. It feels as if am 50yo and not 20 yo. I can’t sleep properly while am trying to sleep either i get pain or having bad nightmares. I don’t how to deal with this. I’ve started to take cod liver oil supplement recently and I think of using spirulina supplement too. Do you think it’d help my problem? I never had bone pain like old ppl before in my life. It all started with vegan diet. If you suggest switching back to Non vegetarian diet I’d gladly start because my bones feel terrible
Hi Bhava,
Thanks for your comments and inquiries.
Unfortunately without doing an extensive history and testing, it’s hard to say why you’re going through this experience. Some people find when they switch back to eating meat they feel better. Sorry I can’t give you definitive answer.
You might want to consult a functional medicine practitioner and/or a chiropractor to help you.
Regards,
Dr. Collins
I quit eating meat 40 some years ago after doing a news article about animal production. The horror of it all made my transition and continued appreciation of the vegetarian (now vegan for many years) diet very easy for me. Not only were my mental questions resolved but all of my physical concerned disappeared.
(BTW, I haven’t made vegetarianism my religion like many, and I don’t normally like to preach to others about the idea unless asked about it. )
However, I think you, Dr. Collins, are approaching the issues of vegetarian health from a very typical materialistic perspective. I have come to understand that physical health is more mental than physical. There are many reason I have come to this conclusion, besides my own experiences.
There are perhaps billions of vegetarians in the world, many raised in largely vegetarian cultures, besides the many who adopt the diet for mental reasons (like me) or perhaps spiritual reasons, for vegetarianism has been promoted in spiritual traditions for many thousands of years.
If a person is having problems with the vegetarian diet, I would make two suggestions: start eating meat again and see what happens; or examine your mental beliefs about your physical well being. I hold strongly to the principle that, regardless of one’s lifestyle choices, physical life experience is “dictated” at least by 90% of the quality of one’s thinking.
I am responding to your opinions because someone asked me about “vegetarian back”, which I had never heard of. and so I decided to search the internet. I would guess there is no such animal. I would guess that these type of “problems” develop because of mental resistance to this or that type of experience in one’s life. Of course, I believe physical problems develop in everyone from time to time, vegetarian or not, for the same reason.
I know this sounds somewhat banal, but thinking good thoughts, looking for things to feel good about, and eating somewhat low on the food chain is the best health insurance a person could ever have.
Hi Orin,
Thanks for your thoughtful and interesting perspective. And I appreciate you keeping your emotions in check. After many years of practicing, at this time I don’t think there is one diet that is perfect for everyone. It’s very individual. I think what vegan, vegetarians, and omnivores could agree on is to eat whole foods.
Thanks again Orin.
Dr. Collins
This article doesn’t hold water, in my opinion. I had lower back pain for over 20 years (from age 22 and onwards), and ate a whole foods based omnivorous diet. Meat at every dinner, and most lunches. I also ate eggs several times a week, as well as dairy products. I was not underfed, or malnourished at all. Blood tests came back showing no deficiencies. I also know many other people with recurring back pain issues, and none of them are vegetarian or vegan. In fact, I don’t know any vegetarians or vegans at all, yet lower back pain is very common.
Denise Minger is a blogger, with no medical or scientific training, I don’t believe she is a good source for nutritional information. She basically writes “opinion” pieces.
Hi Lily,
Thanks for your comments. I am very aware there are many causes of low back pain. This is simply one cause I have observed in my office after 24 years of practice. Any person who holds a core belief to their heart and is challenged is going to get emotional. I understand that fully. This article is meant for LONG-TERM vegans and vegetarians who may be getting recurrent low back pain or other recurrent joint pain. It gives them a common cause of recurrent pain and potential solution they might have not considered. Many vegans and vegetarians will feel great short-term when they start on their diet. Most likely because they are eating more whole foods and staying away from refined flours and sugars. I do know some long-term vegans and vegetarians that seem to do pretty well with their diet, but they are also well versed on how to supplement properly and get enough protein in their diet. But many do not, and eventually end up with health issues as a result. This is why I pointed to Denise Minger. Despite her not having “initials” behind her name, she provides solid references and experience being a vegan previously. She provides some good tips for vegans and she can empathize with them.
The deficiencies vegans and vegetarians are prone to are based on quality research. Those are referenced in the article for the audience if they want to look them up.
Blood tests aren’t always the best way to determine deficiencies for certain vitamins and minerals. As well, some lab ranges conventional medicine uses are used solely to detect final stage deficiencies versus catching deficiencies early. An example of this is B12. The serum B12 levels they use catches the B12 deficiency during the last stage (stage 4) when a person can develop permanent neurological issues. B12 deficiency is best measured by urine in a precursor form called methylmalonic acid (MMA). If methylmalonic acid is high that indicates stage 1 B12 deficiency.
Thanks for challenging me.
Dr. Collins
I have been vegetarian for 8 years and about 7 months ago developed severe low back and hip pain that is disabling and has not been explained by doctors, neurologist, rheumatologist, physical therapist, or naturopath. I have reluctantly started eating meat two weeks ago as something in my mind is telling me this is the issue. I’ll update you if it helps. Thank you for your thoughtful article.
Hi Liz,
Thanks Liz. Yes, please ket me know if it helps.
Dr. Collins
I did a vegan diet for nearly two years. I have some moderate degeneration in my lower lumber spine in my L5 and S1 region. This is likely due to some physical jobs I have had in the past such as being a machinist and pipe inspector. I am currently a nurse. Previously, before switching to a plant based diet I didn’t suffer with back pain. Only fatigue from physical jobs or long flights. I did have some back strains in the past but the pain always resolved itself. However, over the last few months I have been having severe back pain. Making it very hard to sit up after sleeping or bend down when walking. I also had severe pain in the hip region and the knees. I could barley sit up from lying down anymore. The only thing that would release my pain was sleeping on my side. I would literally have to push myself up on one arm and set there for a while until my muscles would stop spasming. Then I could sit up and walk properly. I am fairly active and I work out.
After seeing a chiropractor, a physical therapist, and an MD with no clear answer I wondered what had changed in my life to bring about this chronic pain. The only thing I could point to was my diet. That is when I stumbled across your article. Wouldn’t you know that after a solid week of eating meat like chicken, steak, pork and seafood nearby all my back pain is gone. Like I feel 28 years old again. I just want to say thank you for opening my eyes. I literally googled vegan back pain and your article came up, I think you are spot on with it all. My doctor told me that 80 percent of people suffer with back pain at some point in their lives. They have done studies that have biopsies of muscles in the back and shown that people have weakness due to posture and lifestyle. Well, wouldn’t you know that it is likely my veganism that has been causing this the whole time. I am really mad at the fact that my desire to be health conscious and environmentally concisely led me to so much pain and debilitation. My body likely could recover and support my spine with my physically active job and workout regime. I just want to say thank you for opening my eyes, it is a huge relief in pain that this article has given me and I am tremendously grateful for your insight into this issue. I haughty doubt other vegans who are emotionally attached to the diet will admit it, but you sir are a back saver. Thank yo use much.
Hi Jobe,
Thank you for your kind words and sharing your story. Your story will help others who are having similar issues. I’m so happy you’re feeling better. And thank you for having an open mind.
Dr. Collins
My story can mirror Jobe’s.
I’m 60 years old and have had back issues since 26 but always been able to manage with exercise, stretching, chiropractic care, massage therapy and staying active. I walked 4-5 miles a day 6 days a week, hike, weights, yoga…
I started on a Low Fat Plant based whole food diet about 16 months ago trying to get rid of T2 diabetes. 6 months in lost 35 lbs felt great and A1C dropped 50%.
Last fall started having terrible lower back pain to a point it was hard to sleep, work, walk, exercise. I cannot for the life of me remember what I did to injure myself. Pain radiates down right side thru buttock, hip, thigh into calf.
Jan’ 20 had MRI and diagnosed with herniation of L5 S1. Been to PT, Chiro, Massage, Orthopedic (2 epidurals) and NSAID’s and pregablin for pain.
I have been very committed to my Whole Food, Low Fat, Plant based Diet. Lots of fruit, Potatoes, grains, raw whole vegetables, salads, beans and my Favorite Lentils!
I have been taking B-12 regularly but not much else on supplements. I figured eating a clean plant based diet I would not need all those vitamins, minerals, supplements.
So I am going to slowly add some animal protein (chicken, salmon, beef) back into my diet over the next few months to see if this will make a difference. If not I’l go back to the Plant based diet.
Very interesting article and until today something I have not thought about the back issue could be diet related.
Thank You, Jobe and Dr. Collins
Thanks for sharing Jim. Let me know if it works for you or not.
Dr. Collins
How do you explain how a gorilla gets there protein or an elephant.
Hi Peter,
Thanks for your comment. I’m not a zoologist or veterinarian and so I can’t answer that for you in detail. I would suspect they have different digestive tracts and process nutrients in vegetables differently than humans. They probably eat way more in weight than us as well. I think humans eat about 3-4 pounds per day on average. I read gorillas eat anywhere from 35 to 40 pounds per day.
Dr. Collins
I have been training for 20 years, cardio, weight training on a very clean animal based proteins and whole food diet. I switched over to plant based diet, whole grains and no meat or dairy. I started having these joint pains especially in my lower back just after 2 months of starting this plant based protein diet. To top that I started having couple of other joints and tendons getting full aches. Couldn’t explain and after reading this post, tried clean animal proteins and vegetables with very limited grains ( my old diet that I ate for 20 years). Magic happened and back pain plus other joint pains 90% gone. Can someone explain this. I can’t explain this but certainly happy to eat clean organic meat of it keeps this terrible backache away from me
This is accurate in my experience. I was veggie for 2 years then vegan for a year when I started to have excruciating back pain. All my Drs have blamed it on being overweight but I noticed when I had protein shakes it lessened; then had some meat & it got much better. Dont want to eat meat tho 🙁
Hello,
I have been Vegan 3 months, followed by 3 years 9 months as a Pescatarian. Last Fall I began having horrible nerve pain. Sciatica started at my left buttocks down to my toes. This after maintaining a 3 to 4 day workout regimen with clean eating (fruits, veggies, wild caught fish and salmon, nuts, veg protein smoothies, whole grains, no processed foods, and more) for more than 4 years.
Suddenly, lower back pain surfaced. It became worse and worse. By Thanksgiving, I could stand for 10 max before having sit.
I started with my a Chiropractor twice a week. Adjustments, Lumbar Stretches and massage. This went on for 12 weeks. While it helped, it didn’t resolve. Finally I had an MRI and found that I have a herniated disc between L4 and L5.
I take multiple supplements. B12, Zinc, D, K and more. I had this feeling about my pescatarian diet and began to dig to see if there might be any correlation. I came upon this article and many more.
While of course, everybody’s body is different, I wholeheartedly believe that MY body is telling me to reintroduce meat into my diet. As one reader put it, I feel like my body is falling apart. I’m way too tired. My body hurts. I am losing strength in my joints and muscles. I am going to at least TRY. I will slowly incorporate organic grass fed meats, giving it 4 to 6 weeks and see how I feel.
Thank you for this article. Very insightful.
Hi Victoria,
Thank you for sharing your introspection. I’d love to hear back from you to see how you do with this.
I have a couple of suggestions for you which you eluded to already. You may want to try to introduce meat slowly (small portions) or even start off with bone broth. As well, adding digestive enzymes that help break down protein can help. If your digestive tract isn’t used to meat, and you introduce it too quickly, you could get sick.
At any rate, you may want to consult a functional medicine practitioner or naturopath at some point to help you.
Good luck,
Dr. Collins
I can totally relate to your journey, and I appreciate you sharing your experience. I went through a similar situation with nerve pain, and it turned out I had a herniated disc as well. Like you, I tried various approaches, including chiropractic care and supplements, but the relief was limited. It’s interesting how our bodies send signals, and I also reconsidered my diet. I found that introducing certain elements back into my diet, including responsibly sourced meats, made a noticeable difference. Additionally, I’ve been incorporating a bariatric supplement into my routine, which has played a role in supporting my overall well-being. Of course, everyone’s body is unique, but it might be worth exploring for you. Take it slow, listen to your body, and give yourself the time needed for adjustments. Wishing you all the best on this journey, and I hope you find the relief and strength you’re seeking.
Hi there! I was a vegan for 3 years, and at the beginning of those 3 years I fell down the stairs and had a back injury- never recovered. Been in PT ever since. I went then to develop fibromyalgia, assuming it’s from PTSD and other mental health issues (which could be contributing) Despite feeling very energetic within the first year or so with the vegan diet, I noticed my body was not healing or getting better pain wise. I JUST started today with salmon, and I’ll be implementing local beef, hopeful to get rid of or help chronic pain. I understand it’s might not work for everybody so it may not happen, but it’s the one thing I haven’t tried yet. Thanks for this info!
Hi Adriana, thanks for your comments. If you can remember, let me know further down the road whether changing your diet helps or not. Good luck!
It sounds like this may be my issue. Due to Crohn’s disease, I stopped eating red meat about 10 years ago and seldom eat fish or chicken. Ever since, I’ve had chronic back pain, pain in the bottom of my feet and even my hands sometimes. It seems to be like a tendonitis, not in my joints. I will go weeks and even months at a time without being able to even walk. I just started suspecting that it may have something to do with not eating meat. I am so glad I ran across this article!
I know this is years on from your original post but glad I found it. I switched to Vegetarian about a year ago with only the most minimal use of eggs and dairy. Otherwise I ate only whole food vegetables and grains, no fake meats or anything processed because I couldn’t see the point of using processed fake meat if I was trying to give up meat. Definitely no junk food. I took the requisite supplements as though I was eating fully plant based. I had a nutritionist giving guidance so I was sure I was doing everything right.
Like you described, at first everything was great. I had more energy than ever. I didn’t have a lot of inflammation problems but the few I had went away. Digestion was great, etc., etc. Then a month ago I started noticing pain in my hands and elbows. It moved up to my shoulders. Then it appeared in my knees. Mostly ligament pain at first. But that spread into my muscles and one morning I felt almost too weak to stand properly. My wrist joints started clicking and popping and every thing just hurt. Then my whole spine started popping and feeling unstable. Being sufficiently science and medical savvy I attempted to research the problem to see if maybe I was missing something. I know people who have been vegetarian for several decades with 0 problems. Unfortunately the Vegan and plant based movements are in the ascendant right now and they’d have you believe that if you are doing everything exactly right, my symptoms and decline in health is impossible.
So I had to go with my instincts and had some beef broth with lunch. Then a fillet of mackerel for dinner. The way I reacted emotionally to eating that mackerel told the whole story. I was deficient in something. I kept eating plant based for breakfast and lunch after that but started having a few ounces of healthy meats or fish/shellfish with dinner. Within 2 weeks the pain has mostly subsided but the cracking, popping and instability will take more time to heal. I’ve added a bioactive collagen in to help.
I just found your article this morning and while I know everyone is different and reacts to certain foods differently depending on ancestral origin and upbringing, you said something that resonated about protein absorption. I won’t know without testing but it’s probable that my plant protein absorption isn’t on par with others who are successful vegetarians. I’d still like to stay vegetarian as much as possible because I do have some ethical feelings about industry meat, but in my case Flexitarian might be more realistic. Thx for the article.
I’m happy my post helped you. And most of all thank you for sharing. That’s a good story that encompasses good lessons. It sounds like you are on the right path for yourself. Good luck to you.
Dr. Collins
I was on a vegan diet for 7 years (starting at age of 30) and it made me feel more younger, energetic. I rarely fell sick or had any flu like symptoms. However, I experienced a traumatic injury to my back and legs at work from lifting heavy loads, and climbing stairs a lot. I slowly went back on a normal diet to see if it will help. It hasn’t done much. Granted our body heals itself how much ever it can .. “time heals wounds”
it’s not about the diet itself, but lifestyle choices that puts a lot of pressure on the spine. The type of occupation, martial status, parental influence, activities with a lot of sitting, smoking, inflammatory diet, sports, etc. It is common for people over the age of 30 to feel deteriorated to some extent. We start feeling that by 27. Without a traumatic experience that causes mechanical type of back pain, most people are able to live a normal life even with the mildest presence of degenerative disc disease.
Thanks for commenting and sharing your story Manjot. You are correct, diet alone will not dictate if you get back pain or not. And you are correct there are other lifestyle factors that will contribute to developing low back pain. If you go through my website, I have numerous posts on other lifestyle factors other than diet that will contribute to having low back pain.
Dr. Collins