Have you ever felt like your body is sending you a permanent alarm signal? A recurring pain, stiffness upon waking, a fatigue that settles in for no apparent reason…
I’m Prof. Dr. Patrizia D’Alessio, a physician and researcher specialising in inflammation and anti-inflammation, stress and healthy ageing. Years of research have taught me that chronic inflammation is often at the heart of these symptoms.
Inflammation is, at its core, a normal immune response. Faced with an infection or tissue damage, your immune system reacts, then settles down. The problem arises when it no longer settles down. Inflammation can then become silent, without fever or visible redness. Over time it can damage tissues and contribute to pain that lingers.
Millions of people live with chronic inflammatory pain. Medications relieve it, and some treat the disease itself, but daily habits also play a part that is often overlooked.
That’s exactly what this article explores: the natural approaches that can help relieve pain by acting on the inflammatory process, alongside medical care, to restore a genuine quality of life.
Key Takeaways
- Inflammation makes nerves more sensitive.
- Chronic stress can fuel inflammation.
- Mediterranean eating lowers inflammation markers.
- Move daily, at a moderate pace.
- Supplements have modest, uneven effects.
- Swollen joints need a doctor.
What Is Chronic Inflammation and Why Does It Hurt So Much?
Picture a campfire that can no longer be put out. That’s the image often used for what happens in your body when inflammation becomes chronic.
Acute Inflammation vs. Chronic Inflammation: What’s the Difference?
Acute inflammation is a healthy reaction, the good kind of inflammation. Your body triggers an immune response, repairs tissue, then settles down. Fast, effective, reversible.
Chronic inflammation, on the other hand, stays in a permanent state of alert. When it is low-grade, it often causes no fever and no visible swelling: this is known as silent inflammation, smouldering within your tissues and difficult to recognise from the outside. Systemic chronic inflammation is involved in many common diseases, including cardiovascular disease, type 2 diabetes, some cancers, depression and autoimmune diseases.[1] Other conditions, such as rheumatoid arthritis, ankylosing spondylitis or Crohn’s disease, are inflammatory diseases in their own right, with often visible signs, and need specific medical treatment.
When an inflammatory response is triggered, your body releases messenger molecules, such as cytokines and prostaglandins, that make your pain receptors more sensitive. In chronic inflammation, these signals persist, and the nerves can stay sensitised. The pain settles in: diffuse, exhausting, often misunderstood.[2]
What Are the Signs That Your Body Is in a State of Chronic Inflammation?
Your body talks. You have to learn to listen to it. The most common signs are deep fatigue despite adequate sleep, diffuse pain with no mechanical cause found on examination, morning stiffness lasting more than 30 minutes, recurring digestive issues, inflammatory skin conditions such as psoriasis or atopic dermatitis, and frequent infections. None of these signs is specific. A simple blood test, CRP and erythrocyte sedimentation rate (ESR), can provide initial answers, even if they cannot say where the inflammation comes from.
Why Does Inflammation Become Chronic? The Role of Stress and the Microbiome
Have you ever felt like your body simply can’t recover anymore? That fatigue, pain and general unease settle in for the long haul with no obvious reason? This isn’t inevitable. It may be a sign that your body has entered a vicious inflammatory cycle. Understanding why is the first step to getting out of it.
What Role Does Stress Play in Worsening Inflammation?
Stress is one of the fuels of chronic inflammation. In response to stress, your brain triggers the release of cortisol by the adrenal glands. Cortisol is at first an ally: it curbs inflammation. But when stress persists, immune cells become less responsive to cortisol, and inflammation is less well controlled.[4] Stress also makes the gut barrier more permeable, a phenomenon sometimes called leaky gut.[5]
Researchers are studying how far this low-grade inflammation contributes to joint and back pain, fatigue and mood disorders. The links are plausible, but they vary from one person to another and are not all proven. Long-lasting stress is also associated with faster cellular ageing.
How Does the Gut Microbiome Influence Inflammation?
Your body is home to about 38 trillion bacteria, most of them in the colon: your microbiota.[6] It plays a major role in educating and regulating your immune system. When its balance breaks down, a state called dysbiosis, and the gut barrier becomes more permeable, bacterial fragments can cross it and stimulate the release of pro-inflammatory cytokines.
The inner surface of the digestive tract is about 32 square metres, a vast area of exchange between your body and the outside world.[7] Researchers are exploring how a weakened gut barrier may contribute to inflammation in the skin, the joints or the brain. Looking after your gut is one way to act on inflammation, but it is not a cure for inflammatory diseases on its own.
How Can Diet Worsen or Calm Inflammation?
What you put on your plate every day is one of the levers you have over inflammation. It does not replace medical treatment when you need one, but it acts every day, at every meal.
Which Anti-Inflammatory Foods Should You Favor, and Which Should You Avoid?
The foods most associated with lower inflammation are oily fish rich in omega-3, vegetables (including cruciferous vegetables such as broccoli and cabbage), berries rich in polyphenols, extra virgin olive oil, pulses and whole grains. Herbs and spices such as ginger add flavour; ginger inhibits inflammation enzymes in the laboratory. On the other side, limit added sugar, ultra-processed foods, processed meats and alcohol, which are associated with higher inflammation markers.
What Is the Anti-Inflammatory Diet and How Does It Work?
The anti-inflammatory diet isn’t a fad. It’s a way of eating built on decades of research, inspired by the Mediterranean diet and rich in fibre. In a meta-analysis of 17 randomised trials, the Mediterranean diet lowered two inflammation markers, CRP and IL-6, more than control diets.[8] In the European RISTOMED study, which I co-directed, a balanced diet followed for 56 days lowered an inflammation marker in healthy people aged 65 and over.[9]
Which Plants and Natural Supplements Have Anti-Inflammatory Properties?
Scientific research is taking medicinal plants more seriously. But not all of them are equal, and few have strong clinical evidence. Here’s what studies teach us.
Turmeric is the star of natural anti-inflammatories, but its curcumin has a major bioavailability problem: it is poorly absorbed and unstable. A review of the research, at a time when more than 120 clinical trials had been run, found no double-blind, placebo-controlled trial confirming its broad benefits.[10] Combined with piperine from black pepper or in lipid formulations, its absorption improves; in the laboratory, curcumin inhibits NF-κB, a key pathway in inflammatory signalling. Cases of liver injury have been reported with turmeric supplements.[11]
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Saffron (Crocus sativus) has shown anti-inflammatory effects in the laboratory and has been studied above all for mood, with positive small trials, an illustration of the links between inflammation and depression.[12] Ginger inhibits cyclooxygenases in the laboratory, the same enzymes targeted by non-steroidal anti-inflammatory drugs. Devil’s claw (Harpagophytum) is recognised in the EU as a traditional herbal medicine to relieve minor joint pain.[13]
On the supplement side, omega-3 from fish oil slightly reduced pain in rheumatoid arthritis in a meta-analysis of trials.[14] Vitamin D deficiency is common; in the large VITAL trial, vitamin D supplements reduced new cases of autoimmune disease by 22% over about five years.[15] Finally, psychobiotics, probiotics sometimes combined with prebiotics, are studied for their effects on the gut barrier, inflammation and mood; research is still at an early stage.[16] Eating enough fibre remains the simplest way to feed your gut bacteria.
d-Limonene, a molecule from citrus peel that my own work has focused on, has shown anti-inflammatory effects in the laboratory and in animals: it lowered TNF-α in rats with colitis and strengthened a layer of intestinal cells in culture.[17] In healthy older adults, d-limonene combined with a balanced diet was followed by lower inflammation markers in the blood.[9, 17] In rats, it also reduced signs of stress.[18] These results are encouraging, but they do not yet show an effect on pain in humans.
How Do You Adopt an Anti-Inflammatory Lifestyle Day to Day?
The most effective natural approaches aren’t found in a box of capsules. They’re in your daily habits.
Sleep is perhaps the most underrated anti-inflammatory tool. In a meta-analysis of 72 studies, poor sleep quality was associated with higher CRP and IL-6, short sleep with higher CRP, and very long sleep with both.[19] Inflammation and pain can in turn disturb sleep. Go to bed at regular times, limit screens in the evening, and protect your rest as your most precious asset.
Intermittent fasting, such as the 16/8 model, is being studied for its effects on insulin, weight and inflammation. Results in humans are still mixed, and it isn’t suited to everyone. Consult a healthcare professional before trying it, especially if you have a chronic illness.
Finally, very intense or exhausting exercise causes a temporary rise in inflammation. Moderate, regular movement, on the other hand, is one of the best-documented anti-inflammatory strategies.[20] In mice prone to age-related inflammation, researchers at Newcastle University showed that three months of moderate exercise reduced inflammation and cellular senescence in several organs, even when started late.[21] My recommendation: 30 minutes a day of walking, yoga, tai chi or swimming, moving without hurting yourself, and enjoying it.
Natural Solutions vs. Medications: When and for Whom?
Anti-inflammatory medicines do not work equally well for everyone, and their long-term use has risks. Non-steroidal anti-inflammatory drugs can irritate the stomach and affect the kidneys and the heart.[22] Responses to treatment also vary from one person to another, partly because of genetics.
Natural approaches are particularly relevant for low-grade inflammation linked to lifestyle, for mild joint pain, or to reduce the need for painkillers with your doctor’s agreement. They don’t oppose medical treatment; they complement it. This is the integrative approach. In inflammatory diseases such as rheumatoid arthritis, ankylosing spondylitis or Crohn’s disease, early medical treatment protects your joints and organs, and should never be stopped without medical advice.
In terms of timeframes, changes in diet and activity usually take several weeks to show an effect on inflammation markers: in the RISTOMED study, results were measured after 56 days.[9] Effects vary from one person to another, and they last as long as the habits do.
When Should You See a Doctor Urgently?
Natural approaches have their place, but certain signs call for a clinical examination without delay. See a healthcare professional if you notice swelling in one or more joints, especially in the hands or feet;[3] back pain with morning stiffness that eases with movement and wakes you at night, particularly if it began before 40;[23] extreme fatigue with fever and unexplained weight loss; or digestive symptoms such as persistent diarrhoea, abdominal pain or blood in the stools.[24]
Your doctor may order a blood count, CRP and ESR, and other tests depending on your symptoms. The earlier inflammation is addressed, the better the chances of limiting its consequences.
Sources
- Furman D et al. Chronic inflammation in the etiology of disease across the life span. Nature Medicine, 2019;25(12):1822-1832. DOI 10.1038/s41591-019-0675-0. pubmed.ncbi.nlm.nih.gov
- Ji RR, Chamessian A, Zhang YQ. Pain regulation by non-neuronal cells and inflammation. Science, 2016;354(6312):572-577. DOI 10.1126/science.aaf8924. doi.org
- NICE, guideline NG100, “Rheumatoid arthritis in adults: management”, recommendations on referral for suspected persistent synovitis. nice.org.uk
- Cohen S et al. Chronic stress, glucocorticoid receptor resistance, inflammation, and disease risk. PNAS, 2012;109(16):5995-5999. DOI 10.1073/pnas.1118355109. pubmed.ncbi.nlm.nih.gov
- Vanuytsel T et al. Psychological stress and corticotropin-releasing hormone increase intestinal permeability in humans by a mast cell-dependent mechanism. Gut, 2014;63(8):1293-1299. DOI 10.1136/gutjnl-2013-305690. pubmed.ncbi.nlm.nih.gov
- Sender R, Fuchs S, Milo R. Revised estimates for the number of human and bacteria cells in the body. PLoS Biology, 2016;14(8):e1002533. DOI 10.1371/journal.pbio.1002533. ncbi.nlm.nih.gov
- Helander HF, Fändriks L. Surface area of the digestive tract – revisited. Scandinavian Journal of Gastroenterology, 2014;49(6):681-689. DOI 10.3109/00365521.2014.898326. pubmed.ncbi.nlm.nih.gov
- Schwingshackl L, Hoffmann G. Mediterranean dietary pattern, inflammation and endothelial function: a systematic review and meta-analysis of intervention trials. Nutrition, Metabolism & Cardiovascular Diseases, 2014;24(9):929-939. DOI 10.1016/j.numecd.2014.03.003. pubmed.ncbi.nlm.nih.gov
- Ostan R, Béné MC, Spazzafumo L, et al., d’Alessio PA. Impact of diet and nutraceutical supplementation on inflammation in elderly people. Results from the RISTOMED study, an open-label randomized control trial. Clinical Nutrition, 2016;35(4):812-818. DOI 10.1016/j.clnu.2015.06.010. doi.org
- Nelson KM et al. The essential medicinal chemistry of curcumin. Journal of Medicinal Chemistry, 2017;60(5):1620-1637. DOI 10.1021/acs.jmedchem.6b00975. pmc.ncbi.nlm.nih.gov
- Anses, Vigil’Anses no. 17, “Curcuma et effets hépatiques”, June 2022. vigilanses.anses.fr
- Marx W et al. Effect of saffron supplementation on symptoms of depression and anxiety: a systematic review and meta-analysis. Nutrition Reviews, 2019;77(8):557-571. DOI 10.1093/nutrit/nuz023. doi.org
- European Medicines Agency, herbal medicine “Harpagophyti radix” (devil’s claw root). ema.europa.eu
- Senftleber NK et al. Marine oil supplements for arthritis pain: a systematic review and meta-analysis of randomized trials. Nutrients, 2017;9(1):42. DOI 10.3390/nu9010042. pubmed.ncbi.nlm.nih.gov
- Hahn J et al. Vitamin D and marine omega 3 fatty acid supplementation and incident autoimmune disease: VITAL randomized controlled trial. BMJ, 2022;376:e066452. DOI 10.1136/bmj-2021-066452. doi.org
- Dinan TG, Stanton C, Cryan JF. Psychobiotics: a novel class of psychotropic. Biological Psychiatry, 2013;74(10):720-726. DOI 10.1016/j.biopsych.2013.05.001. pubmed.ncbi.nlm.nih.gov
- d’Alessio PA, Ostan R, Bisson JF, Schulzke JD, Ursini MV, Béné MC. Oral administration of d-limonene controls inflammation in rat colitis and displays anti-inflammatory properties as diet supplementation in humans. Life Sciences, 2013;92(24-26):1151-1156. DOI 10.1016/j.lfs.2013.04.013. doi.org
- d’Alessio PA, Bisson JF, Béné MC. Anti-stress effects of d-limonene and its metabolite perillyl alcohol. Rejuvenation Research, 2014;17(2):145-149. DOI 10.1089/rej.2013.1515. doi.org
- Irwin MR, Olmstead R, Carroll JE. Sleep disturbance, sleep duration, and inflammation: a systematic review and meta-analysis of cohort studies and experimental sleep deprivation. Biological Psychiatry, 2016;80(1):40-52. DOI 10.1016/j.biopsych.2015.05.014. pmc.ncbi.nlm.nih.gov
- Gleeson M et al. The anti-inflammatory effects of exercise: mechanisms and implications for the prevention and treatment of disease. Nature Reviews Immunology, 2011;11(9):607-615. DOI 10.1038/nri3041. research.birmingham.ac.uk
- Bianchi A, Marchetti L, Hall Z, et al., Wilson CL. Moderate exercise inhibits age-related inflammation, liver steatosis, senescence, and tumorigenesis. Journal of Immunology, 2021;206(4):904-916. DOI 10.4049/jimmunol.2001022. eprints.ncl.ac.uk
- NHS, “Non-steroidal anti-inflammatory drugs (NSAIDs)”. nhs.uk
- NHS, “Symptoms – Ankylosing spondylitis”. nhs.uk
- NHS, “Symptoms – Crohn’s disease”. nhs.uk
- Dantzer R, O’Connor JC, Freund GG, Johnson RW, Kelley KW. From inflammation to sickness and depression: when the immune system subjugates the brain. Nature Reviews Neuroscience, 2008;9(1):46-56. DOI 10.1038/nrn2297. pubmed.ncbi.nlm.nih.gov
Anti-inflammatory capsules
«Inside-out» dietary supplement supports the integrity of the intestinal barrier and a balanced microbiome, helping to manage stress. 2 to 4 capsules daily on an empty stomach. Content corresponds to a take for 2–3 weeks. European clinical study on 138 healthy patients aged 65–85, for 45 days.
FAQ
Everything you need to know before placing an order: simple and clear.
What Are the Signs of Chronic Inflammation?
Chronic inflammation does not always show obvious signs. The most common are fatigue that does not ease with rest, joint or back pain without a mechanical cause, morning stiffness lasting more than 30 minutes, recurring digestive problems, inflammatory skin conditions such as psoriasis, and frequent infections. None of these signs is specific: a doctor can confirm inflammation with blood tests and look for its cause.[1]
What Are the 3 Types of Fatigue Linked to Inflammation?
Researchers describe several forms. Peripheral fatigue is felt in the muscles: you feel heavy and weak. Central fatigue comes from the brain: when inflammatory signals reach it, they trigger tiredness, poor concentration and low motivation, a response known as sickness behaviour. Finally, inflammation and pain disturb sleep, which adds its own fatigue. The three often add up.[19, 25]
Why Am I Tired All the Time Despite Resting?
Fatigue that resists rest has many possible causes: poor-quality sleep, stress, depression, anaemia, thyroid problems, sleep apnoea, or an inflammatory disease. Inflammatory molecules such as IL-6 and TNF-α can cause fatigue by acting on the brain. Rather than assuming the cause, see your doctor: a few blood tests can guide the diagnosis.[25]
Can Chronic Inflammation Be Treated Naturally?
Low-grade inflammation linked to lifestyle often decreases with a Mediterranean-style diet, regular moderate exercise, good sleep and stress management. In the European RISTOMED study, a balanced diet lowered an inflammation marker in healthy older adults, and the group that also took d-limonene saw further improvements in other markers. Inflammatory diseases such as rheumatoid arthritis or Crohn’s disease need medical treatment; natural approaches complement it.[8, 9]
When Do Fatigue and Pain Become Truly Concerning?
When fatigue lasts more than a few weeks despite rest, when pain wakes you up at night, when a joint is swollen, warm and stiff for more than an hour in the morning, or when fatigue comes with fever and unexplained weight loss. These signs need a medical assessment, urgently if they come together.[23]
When Should You Absolutely See a Doctor for Persistent Inflammatory Pain?
See a doctor without delay for swelling in one or more joints, especially in the hands or feet; for back or buttock pain with long morning stiffness that improves with movement, particularly before 40; for chronic diarrhoea, abdominal pain or blood in the stools; or for widespread pain lasting more than 3 months without explanation. Early diagnosis protects your joints and your health.[3, 23, 24]
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