Are Imbalances in Your Gut Flora Contributing to Your Musculoskeletal Pain?

By: Dale J. Buchberger, PT, DC, CSCS, DACBSP

Most of us don’t associate our gut (intestinal) health to other systems of the body. We often think that when our stomach is “off”, we are just having “digestive issues”, but more research is pointing imbalances in the gut to other systems. Studies are showing a difference in people that are healthy with a healthy gut and people that have chronic inflammatory conditions have an unhealthy gut. A normal, healthy gut consists of 100 trillion cells, including a variety of bacteria, viruses, and other microorganisms, as well as a wide array of fungi. If all is going well, these organisms live in perfect harmony with you. When your gut bacteria are out of balance, it makes you weak, tired, and inflamed. An unhealthy gut microbiome (environment) can lead to leaky gut.


Leaky gut is one proposed condition that is presumed to cause many health problems. It is not often discussed in the mainstream media or in most doctors’ offices. Assuming leaky gut syndrome exists, it is thought that it goes largely undiagnosed. One reason is that main stream medicine is reluctant to include leaky gut syndrome in the differential diagnosis to begin with.


The leaky gut source is located in the small intestine. The small intestine is important because the majority of the vitamins, minerals and nutrients from the foods you eat are absorbed there. In order for the vitamins and minerals to be absorbed, the small intestine contains microscopic pores so the nutrients can be transferred into the bloodstream. Once transferred, the nutrients are then shuttled and deposited all around the body through the bloodstream.


The wall of the intestine is considered semipermeable. This means the pores only allow particular molecules to enter the bloodstream and block other molecules from entering the bloodstream. For instance, specific molecules and nutrients are allowed to pass through, but toxins and large undigested food particles are blocked.


The problem with leaky gut is it causes the pores in your intestine to widen. When this happens, the undigested food particles and toxins that are supposed to be blocked are allowed to make their way into the bloodstream. Because these items are not supposed to be in the blood, they cause the immune system to go into attack mode, which can lead to allergies and other autoimmune disorders.


What causes the process of leaky gut syndrome to start? Usually several things have occurred together and repeatedly over the course of time, including excessive NSAID use; alcohol consumption; calcium, vitamin A, zinc, magnesium, and vitamin D deficiencies; processed food and high fructose diets; psychological and physical stress; frequent antibiotic use; and small intestine bacterial overgrowth (SIBO).


There are nine basic signs and symptoms that what you are experiencing could be linked to leaky gut syndrome: digestive issues (bloating, gas, irritable bowel syndrome, or diarrhea); seasonal allergies or asthma; hormonal imbalances, such as PMS; autoimmune diseases, such as celiac disease, psoriasis, or lupus; chronic fatigue or fibromyalgia; mood issues, including depression, anxiety, ADD, or ADHD; acne, rosacea, or eczema; candida (yeast) overgrowth; and food allergies and intolerances.

The leakage of toxins is associated with a number of chronic inflammatory, autoimmune, and functional disorders. Conditions caused by or seen in connection with intestinal permeability defects include joint disorders that we as physical therapists see, such as inflammatory joint disorders, rheumatoid arthritis, ankylosing spondylitis, or psoriatic arthritis.


Amy Myers, MD, recommends the following process in order to heal leaky gut syndrome: Remove the bad. The goal is to get rid of things that negatively affect the environment of the GI tract, such as inflammatory and toxic foods and intestinal infections. Replace the good. Add back the essential ingredients for proper digestion and absorption, such as digestive enzymes, hydrochloric acid, and bile acids. Re-inoculate the gastrointestinal bacteria. It’s critical to restore beneficial bacteria to reestablish a healthy balance of good bacteria. Repair the lining of the gut. It’s essential to provide the nutrients necessary to help the gut repair itself. One of her favorite supplements is L-glutamine, an amino acid that helps to rejuvenate the lining of the gut wall. If you still have symptoms after following the above recommendations, I would recommend finding a functional medicine physician in your area to work with you and to order a comprehensive stool test, which offers a look at the overall health of the gastrointestinal tract.


Keep in mind that leaky gut syndrome happens over time and it can take a significant amount of time to repair. You need to be dedicated to making a dietary lifestyle change. Unfortunately there is no pill from the pharmaceutical industry that will fix leaky gut. For information regarding the functional medicine approach you can go to: Thank you to Tom Zirilli, PT and Carolyn Collier, PTA for their contribution to this article.