Musculoskeletal symptoms and orthopaedic conditions are a common cause of concern for many patients. Concentrated fish oil, providing the omega-3s EPA and DHA, is emerging as a cost effective tool with a favourable safety profile for optimising outcome from traditional treatment strategies. Scientific and clinical evidence shows that EPA and DHA may address all three of the major components of pain and injury: inflammatory response, cellular/tissue structural integrity, and nervous system signalling.
EPA and DHA may significantly modify the class of prostaglandins and leukotrienes produced via COX- and LOX-mediated pathways to encourage a flux away from the 2- and 4- series and towards the 3- and 5- series. In addition, specialised downstream lipid mediators—end products of metabolism from EPA and DHA known as resolvins, protectins, and maresins—are now touted as critical to signalling the termination of acute inflammation toward homeostasis and away from a chronic inflammatory state. Hence, suboptimal EPA and DHA leads to poor tissue repair as a result of insufficient signalling of granulocytes, multi-potent stem cells, macrophages, and fibroblasts.
Cellular / Tissue Structural Integrity
EPA and DHA provide plasma membrane structural support for repairing injured tissue, and provide necessary chemical building blocks for restoring normal function to cell membranes across all tissue types and organ systems. Additionally, by enhancing the novel fibroblast collagen formation, musculoskeletal tissue may undergo structural repair to address a persistent pain generator.
Peripheral and Central Nervous System Signalling
Finally, fish oil may stabilise nerve thresholds and neuroendocrine axes for managing central and peripheral neural pain signalling processes. There is preliminary evidence and rationale for neural pain fiber membrane stabilisation as a result of sufficient EPA and DHA.
Thus, there is powerful construct validity for administering concentrated fish oil to address the biochemical and metabolic processes of musculoskeletal pain and injury.