The Gut-Spine Axis: How Gut Health, Inflammation & the Microbiome May Influence Pain
The Gut–Spine Axis: How Gut Health, Inflammation & the Microbiome May Influence Pain
Back pain, joint discomfort and chronic pain conditions are often viewed as problems affecting muscles, joints, discs or nerves.
However, researchers are increasingly exploring whether the digestive system may also play a role.
Emerging evidence suggests the gut microbiome, immune system, nervous system and musculoskeletal system are more connected than previously understood. This growing field of research is sometimes referred to as the gut-spine axis or gut-pain connection.
While scientists are still working to understand these relationships, studies suggest that gut health, inflammation, immune signalling and pain perception may all interact in complex ways.
This article explores:
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What the gut microbiome is
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The emerging science behind the gut-spine axis
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Gut health and chronic pain
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Fibromyalgia and the microbiome
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Nutrition strategies that support overall wellbeing
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Where bone broth fits into a food-first approach
What Is the Gut Microbiome?
The gut microbiome is the collection of trillions of microorganisms that live throughout the digestive tract.
These microorganisms play important roles in:
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Digestion
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Immune function
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Nutrient metabolism
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Production of certain vitamins
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Communication with the nervous system
Researchers now recognise the microbiome as an important contributor to overall health.
The gut microbiome is constantly influenced by:
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Diet
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Stress
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Sleep
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Physical activity
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Medications
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Ageing
The Gut–Brain Axis: A Well-Established Connection
Many people are familiar with the gut-brain axis, which describes the ongoing communication between the digestive system and the brain.
This communication occurs through:
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The vagus nerve
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Hormones
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Immune signalling
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Microbial metabolites
Researchers continue to investigate how gut health may influence mood, cognition, stress responses and overall wellbeing.
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The Emerging Gut–Spine Axis
Scientists are now exploring whether a similar relationship may exist between the gut microbiome and the spine.
Several recent reviews have examined how changes in gut microbial diversity may influence:
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Inflammation
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Immune regulation
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Pain signalling
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Musculoskeletal health
A review published in Frontiers in Microbiology suggested that interactions between the microbiome and immune system may influence spinal health, while researchers called for further studies to better understand these relationships.
More recently, a review in Frontiers in Immunology reported that people living with chronic pain often demonstrate differences in gut microbial diversity compared with healthy controls.
Importantly, these studies identify associations rather than proving direct cause and effect.
Nevertheless, they highlight an exciting area of ongoing research.
Inflammation: The Missing Link
One of the strongest theories connecting gut health and pain involves inflammation.
Inflammation is a normal and essential part of the body's defence system.
However, when inflammatory processes become prolonged, they may contribute to:
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Pain sensitivity
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Fatigue
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Reduced recovery
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Musculoskeletal discomfort
Researchers are investigating how dietary patterns, microbiome diversity and immune function may influence these inflammatory pathways.
Learn more:
Reduce Chronic Inflammation naturally
Can Digestive Issues Influence Back Pain?
Many people notice digestive symptoms and back discomfort occurring at the same time.
Researchers are investigating several possible explanations.
Shared Nerve Pathways
The digestive system and spinal structures share complex nerve networks.
This means discomfort originating in the digestive tract may sometimes be perceived in nearby areas such as the lower back.
Constipation and Mechanical Pressure
Constipation may increase abdominal pressure and contribute to feelings of lower back discomfort.
Inflammation and Pain Sensitivity
Researchers are exploring whether ongoing immune activation and inflammatory signalling may influence how pain is perceived throughout the body.
While these theories are promising, further research is needed before firm conclusions can be made.
Fibromyalgia and the Gut Microbiome
Fibromyalgia is a chronic condition characterised by:
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Widespread pain
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Fatigue
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Sleep disturbances
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Cognitive difficulties
Researchers at McGill University in Canada investigated whether people living with fibromyalgia had different gut microbial patterns compared with healthy individuals.
The study identified differences in the abundance of several bacterial species and found that certain microbial patterns appeared to correlate with symptom severity.
Using machine-learning analysis, researchers were able to identify participants with fibromyalgia with a high degree of accuracy based on microbiome data alone.
Importantly, the findings do not prove that gut bacteria cause fibromyalgia.
Instead, they suggest that the microbiome may represent an important area for future investigation in chronic pain research.
Further studies are needed to determine whether microbiome changes are a consequence of the condition, a contributing factor, or both.
The Gut, Energy and Recovery Connection
The digestive system influences far more than digestion alone.
Researchers continue to investigate relationships between:
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Digestive wellbeing
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Nutrient absorption
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Metabolism
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Recovery
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Energy production
A healthy digestive system supports the body's ability to utilise nutrients effectively.
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Foods That Support Gut Health and Overall Wellbeing
Rather than focusing on individual "superfoods," most experts recommend dietary patterns built around whole foods and dietary variety.
Mediterranean-Style Eating
The Mediterranean diet emphasises:
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Vegetables
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Fruit
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Legumes
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Whole grains
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Fish
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Olive oil
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Nuts and seeds
This eating pattern is widely associated with healthy ageing, cardiovascular health and overall dietary quality.
Read more:
Mediterranean, Paleo & Keto Diet
Omega-3 Rich Foods
Foods rich in omega-3 fatty acids include:
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Salmon
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Sardines
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Mackerel
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Walnuts
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Chia seeds
These foods contribute valuable nutrients and support overall dietary quality.
Fibre-Rich Foods
Dietary fibre helps support digestive wellbeing and contributes to a diverse diet.
Good sources include:
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Vegetables
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Fruit
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Legumes
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Whole grains
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Nuts and seeds
Resistant Starch
Resistant starch is a type of carbohydrate that reaches the large intestine where it can be utilised by beneficial gut bacteria.
Sources include:
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Cooked and cooled potatoes
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Cooked and cooled rice
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Cooked and cooled pasta
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Beans
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Lentils
Protein-Rich Foods
Protein contributes to muscle maintenance and repair.
Examples include:
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Fish
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Eggs
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Poultry
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Lean meats
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Dairy foods
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Legumes
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Bone broth
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Where Bone Broth Fits
Bone broth has been consumed traditionally in cultures around the world for centuries.
It provides:
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Naturally occurring protein
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Collagen-derived amino acids
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Minerals
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Rich flavour
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A versatile cooking base
Broth & Co Bone Broth provides approximately 5g of naturally occurring protein per serve together with collagen-derived amino acids including glycine, glutamine and proline.
Many people include bone broth as part of broader nutrition routines focused on:
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Digestive wellbeing
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Recovery
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Protein intake
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Healthy ageing
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and
The Broth & Co Clinical Study
Broth & Co Bone Broth Powder was evaluated in a clinical study conducted through the National Institute of Integrative Medicine (NIIM).
The study investigated daily bone broth consumption in Australian adults experiencing lower gastrointestinal disturbances.
Researchers observed improvements in:
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Digestive wellbeing outcomes
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Gastrointestinal symptom measures
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Quality of life measures
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Markers associated with intestinal permeability
following daily bone broth consumption.
Lifestyle Habits That Support Recovery
Nutrition is only one part of the picture.
Regular Movement
Movement supports:
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Joint mobility
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Muscle strength
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Physical function
Walking, resistance training and mobility exercises can all be valuable.
Sleep
Sleep is essential for:
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Recovery
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Tissue repair
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Immune function
Stress Management
Chronic stress can influence:
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Digestive function
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Sleep quality
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Pain perception
Strategies may include:
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Breathing exercises
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Meditation
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Walking
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Yoga
Hydration
Adequate hydration supports:
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Digestion
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Physical performance
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Overall wellbeing
What Researchers Still Don't Know
Research into the gut-spine axis remains in its early stages.
While associations have been identified between:
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Gut microbiome diversity
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Inflammation
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Chronic pain
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Fibromyalgia
scientists are still working to understand exactly how these relationships function.
Current evidence does not prove that poor gut health directly causes chronic pain conditions.
Instead, it suggests that the gut microbiome may represent one piece of a much larger health picture involving:
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Diet
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Sleep
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Physical activity
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Stress
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Recovery
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Genetics
Future studies will help clarify these relationships.
Frequently Asked Questions
Can poor gut health cause back pain?
Research suggests there may be links between gut health, inflammation and pain perception, but further research is needed to determine cause and effect.
Does fibromyalgia affect the gut microbiome?
Studies have identified differences in gut microbial patterns in people with fibromyalgia, although researchers are still investigating the significance of these findings.
What foods support gut health?
A varied dietary pattern that includes vegetables, fruit, legumes, whole grains, healthy fats and adequate protein supports overall digestive wellbeing and dietary quality.
Is bone broth good for gut health?
Bone broth provides protein and collagen-derived amino acids and can be included as part of a balanced dietary pattern focused on digestive wellbeing.
What is the gut-spine axis?
The gut-spine axis is a developing area of research investigating possible connections between the gut microbiome, inflammation, immune function and musculoskeletal health.
Final Thoughts
Researchers continue to uncover fascinating connections between the digestive system, immune system, nervous system and musculoskeletal health.
While much remains to be learned, emerging evidence suggests that supporting overall health through nutritious food, movement, sleep, stress management and recovery may benefit multiple systems throughout the body.
The goal is not to focus on a single food or supplement, but to build a sustainable foundation that supports long-term wellbeing.
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