Managing chronic pain with exercise

March 21, 2016 Gordon A. Irving, MD

I can’t exercise because I hurt too much.

Is this something you have said or heard from someone who suffers from chronic pain?

Fact: If you do not exercise, you will hurt more. Muscles, joints and ligaments need to have blood flowing through them, and movement encourages the uptake and excretion of toxins. Stop moving and arthritis and muscle pain will worsen.

Exercise also releases substances such as brain-derived neurotrophic factor, or BDNF. This substance enables neuroplastic changes that help the brain adapt and thus ease pain.

Need more reasons to exercise?

It’s worth noting that exercise does a lot more than just ease pain. Here’s how it helps the entire body:

  • Nervous system: Improves mental function, decreases depression and anxiety, helps with organization, planning and attention, and lowers the risk of Alzheimer’s
  • Immune system: Protects the body from inflammation; however, too much exercise may weaken the immune system temporarily, so pacing is important
  • Musculoskeletal system: Helps prevent fractures and falls, and decreases fatigue
  • Endocrine system: Improves response to insulin and decreases the risk of diabetes
  • Cancer: Lowers the risk of breast, colorectal and other cancers
  • Cardiovascular system: Lowers the risk of heart attack and stroke

For more on the benefits of exercise, watch this video, titled “23½ Hours.”

How do I exercise with my pain?

When it comes to pain, think of exercise as your prescription medicine and take it every day. It's a good idea to include some type of “moderate” intensity exercise in your morning routine. This may mean walking a little more briskly from the kitchen to the bathroom. Whatever exercise you choose, don’t work so hard that you become out of breath. You should be able to carry on a conversation, if necessary, but not sing continuously.

Plan specific activities each day. For example, if you are going to garden, have a job in mind, such as planting flowers. Then break the activity into smaller tasks and rest intermittently so you are not fatigued when you are done. As you pause, assess your energy and fatigue so you become aware of how to pace yourself.

What exercise is best for me?

Many exercises have been shown to help with chronic pain, so choose something that you enjoy. Exercising with a companion – a friend or a dog -- can make it far easier and enjoyable.

Here are some suggestions to get started.

Walking: This is the simplest and cheapest way to exercise. Your goal is to feel a little bit energized or at least not further fatigued following a walk. Consider using Alpine walking poles. They are similar to ski poles but with rubber tips to prevent slipping on sidewalks.

Walking poles decrease stress on the knees, hips and back. They also improve posture and increase calories burned by using muscle groups other than the legs. Many drugstore chains and recreational equipment stores sell walking poles. You also can use old ski poles. Fit them with rubber tips, which you can buy from a medical appliance store.

Water exercises: Water walking, water aerobics and lap swimming all build your core without placing undue stress on your joints. The breaststroke and backstroke are best for back pain because they cause the least rotation of your spine. The Y offers many water classes, including arthritis programs, shallow- and deep-water fitness, water Pilates and water Zumba. Financial assistance may be available.

Tai chi: Practicing tai chi once or more a week, even when seated, has been shown to have significant benefits to health and well-being. Low-cost classes are available in many areas. There also are free lessons on YouTube.

Yoga: There are many types of yoga to choose from. This series is yoga for people in pain and includes question-and-answer periods.

Do you need to exercise every day?

Chronic pain sufferers need some type of exercise, even from a chair, several times a day. Prolonged sitting after exercising, even in those without pain, cancels some of the health benefits gained from the exercise. The trick is to do small amounts of exercise throughout the day.

If you need some inspiration to get started, watch this TED Talk and visit our website to learn more ways to care for your body to reduce pain.

If you are having trouble managing pain, visit Swedish Pain Services to learn how to schedule a consultation at one of our convenient locations.

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