Chronic Pain: Is Exercise A Friend Or Foe?

Chronic Pain: Is Exercise A Friend Or Foe?

One in ten people in Hong Kong are living with chronic pain, according to research. According to the World Health Organisation, chronic pain is one of the most underestimated healthcare problems in the world, causing major consequences for the quality of life of the sufferer. Living with and experiencing chronic pain can affect a person’s ability to work, do the activities they love, and even enjoy their time with family and friends. Living with constant pain can also negatively affect mental health, contributing to isolation, low mood and anxiety, as well as sleep difficulties and poor overall health.

With this said it’s not surprising that exercise may be the last thing on the to-do list of someone with chronic pain. What is less well known, however, is that regular exercise can actually help relieve pain and improve function, making it an important part of a person’s chronic pain management.

Here’s a look into how exercise is helping chronic pain sufferers improve their mobility and their quality of life.

Understanding Chronic Pain

Chronic pain is defined as pain that has lasted longer than three months - well beyond the body’s usual healing time. Unlike acute pain that occurs immediately in response to damage or injury, chronic pain persists even when there’s no longer tissue damage in the painful area, due to the complex process of how pain is created in the body’s nervous system.

Exercising With Chronic Pain

Historically, those living with chronic pain were advised to rest and avoid activity, for the fear of worsening the pain. Recent evidence, however, now clearly shows that being inactive will often strengthen pain-sensitive pathways which can actually worsen the pain you feel - while exercising reduces the extent to which we feel the pain, even after only one session.

Engaging in regular exercise can also raise people’s pain thresholds and pain tolerance, and reduce the number of regular pain flare-ups that those with persistent pain experience. Research has also found that in some cases, exercise has been just as effective as interventions like massage in helping reduce pain, with the bonus of being able to be performed at any time that works for you.

Why Is Exercise Good For Chronic Pain?

As the way our bodies perceive pain is complex, different exercises can reduce persistent pain by tackling it from a range of angles - one of the areas where your physiotherapist can help by selecting the right exercises for your unique circumstances.

Exercise is believed to alleviate pain partly by releasing endorphins, which are natural chemicals in our bodies that make us feel good and relieve pain. It can help to improve our joint health, flexibility, and increase our muscle strength, all of which can reduce pain. Exercise also has a significant effect on our central nervous system (our brain and nerve pathways responsible for pain), and can help rewire the way that our brain processes pain signals.

How To Exercise With Chronic Pain

To help you get the most out of exercising with chronic pain:
  • Get clearance from your physiotherapist: If you’re living with persistent pain, we recommend making an appointment with a trusted physiotherapist who can assess your body and support any underlying injuries before you get started.
  • Prioritise your preferences: Everyone has different preferences, physical abilities and schedules, so there’s no one-size-fits-all approach that is guaranteed to work for everyone. It is much easier to participate in and sustain activities that you enjoy and that feels good to you, and for many people, this may be found outside of the gym. We see many patients who incorporate yoga, Tai Chi, swimming, a short walk in a scenic park, or strength training to help them manage their pain and optimise their lifestyle. Non-weight-bearing activities, like water-based or pool activities or cycling, may be more beneficial for some people with joint pain, and even gardening or walking the dog can help. The goal is to increase the amount of time spent moving versus sitting.
  • Choose variety: Within your preferences, try to find some variety, including strengthening exercises to help build strong muscles, and cardiovascular exercises to help improve your overall health and physical well-being, while helping you best manage your pain.
  • Stretch regularly: Stretching at least once a day can help increase flexibility, loosen tight or stiff muscles, and improve your range of motion, to make everyday movements easier.
  • Slow and steady wins the race: Remember that your goal when exercising with chronic pain is to do so regularly and gently. So take it slow, keep your exercise manageable, and avoid prolonged periods of inactivity. If your exercise routine no longer excites you, try something different, or talk to your physiotherapist about what could help.
  • Listen to your body: Cease any activity that increases your pain more than two points from baseline, on a pain scale from 0-10. Work with your physiotherapist to modify this exercise to avoid a pain flare-up in the future.

Working With Our Team At PhysioCentral

The final step of our exercise recommendations is to work together with a knowledgeable and trusted physiotherapist to help you get the most out of using exercise to improve persistent pain. Your physio will pick up on things you may not be aware of, such as you unconsciously over-bracing or performing ‘protective’ movements which may actually be unhelpful or contribute to ongoing pain and fear of movement. Having a physio on your team means that they can support you with individualised, targeted interventions i.e., interventions that are specific to you, your story and your goals and answer any questions about your pain or exercise program to ensure you are fully supported and receiving the best care.

Book an appointment with one of our physiotherapists online here