How to exercise with chronic pain

How to exercise with chronic pain teaser
Do you suffer from chronic pain? Is it restricting you from being able to complete exercise or everyday activities? Check out these tips for exercising with chronic pain.



 
First of all, what is chronic pain? Chronic pain is classified as a pain that has been present for 3 or more months and it doesn’t necessarily relate to the amount of tissue damaged, but to the changes within our body.
In Australia approximately 1 in 5 individuals are affected by chronic pain which impacts their day to day living.

At the point of acute pain (injury) our body experiences a stress response which means your sympathetic nervous system (increased heart rate, sweat), motor system (muscles activated), endocrine system, pain production system, immune system and parasympethic system are all activated as your body thinks you are in ‘danger’. Generally these systems switch themselves off when they are no longer needed, however for poorly understood reasons sometimes this doesn’t happen. This then leads to a ‘persistent stress response’.

Persistent stress response results in:
  • Fatigue
  • Less movement
  • Mood changes
  • Widespread pain and tenderness
  • Appetite disturbed
  • New pain sites
  • Mental stress

As a result, your pain becomes chronic as these do not switch off due to central sensitisation which means the central nervous system is heightened (imagine turning up a car radio with the beat and sound on maximum to your pain). The main cause of this is the typical busy human in everyday life. We tend to accommodate to the ‘no pain no gain’ idea and push through our pain during exercise and everyday activities which results in a flare up. This means you are back to square 1 and your central nervous system still remains heightened.

To be able to increase your exercise tolerance for weight loss and/or health benefits and to manage your pain levels you need to follow the below steps for pain management:

Step 1.
  • Identify what is important to you (for example: to be able to complete housework, to be able to play with the grandchildren, weight loss etc)
  • Identify what is triggering flare ups (for example: If you walk for 20 minutes/ vacuum for 10 minutes etc and you are out of action the next day). Make sure you are familiar with all of them
  • Identify what you would classify as ‘me time’ that will reduce stress levels
  • Identify exercise that you will enjoy doing
Step 2.
Make realistic goals. Start off with a short term goal and once you have reached that, make another short term goal. Do not make a long term goal and focus on that, focus on your short term achievements and celebrate when you meet them 

Step 3.
Commence your plan of action. Do not increase your exercise on a good day and try not to decrease your exercise on a bad day.

Decrease the amount you spend on activity that is triggering your flare ups (If you went for a 20 minute walk and were out of action the next day, drop it back to 10-15 minutes / vacuum for 5 minutes instead of 10 minutes etc)
Take regular breaks during activity to avoid flare ups (sit down on a park bench/ rest in between house work etc when you know your pain is slowly increasing to your maximum level)

Step 4.
Increase your activity gradually week by week. Listen to your body and never push through pain. Eventually your pain and exercise tolerance will improve and you will be able to do more activity to achieve your goals.

Key points
  • Never push through pain
  • Identify what is important to you
  • Do more of what makes you happy
  • Slowly increase your exercise week by week
  • Listen to your body!

Sometimes other factors contribute to chronic pain such as abnormal posture, abnormal gait, musculoskeletal deconditioning and lack of fitness. You should consult an Accredited Exercise Physiologist for a tailored exercise plan to help you achieve your goals.   
 
360 Health + Community have Accredited Exercise Physiologists all over the Perth metro area who can help you reach your exercise goals and work through your chronic pain. Call us on 1300 706 922 to get started.

Travis King
Accredited Exercise Physiologist
360 Health + Community

References
Chronic Pain and Exercise (2014). Exercise is Medicine Australia. www.exerciseismedicine.org.au.

F, Blyth., L, March., J, Alan., L, Jorm., M, Williamson., & M, Cousins. (2001). Chronic Pain in Australia: A Prevalence Study. International Association for the Study of Pain. 127 – 134.

R, McCaffrey., T, Frock., H, Garguilo. (2003). Understanding Chronic Pain and the Mind-Body Connection. Holistic Nursing Practice. 281-287. 

K, Beissner., C, Henderson., M, Papaleontiou., Y, Olkhovskaya., J, Wigglesworth., & M, Reid. (2009) Physical Therapists’ Use of Cognitive-Behavioural Therapy for Older Adults With Chronic Pain: A Nationwide Survey. Department of Physical Therapy. 456-469. 
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