Don’t Let Chronic Pain Keep You from Exercising

An astonishing one in five people in the United States live with chronic pain, according to the U.S. Centers for Disease Control and Prevention¹. That's more than heart disease, cancer and diabetes combined. But chronic pain doesn't have to stop you from being physically active. In fact, movement can help relieve pain while boosting your mood and enhancing your overall well-being. Here’s how to get started.

What Is Chronic Pain?

Chronic pain is any pain that lasts for 3 to 6 months or more. Many people living with chronic pain have discomfort related to musculoskeletal conditions such as arthritis, degenerative disc disease and other issues impacting the joints and muscles of the body.

Living with perpetual discomfort can take its toll. It can also affect you in other ways as well, such as by:

• increasing symptoms of anxiety and depression
• disrupting sleep
• affecting your engagement in personal relationships
• impairing your quality of life

Why You Hurt

Pain is a feeling stimulated by a complex interaction of signals in the nervous system. When you touch a hot surface, for example, receptors in your skin called nociceptors detect the heat and send signals via sensory nerves to your spinal cord. Those signals pass to a motor nerve controlling the muscles in your arm, which almost instantaneously causes the muscles to contract so you pull your hand away from the hot surface. In the case of an injury, nerve signals along the pathways connected to the area where the injury occurred travel to the spinal cord and brain, where pain is perceived, and you feel the pain.

But that's only part of the equation. While your nervous system plays a key role in the conduction of signals triggered by a pain-inducing event, much of the way you perceive pain has to do with the nature of the pain — sharp or dull, throbbing or constant, localized or widespread — and its cause. Is the pain caused by an injury to or compression of nerve tissue, such as a bulging herniated disc pressing on a nearby nerve? Or is it caused by inflammation or muscle spasms?

The perception of pain varies dramatically from one person to the next and is not necessarily linked to the severity of an injury. Some people are genetically predisposed to have lower or higher thresholds for feeling pain than other people. In addition, psychological factors play a critical role, with stress, anxiety and depression often amplifying the way you perceive your pain. That's where movement can help.

Avoid the Kinesiophobia Cycle

Many people believe that moving will make their chronic pain worse, but that's not always the case. The fear of causing pain or injury by moving actually has a name: kinesiophobia. People with kinesiophobia may also believe that not moving will reduce their pain, leading to a dangerous cycle that promotes further pain and deconditioning.

How Movement Can Relieve Your Pain

Evidence shows that carefully guided activities and movements can actually reduce pain by:

• improving circulation and boosting mood
• lubricating your joints
• reducing swelling and inflammation
• blocking pain receptors
• reducing blood pressure and blood sugar levels, which benefits your overall health

It may be hard to get started, but by choosing the most appropriate activities for you, you can create a new positive cycle.

Which Activity Is Best for You?

If you haven't been active in a while or never followed an exercise program, it's a good idea to see your primary care physician for a check-up and ask for guidance about the best activities for you. If you're already under the care of a doctor for your chronic pain, ask him or her for recommendations.

It can also be helpful to schedule an appointment with a physical therapist or a physiatrist (a physician who specializes in physical medicine and rehabilitation) to assess your body mechanics, range of motion and other factors that can help identify which exercises are most beneficial for you — and which ones you should avoid. For example, some people with joint conditions may be advised to avoid high-impact exercise such as running but are encouraged to choose lower-impact activities such as swimming.

If you have problems with your knees, you may benefit from working out using an upper body ergometer (which is like a bicycle for your arms and shoulders). Conversely, those with shoulder pain may prefer walking or light hiking. Other movements that are gentle on the body include:

• yoga, if practiced with modifications that address your range of motion and comfort
• t'ai chi, which includes slow gentle movements that also promote balance and relaxation
• stationary cycling
• elliptical training, which is like running without the impact and can also incorporate arm movement
• stair climbers

Steps to Success

Knowing how much and how often to work out is just as important as the type of activities you choose. Here are some tips:

• Aim for 20 minutes of exercise each day. You don't have to do 20 consecutive minutes of activity; break it up into smaller chunks if that is easier, such as 10 minutes of walking in the morning and 10 more in the evening.
• Find joy in movement. Choosing activities that you enjoy will make it easier to stick with them.
• Make it social. Exercise with friends and family members.
• Follow a leader. Consider in-person or virtual exercise classes, individually or with a group.
• Listen to your body. Your goal is to engage in activities that alleviate pain, rather than provoke it. Consider activities such as chair yoga or t’ai chi if those are safest and most comfortable for you.
• Take it easy. Your activity level doesn't need to be vigorous to be effective.
• Something is better than nothing. Don't get down on yourself if you miss a day or can't achieve a full 20 minutes. Fit in whatever movement you can.

Our lifestyle today can work against us, with many of us hunched over computers and not moving enough. Recognizing that you have control over how you move and learning how to integrate healthy activities into each day can help you live a more comfortable life despite chronic pain. Replace the thought "If I move, I hurt" with the more positive approach, "When I do this activity, I feel better." Movement is medicine that will always be with you.

This article is from the Health Connection: Movement is Medicine issue and brought to you by Community Education & Outreach.

Footnote: Products - Data Briefs - Number 390 - November 2020 (cdc.gov)