Exercise

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The Neuroscience of Pain
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Pain Rehab
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Family & Parenting

Why Should I Exercise if I am in Pain?

            If someone asks you to work out regularly while in pain, it seems like they are asking you to climb Mount Everest. Just moving from the bed to the couch can seem like a marathon on its own, rather than a five-foot walk. Historically, doctors recommend plenty of bed rest for pain conditions- which in of itself is fine to help the body recover before movement. However, being confined to your bed all day can lead to health detriments, such as muscle atrophy, which makes it harder to build momentum towards recovery. Additionally, inactivity allows cortisol (a stress hormone) to build up in the body, increasing the pain experienced which may make you feel more scared to move (a vicious cycle!).

Physical activity helps strengthen the body. Although regularly scheduled exercise will not cure chronic pain, it can help relieve muscle tension, increase blood flow, strengthen the heart and body, decrease cortisol levels, and increase nociception, meaning less pain over time1.

Kinesiophobia is the fear of moving, which can be developed as a result of maladaptive coping strategies in earlier stages of chronic pain development2. The only real “cure” for this fear is to just move3. As daunting as it can seem, once the body is in motion it is easier for it to keep moving as it adjusts to moving again (think of Newton’s Law).

How do I Exercise if I am in Pain?

Experts recommend low impact aerobics for people with chronic pain. This includes yoga, tai chi, and water aerobics for those taking their first steps. Power walking, stationary bicycling, swimming, and elliptical trainers offer more physical activity while maintaining a relatively low strain on the body. Remember to stretch before and after working out and to stay hydrated.

Yoga, in particular, is a great way to exercise in chronic pain because it combines low impact aerobics with mindfulness practices4. Special control of both the mind and the body are used to stay active while causing less physical stress than, say, running. With this, both parts of the mind-body connection get exercised, decreasing somatic pains while relaxing the mind through mental concentration5.

How do I Maintain Activity if I am in Pain?

You do not have to run a marathon every day. Just living with chronic pain can seem like its own marathon. It is ok if there are days when just getting out of bed feels like moving a mountain. Instead of beating yourself up, focus on at least moving a few times each day.

Every step you take is another block added to the foundation of your health. Just because you only added one block, does mean the others will vanish. Make a goal for your physical activity, even if it is simply moving from the bed to the couch, and try your best to reach that goal.

Exercise Resources

Do Yoga With Me: Huge online database of free yoga workouts. Very beginner friendly.

https://www.doyogawithme.com/yoga-classes

References

1 Kichline, T., & Cushing, C. C. (2018). A systematic review and quantitative analysis on the impact of aerobic exercise on pain intensity in children with chronic pain. Children’s Health Care48(2), 244–261. https://doi.org/10.1080/02739615.2018.1531756

2 Malfliet, A., PT, MSc, Van Oosterwijck, J., PT, PhD, Meeus, M., PT, PhD, Cagnie, B., PT, PhD, Danneels, L., PT, PhD, Dolphens, M., PT, PhD, … Nijs, J., PT, PhD. (2017). Kinesiophobia and maladaptive coping strategies prevent improvements in pain catastrophizing following pain neuroscience education in fibromyalgia/chronic fatigue syndrome: An explorative study. Physiotherapy Theory and Practice33(8), 653–660. https://doi.org/10.1080/09593985.2017.1331481

3 Brooks, J. M., Iwanaga, K., Chiu, C.-Y., Cotton, B. P., Deiches, J., Morrison, B., … Chan, F. (2017). Relationships between self-determination theory and theory of planned behavior applied to physical activity and exercise behavior in chronic pain. Psychology, Health & Medicine22(7), 814–822. https://doi.org/10.1080/13548506.2017.1282161

4 Moody, K., Abrahams, B., Baker, R., Santizo, R., Manwani, D., Carullo, V., … Carroll, A. (2017). A Randomized Trial of Yoga for Children Hospitalized With Sickle Cell Vaso-Occlusive Crisis. Journal of Pain and Symptom Management53(6), 1026–1034. https://doi.org/10.1016/j.jpainsymman.2016.12.351

5 McNamara, C., Johnson, M., Read, L., Vander Velden, H., Thygeson, M., Liu, M., … McNamara, J. (2016). Yoga Therapy in Children with Cystic Fibrosis Decreases Immediate Anxiety and Joint Pain. Evidence-Based Complementary and Alternative Medicine2016, 1–10. https://doi.org/10.1155/2016/9429504