Exercise for chronic pain

Exercise. How on earth could anyone expect a person with chronic pain to exercise – surely it’s only going to INCREASE pain?

The short answer is “YES” it’s likely to increase pain – BUT without exercising you’ll be able to do less and less over time. Exercising is good for chronic pain, but it’s got to be done carefully.

The best predictor of whether you’ll do exercise is what you choose as your exercise form. What I mean by this is that although vacuuming the floor is exercise, it’s not my favourite form, and so I avoid it like the plague – but get me into the garden for an hour or so, and I’m as happy as a clam.

If you’ve been nagged to get out and exercise, here’s a few tips on how to go about it.

  1. Decide why YOU want to exercise. Is it to get fitter and less puffed when you do everyday activities? Is it to clear your mind of the stresses of the day? Is it to reduce weight? Deciding on the reason for exercising will help you choose the right kind of exercise for you. What researchers have found out is that for some forms of chronic pain, like fibromyalgia and those with problems down-regulating the amount of information reaching the brain, powerlifting and heavy weight training is not as useful as walking, cycling or swimming.
  2. Begin low and increase slowly. If you’ve decided to use walking as your exercise (it’s a good choice! Walking is generally safe, you don’t need any equipment except a pair of shoes, and it’s free), decide how much you can do right now without giving yourself a flare-up. If that means you can only do five minutes, that’s fine. Do that five days out of seven. I don’t have any particular formula for deciding how often except that for me, setting a goal of walking every day will fail. Just because I do things some nights of the week and I can’t commit to seven days. I’d feel guilty if I couldn’t do what I set out to do, and I’d probably stop. So five days is a good number for me.
  3. After working at your baseline for a week, or meeting your goal for a week, you can decide to increase a little bit. Now once again there’s no real formula. If you’ve been doing five minutes each time, maybe increase by 10% or maybe a minute. Up to you. You’ll probably feel a bit more tired when you do this, but that won’t last for long, just a couple of days. BUT if you increase by a lot, you can bet you’ll get a flare-up, stop doing any, feel guilty and never start again. Truth.
  4. Develop a good “recovery” programme. Recovering from a change in exercise level, or even a change in the type of exercise is a vital part of maintaining your activity level. At the end of each exercise session, use some diaphragmatic breathing and quiet mindfulness to calm your mind and body down. In the days between your exercise sessions, do something good for your soul – read a book, gaze at a sunset, sip on a luscious cup of hot chocolate. These “recovery” days are integral to managing your pain because they give your brain time to chill out.

There are many myths about exercising and chronic pain. What I know is that people mainly use exercise for its mental health properties. It helps brains relax a bit, and gives you some time out from having to think and process information for a while. There are no particular types of exercise that “cure” back pain, fibromyalgia, or headaches – so don’t worry if you loathe “core stability” exercises, or just don’t like lifting weights or going on a cross-trainer or treadmill. Remember that when we were hunter-gatherers on the savanna, we didn’t do “exercise” the way many people do today. We just took “exercise snacks” as we did everyday life. That’s all we’re aiming to do for chronic pain management.



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