Chronic Pain and Exercise

Should I move it if it’s sore?  Is no pain, no gain really the right attitude?

How should we think about exercise when we have persistent pain? Is it good or bad?

At Own Body Physiotherapy we understand that there is abundant evidence from pain science research that exercise – particularly aerobic exercise like walking and cycling – has a pain modulating effect.  This is known as ‘Exercise Induced Hypoalgesia’ or EIP.  In other words, exercise can reduce pain levels.  This is true both in the short term – during and immediately following exercise – and in the long term. 

While the reasons for this are still being investigated, the theory is that exercise activates neural pathways that release opioids produced in your own body.  These endogenous opioids have an analgesic effect on your body. That’s right, your body is equipped with it’s own internal pharmacy with pain medications that get released during exercise! It’s like a biological pharmaceutical benefits scheme! (Sort of…) 

I’ve been in pain for a long time, will exercise still work for me?

If you’ve been in pain for a long time (typically longer than 3 months), it can be a little more complicated as there are other factors involved.  One of these factors is inflammation, which can be increased in a pain-sensitised person as the nervous system and the immune system are intricately connected.  This makes it more likely for a person with persistent pain to be a bit more sore with exercise. 

But, all is not lost!  This does not mean that your internal pharmacy stops dishing out the drugs.  It simply means that lower levels of exercise may be necessary when starting on a new program.  In this scenario, we reject the motto: “no pain, no gain.” This may be a great motivator if you’re Nat Fyfe, playing in the AFL finals with a broken leg, but it’s simply not appropriate for a person who has a hypersensitive pain system.  When your pain detection system is on high alert we want to aim for is exercise that doesn’t significantly increase your baseline level of pain leaving you unable to perform your normal daily activities.

Exercise Tips

  • Choose exercise you enjoy
  • Include some cardiovascular exercise in your program
  • Try low impact exercise such as hydrotherapy or pilates
  • Start slow and gradually build up
  • Stay consistent even on your bad days

You may not feel like you’re ready to run the Melbourne marathon (is it even possible to feel ‘ready’ to run a marathon?), but you will be taking steps toward accessing that internal pharmacy and decreasing your overall pain levels. 

For more information and an individualised treatment plan, contact us to make an appointment with one of our mobile physiotherapy team.

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