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David Baxter PhD

Late Founder
Exercise takes the edge off chronic pain
August 29, 2007
Mayo Clinic

Exercise can be a great way to ease chronic pain. Consider the risks of inactivity and the benefits of movement.

When you're in pain, exercise is probably the last thing on your mind. But it may be more important than you think. Regular exercise is a versatile weapon in the fight against chronic pain.

The risks of inactivity
When you're inactive, your muscles ? including your heart ? lose strength and work less efficiently. Your risk of high blood pressure, high cholesterol and diabetes increases. Inactivity can increase fatigue, stress and anxiety as well.

"Years ago, people who were in pain were told to rest," says Edward Laskowski, M.D., a physical medicine and rehabilitation specialist and co-director of the Sports Medicine Center at Mayo Clinic, Rochester, Minn. "But now we know the exact opposite is true. When you rest, you become deconditioned ? which may actually contribute to chronic pain."

The benefits of movement
As tough as it may be to start an exercise program, your body will thank you. Are you skeptical? Consider the facts. Exercise can:

  • Prompt your body to release endorphins. These chemicals block pain signals from reaching your brain. Endorphins also help alleviate anxiety and depression ? conditions that can make chronic pain more difficult to control. "Endorphins are the body's natural pain relievers," Dr. Laskowski says. "Endorphins have the potential to provide the pain-relieving power of strong pain medications, such as morphine."
  • Help you build strength. The stronger your muscles, the more force and load you'll take off your bones and cartilage ? and the more relief you'll feel.
  • Increase your flexibility. Joints that can move through their full range of motion are less likely to be plagued with aches and pains.
  • Improve your sleep quality. Regular exercise can lower your stress hormones, resulting in better sleep.
  • Boost your energy level. Think a walk around the block will wipe you out for the rest of the day? Not likely, and if you do it again tomorrow and the day after, it'll be easier each time. In the long run, regular exercise can actually give you more energy to cope with chronic pain.
  • Help you maintain a healthy weight. Exercise burns calories, which can help you drop excess pounds. This will reduce stress on your joints ? another way to improve chronic pain.
  • Enhance your mood. Exercise contributes to an overall sense of well-being. It increases blood and oxygen flow to all your tissues, livening up your skin tones and nourishing your brain. These positive effects perpetuate themselves. The better you look and feel, the greater your confidence and motivation to keep exercising.
  • Protect your heart and blood vessels. Exercise decreases the risk of high blood pressure, diabetes, heart attack and stroke.
Getting started
Consult your doctor for help designing an exercise program that meets your specific needs. Your doctor will likely recommend various stretching, strengthening and aerobic activities. Exercises that help you relax ? such as meditation and yoga ? may be helpful, too.

It's natural to be worried about hurting yourself or making your pain worse. But with your doctor's reassurance and guidance, you can safely exercise with the knowledge that your pain isn't serving a useful protective purpose. Remember, regular exercise actually eases chronic pain for many people.

Exercise program components
Exercising regularly can both increase function and decrease pain in as little as three weeks, even when you're starting slowly. A multidisciplinary pain rehabilitation program can provide an individualized exercise prescription based on your current abilities and your goals for pain relief. Physical therapists also can help you understand body mechanics, posture principles and proper lifting techniques, all of which can decrease chronic pain. Rehabilitation programs are intended to give tools for long-term pain relief through functional improvement over time, but most people leave a pain rehab program with noticeably less pain than when they started.

Even if you're not in a pain rehabilitation program, you can adapt some of their recommendations in your own exercise routine with the advice of your doctor:

  • Aerobic exercise. For physical conditioning, start slowly at a safe point for your current abilities. Over several months, work up to a regular routine of working out for 20 to 30 minutes, four to five times a week. Low-impact exercise such as biking and walking are often good choices, and swimming may be especially effective ? and more comfortable ? if you have joint disease.
  • Strength training. Dumbbells, resistance tubing, body weight, strength training machines or sandbag weights can all be used for strength training. Start with a resistance with which you can perform 12 to 15 repetitions and try to work major muscle groups in the upper body, lower body and core.
  • Stretching. Increasing your flexibility can be a helpful component of pain relief. Start a consistent stretching routine with advice from your doctor. Gentle stretching exercise like yoga or body movement exercise such as Pilates may be beneficial as well.
If you're not consulting with a physical therapist, be sure to check in with your doctor periodically to be sure you're not pushing yourself too hard ? or letting yourself off too easy. While you might need encouragement to progress, others can get impatient and push themselves too hard, and need to be held back.

"Exercise is not an overnight success story, but if a person is consistent and patient, they are almost guaranteed success," says John Postier, R.P.T., a physical therapist in the Pain Management Center at Mayo Clinic in Rochester, Minn.
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