CHRONIC PAIN... HOW EXERCISE IS YOUR MEDICINE!

Chronic pain has been defined as pain that continues beyond normal healing time, which is usually seen as about 12 weeks (3 months). About 20% of the adult population suffers from chronic pain. This increases as the population ages,32% adults aged 25-34,62% adults aged over 75. Chronic pain causes many problems, beyond the pain itself, including fatigue, anxiety, depression, and poor quality of life. Chronic pain is seen as a public health issue worldwide and is responsible for considerable decreases in quality of life and employment for the patients and substantial increases in cost for the health system.

Up until recently, the therapies for chronic pain included medication and inactivity or rest. General advice now is to keep active - whether to affect the pain directly or to combat the other problems associated with it. Some of the

associated with chronic pain include smoking, alcohol intake, diabetes, and poor nutrition.

With the new recommendation of physical activity or exercise as a therapy, research has shown that it can reduce the severity of pain, as well as have general health benefits that would help in improving overall physical and mental health and improving physical function.

The results of the research have shown a favorable reduction in pain severity and mental health, alongside an increase in physical function. The only negative aspect that was seen was the increase in muscle pain that patients experienced for a number of weeks, but after adaptation to exercise, those pains resided.

The National Institute for Health and Care Excellence in the UK (NICE) for osteoarthritis has suggested that exercises should be a core treatment irrespective of age, comorbidity, pain severity, or disability. Health professionals or the patients themselves would have exhausted all pharmacological options as a primary treatment before looking into other therapies (non-pharmacological) that may be available. It is time to start viewing exercise as a medicine that can do so much more for you than any pill or medication would.

It does not necessarily need to be a vigorous exercise that you partake in, but keeping physically active and not going solely by the rules that went before bed rest and tons of medication. World Health Organisation (WHO) said, “Physical activity is any bodily movement produced by the skeletal muscles that require energy expenditure, including activities undertaken while walking, playing, carrying out household chores, traveling and engaging in recreational pursuits”.

When going to exercise, it can be water or land-based and include activities such as building strength, improving flexibility, improving endurance, range of motion, and muscle activation.

Things to remember:

It is important to start slowly when beginning an exercise program and avoid pushing into stronger pain. It is often useful to use the 0-10 scale to monitor your pain levels while exercising.

If pain levels increase by more than 2 points from baseline you should stop and modify that exercise, to ensure that you do not cause a flare-up of your pain.

Swimming and water aerobics in a heated pool:

Warm water relaxes muscles, and weightlessness helps with movement and minimizes the load on your joints. Avoid exercise in cold water as this can make muscles tense

Exercise in the mid-morning or early afternoon:

You may be best exercising in the mid-morning or early afternoon – or otherwise when any pain medication is in its peak effectiveness. Avoid exercising when your muscles may be tense, or when the threat of fatigue is at its worst.

While you sleep, your body temperature drops, leaving you stiff and lacking flexibility in the morning. Since flexibility helps your joints move in their full range of motion during a workout, you may not perform optimally first thing in the morning. Everybody is different, however, so listen to your body and talk to your accredited exercise professional for more advice.

If you are experiencing chronic pain and want to start an exercise program or want to look into getting one, it is best to speak first to your GP in order to get clearance to exercise and then your Physiotherapist can advise on types or programs best suited to you and your goals.

If you have any queries, don't hesitate to send us an email at Aisling@elevatephysiotherapy.ie