Chronic pain (also known as persistent pain) is pain that persists beyond the expected healing time of an injury. Unlike acute pain which is caused by tissue damage, chronic pain or persistent pain is less about the structural or tissue damage and more about the sensitivity of the nervous system and ‘non tissue related factors’.
Significant research has shown that exercise is an essential aspect in the treatment of chronic pain.
Often when we experience chronic pain we avoid activity in an attempt to not cause pain flare ups. However we know that gradually over time people experiencing chronic pain become less able to complete activities which were previously enjoyed, for example walking and commonly also have difficulties in completing activities of daily living such as housework
Why it’s important to exercise
Research has shown that exercise can be an effective way to reverse this downward cycle of deconditioning and worsening pain and gradually over time help those with chronic pain engage more in activities of enjoyment and essential activities of daily living with greater ease.
Things to remember
Remember that “Exercise is Medicine!” and is an important daily strategy used to assist in the management of pain conditions.
Stretch to cool down, not warm up and do short bursts of exercise, not long stretches.
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.
Types of exercise recommended
People with Fibromyalgia should generally avoid activities that involve fast, sudden movements and high impact activities, such as running and jumping, although some people may progress to this level of activity
It is recommended to combine multiple forms of exercise for chronic pain, including:
It is important to stretch at least once a day to help increase flexibility, loosen tight/stiff muscles and improve your range of motion. Stretching everyday will help ease your everyday movements.
To help build strong muscles, for example squats, wall pushups or bicep curls.
Walking, swimming or bike riding provide light aerobic exercise, which provides a list of healing benefits. If working out in a gym, try an elliptical trainer (which is lower impact than a treadmill)
• When you first start exercising, get advice and supervision from a physiotherapist or physiologist. They can suggest safe exercises tailored to your condition and ability. They will also ensure you are doing your exercises correctly to avoid injury.
• People with Fibromyalgia may find that their pain and tiredness increases initially when first starting to exercise. If this is the case, cut back the amount of exercise you are doing until you find a level that you can cope with. It can be hard to predict how your body will cope with a new activity. The most important thing to do is to listen to your body. A general guide is the ‘two hour pain rule’ – if you have extra or unusual pain for more than two hours after exercising, you’ve done too much. Next time you exercise, slow down or do less.
• Always start gently and build slowly. When you first start, do much less than you think you will be able to manage. If you cope well with that level, do a little bit more next time and keep building gradually.
• You should stop exercising if it is causing you unusual pain or increases your pain beyond what is normal for you. Exercising through this type of pain may lead to injury or worsening of your fibromyalgia symptoms. (Note, many people with fibromyalgia have some amount of pain all the time. This is not a reason to avoid exercise. You should only stop if you notice extra or unusual pain while you are exercising).
• Pace yourself. You may find it more comfortable to do several short sessions, such as five to ten minutes, throughout the day rather than one longer session.
• Always start your exercise by doing some gentle movements to prepare your muscles and joints for the activity. This will help prevent pain and injury. You may find it useful to use heat packs or warm showers before and/or after activity to loosen up stiff joints and muscles
See a physiotherapist or exercise physiologist for further advice if you are finding it difficult to get started.