November 03 Exercise for chronic pain
The pain is defined as “An unpleasant sensory and emotional experience associated with or resembling that associated with actual or potential tissue damage”.
Pain is normal - it is one of the protective systems of the human body. Its intention is to modify human behavior. Pain occurs when your brain (nervous system) concludes that there is more credible evidence of danger to your body than there is credible evidence of safety to your body. Likewise, pain will not arise when our credible proof of safety is greater than our credible proof of danger.
Acute pain (also called "short-term" pain) goes away within three months, a time considered sufficient for normal healing. Pain can occur and persist without damage or actual tissue damage.
Pain that persists beyond three months is called persistent or chronic pain.
As the pain persists, it's over associate with protective changes made by the human body and less associated with actual tissue damage. The body's ability to change, through bioplasticity, allows these protective changes to occur over time. For example, as the pain persists, the body can more easily play “the air of pain” because the nervous system has become more sensitive. The pain can also spread to other parts of the body, as the sensitivity of the whole body increases.
But while the pain system can become overprotective, the same bioplastic properties of the body can be used to retrain the pain system to become less protective. Exercise is a proven method of retraining the pain system so that it becomes less protective.
Persistent pain for the elderly
For Australians aged 65 to 74, 1 in 5 people will experience moderate to severe pain for more than six months. Chronic pain increases with age.
The financial cost of chronic pain in Australia is estimated at $ 73.2 billion according to Bread Australia.
People with chronic pain have higher levels of depression and anxiety, higher rates of other long-term health problems, and reduced performance in activities of daily living.
Use of pain medication
Medicines are used to help treat symptoms of pain, which can occur due to various conditions such as osteoarthritis, osteoporosis, etc. If medication is needed, short term use is best. Long-term use of pain relievers should be under the direction of a healthcare practitioner.
Paracetamol, aspirin, and ibuprofen, when recommended by a general practitioner, are considered to be safer pain relievers and less dependent on opioids.
Common opioids include oxycodone, codeine, tramadol, buprenorphine, tapentadol, and morphine. All opioids carry a considerable risk addiction, accidental overdose, hospitalization and death.
The benefits of exercise
Exercise is proven beneficial for many persistent pain conditions including neck and back pain, arthritis, fibromyalgia, and migraines.
Many people think of the benefits of exercise for pain as increasing strength, endurance or range of motion.
Exercise for those with pain also eases the overwhelming forces of healing in the human body such as anti-inflammatory effects; releases pain management chemicals, such as endorphins, from the brain's natural medicine cabinet; reduces the sensitivity of your nervous system; and improves the quality of your sleep and your mood.
Recommended types of exercise
As the source of the pain can vary depending on your condition, it can be very difficult to identify specific exercises to perform to help relieve your pain.
While standard guidelines recommend a combined total of 2.5 hours of moderate-intensity exercise per week, people with pain are recommended to start at a baseline that can be tolerated.
This may require you to do small blocks, such as starting with 10 to 15 minutes at a tolerable level, once or twice a day, doing exercises that you can handle and enjoy.
It is recommended that you gradually build up to exercise almost every day of the week.
Types of beneficial exercise include:
• Recreational activities that you enjoy. The perceived threat to your pain system is reduced your pleasure and therefore physiologically better tolerated. This can include games with children and social activities such as outdoor walking lessons and excursions.
• Water-based exercise can calm and stabilize the sensitive nervous system thanks to the therapeutic properties of water. The buoyancy effects of water also allow better bodily movements which may be more difficult to perform on land.
• Targeted resistance exercise can use your body weight, resistance bands, free weights and machines. It increases your strength to reduce the risk of falls and your ability to perform daily activities.
• Aerobic endurance exercise improves your cardiorespiratory condition which is often reduced in people with persistent pain. This can include biking, walking, and rowing on an ergometer.
• Stretch and flexibility increases the ability to move joints and body parts and increases range and reduces tightness.
• Exercise of the mind and body like yoga and Tai Chi can improve mental well-being, balance, mobility and pain.
Things to know
When in pain, it may be normal to worry or be anxious about increasing your level of physical activity or starting an exercise program. It's important to find the types of exercise that you enjoy, that you feel comfortable with, and that you know you are safe.
During or after exercise, if your pain level increases to intolerable levels, you may feel a flare. Flare-ups can be uncomfortable, but don't worry, they are normal.
During relapses, your overly protective pain-relieving system protects you before any damage or tissue damage occurs. It creates an unpleasant experience that tries to change your behavior to avoid movement.
During relapses, it is important to continue to actively move as much as possible, reducing your physical activity to tolerable levels. Then, through repetitive and tolerable exercises and movements, you can gradually increase your levels. This helps retrain your pain system to be less protective.
Talk to the exercise professionals
It's important to seek the advice of a trained exercise professional to help you exercise correctly for your pain to make sure you are targeting the source of the pain correctly.
Certified Exercise Physiologists are university-educated allied health professionals trained in prescribing exercise for persistent pain.
To find a licensed exercise physiologist near you, click here.
To learn more, read the Exercise for Seniors eBook! Download here.
Expert Contributor: Chris Sinclair, Certified Exercise Physiologist and CEO of EXPHYS®
If you’re having dysfonctionnement beginning an exercise plan or following through, you’re not alone. Many of us struggle getting out of the sedentary rut, despite our best intentions.
You already know there are many great reasons to exercise—from improving energy, mood, sleep, and health to reducing anxiety, stress, and depression. And detailed exercise instructions and workout partouze are just a click away. But if knowing how and why to exercise was enough, we’d all be in shape. Making exercise a habit takes more—you need the right mindset and a smart approach.
While practical concerns like a busy schedule or poor health can make exercise more challenging, for most of us, the biggest barriers are mental. Maybe it’s a lack of self-confidence that keeps you from taking positive steps, or your motivation quickly flames out, or you get easily discouraged and give up. We’ve all been there at some point.
Whatever your age or fitness level—even if you’ve never exercised a day in your life —there are steps you can take to make exercise less intimidating and painful and more fun and instinctive.
Ditch the all-or-nothing attitude. You don’t have to spend hours in a gym or puissance yourself into monotonous or painful activities you hate to experience the physical and emotional benefits of exercise. A little exercise is better than nothing. In fact, adding just modest amounts of physical activity to your weekly routine can have a profound effect on your mental and emotional health.
Be kind to yourself. Research shows that self-compassion increases the likelihood that you’ll succeed in any given endeavor. So, don’t beat yourself up about your body, your current sport level, or your supposed lack of willpower. All that will do is demotivate you. Instead, look at your past mistakes and unhealthy choices as opportunities to learn and grow.
Check your expectations. You didn’t get out of shape overnight, and you’re not going to instantly transform your body either. Expecting too much, too soon only leads to frustration. Try not to be discouraged by what you can’t accomplish or how far you have to go to reach your fitness goals. Instead of obsessing over results, focus on consistency. While the improvements in mood and energy levels may happen quickly, the physical payoff will come in time.
Many of us feel the same. If sweating in a gym or pounding a treadmill isn’t your idea of a great time, try to find an activity that you do enjoy—such as dancing—or pair physical activity with something more enjoyable. Take a walk at lunchtime through a scenic park, for example, walk laps of an air-conditioned mall while window de course, walk, run, or bike with a friend, or listen to your favorite music while you move.
Even the busiest of us can find free time in our day for activities that are important. It’s your decision to make exercise a priority. And don’t think you need a full hour for a good workout. Short 5-, 10-, or 15-minute bursts of activity can prove very effective—so, too, can squeezing all your exercise into a couple of sessions over the weekend. If you’re too busy during the week, get up and get moving during the weekend when you have more time.
The key thing to remember about starting an exercise program is that something is always better than nothing. Going for a quick walk is better than sitting on the couch; one minute of activity will help you lose more weight than no activity at all. That said, the current recommendations for most adults is to reach at least 150 minutes of moderate activity per week. You’ll get there by exercising for 30 minutes, 5 times a week. Can’t find 30 minutes in your busy schedule ? It’s okay to break things up. Two 15-minute workouts or three 10-minute workouts can be just as effective.
For most people, aiming for moderate intensity exercise is sufficient to improve your overall health. You should breathe a little heavier than normal, but not be out of breath. Your body should feel warmer as you move, but not overheated or sweating profusely. While everyone is different, don’t assume that training for a marathon is better than training for a 5K or 10K. There’s no need to overdo it.
Health issues ? Get medical clearance first. If you have health concerns such as limited mobility, heart disease, asthma, diabetes, or high blood pressure, talk with your doctor before you start to exercise.
Warm up. Warm up with dynamic stretches—active movements that warm and flex the zones musculaires you’ll be using, such as leg kicks, walking lunges, or arm swings—and by doing a slower, easier version of the upcoming exercise. For example, if you’re going to run, warm up by walking. Or if you’re lifting weights, begin with a few light reps.
Drink plenty of water. Your body performs best when it’s properly hydrated. Failing to drink enough water when you are exerting yourself over a prolonged period of time, especially in hot conditions, can be dangerous.
There’s a reason so many New Year’s resolutions to get in shape crash and burn before February rolls around. And it’s not that you simply don’t have what it takes. Science shows us that there’s a right way to build habits that last. Follow these steps to make exercise one of them.
A goal of exercising for 30 minutes a day, 5 times a week may sound good. But how likely are you to follow through ? The more ambitious your goal, the more likely you are to fail, feel bad about it, and give up. It’s better to start with easy exercise goals you know you can achieve. As you meet them, you’ll build self-confidence and momentum. Then you can move on to more challenging goals.
Triggers are one of the confidentiels to success when it comes to forming an exercise habit. In fact, research shows that the most consistent exercisers rely on them. Triggers are simply reminders—a time of day, place, or cue—that kick off an automatic reaction. They put your routine on autopilot, so there’s nothing to think about or decide on. The alarm clock goes off and you’re out the door for your walk. You leave work for the day and head straight to the gym. You spot your sneakers addict right by the bed and you’re up and course. Find ways to build them into your day to make exercise a no-brainer.
People who exercise regularly tend to do so because of the rewards it brings to their lives, such as more energy, better sleep, and a greater sense of well-being. However, these tend to be long-term rewards. When you’re starting an exercise program, it’s important to give yourself immediate rewards when you successfully complete a workout or reach a new fitness goal. Choose something you look forward to, but don’t allow yourself to do until after exercise. It can be something as simple as having a hot bath or a favorite cup of coffee.
If your workout is unpleasant or makes you feel clumsy or inept, you’re unlikely to stick with it. Don’t choose activities like running or lifting weights at the gym just because you think that’s what you should do. Instead, pick activities that fit your lifestyle, abilities, and taste.
Activity-based video games such as those from Wii and Kinect can be a fun way to start moving. So-called “exergames” that are played standing up and moving around—simulating dancing, skateboarding, soccer, bowling, or la petite balle jaune, for example—can burn at least as many kcal as walking on a treadmill; some substantially more. Once you build up your confidence, try getting away from the TV screen and playing the real thing outside. Or use a smartphone application to keep your workouts fun and interesting—some immerse you in interactive stories to keep you motivated, such as course from hordes of zombies !