The 5 Best Exercises for Chronic Pain

From rolling out your yoga mat to taking a stroll around the block, there's something for everyone on this list.

Photos: Unsplash

If you live with chronic pain from fibromyalgia, rheumatoid arthritis, chronic fatigue syndrome, endometriosis or any other chronic illness, you’ve probably already heard that regular exercise can be beneficial for your health. But did you know that it can actually help ease a bit of the pain you’re feeling?

“The body was meant to move and it is healthiest and happiest when it is moving and active,” says Chronicality advisor Peter Abaci, MD, medical director of the Bay Area Pain and Wellness Center in Los Gatos, CA, and author of Take Charge of Your Pain: The Latest Research, Cutting-Edge Tools, and Alternative Treatments for Feeling Better. “When you put it in a position where you don’t let it move or are inactive consistently, then the body starts to function worse. There is the onset of pain, quality of life is affected, anxiety and depression set in, and it all becomes a cascading problem.”

But why does being active help? And what are the best exercises to try when don’t feel like yourself and your muscles and joints ache and throb with every move? Here’s what you should know about how exercise affects pain, plus the five best exercises for chronic pain.

How Exercise Helps Ease Pain

Pain is an interesting phenomenon. Normally, when you hurt yourself, your body automatically responds by stimulating pain receptors that release chemicals. Let’s say you jam your finger in the car door, for example. These chemicals carry messages directly to the spinal cord, which then relay those pain messages to the brain. This all happens so quickly that you feel the pain pretty much immediately after jamming your finger.

But for those who experience chronic pain that just won’t go away, the same pain process as acute pain from injury doesn’t apply. Instead, chronic pain seems to affect the central nervous system, which can become overly sensitive to pain, says Abaci. Research shows that those who experience chronic pain may have impaired neuroplasticity, which is a term that describes the brain’s ability to change with experience and use. It allows the body to adapt to injury and disease. Without neuroplasticity, the nerve cells become so sensitive that the brain may perceive even a gentle touch as painful. This pain perception leaves an imprint on the brain, which means that over time, the brain feels chronic and persistent pain more intensely.

Fortunately, increasing neuroplasticity may help with chronic pain treatment, according to a recent study in the Journal of Pain. And research suggests that exercise can help by improving blood flow and oxygen to the brain, which are crucial for improving neuroplasticity.

“Even though exercise is not going to act like a Tylenol and immediately make the pain better, over time it will address the neuroplastic changes that cause pain and work to help people feel better,” says Abaci.

5 Best Exercises for Chronic Pain

From rolling out your yoga mat to taking a stroll around the block, there’s something for everyone on this list.

1. Walking

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For those capable of walking, going for a long walk is a low impact activity that can be done almost anywhere, from a treadmill to standing in place. Studies show that walking can increase blood flow, which boosts energy and helps with neuroplasticity, as oxygenated blood is pumped to the brain and throughout the body. Early research in the field of exercise science has suggested that walking is the most perfect form of exercise, as it is a cardiovascular workout that is load bearing, but gentle, and can help reduce stiffness and pain in the muscles and joints.

“The mechanics of walking involves a lot of muscle groups including your core, back and legs, all areas that people with chronic pain usually experience pain in,” says Abaci. “Nowadays, we don’t do enough walking, even though our bodies were biologically built to walk everywhere.”

2. Swimming

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Warming up to the idea of exercising, but you feel that your joints still need a gentle start? For most people, swimming or doing water exercises can help relax muscles, while the buoyancy of the water can help those with musculoskeletal or joint pain.

Swimming has been shown to improve cardiovascular health, stamina, muscle strength and flexibility, which can all work to improve neuroplasticity and strengthen and work key muscles in the back, shoulders, legs and core.

3. Yoga

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To ease chronic pain, proper breathing techniques practiced in yoga might be just as helpful as the stretching and strength components that you will learn, German researchers have found. Plus, studies show that acceptance- and mindfulness-based meditation practices, which can help you acknowledge and accept your chronic pain, can be practiced alongside yoga to ease pain.

Keep in mind that not all yoga consists of gentle stretching and slow movements — there are movements and poses in yoga that can involve the spine and other joints, which may be too extreme for all participants, according to the Johns Hopkins Arthritis Center. Follow the instruction of a qualified yoga instructor and stop if you experience any pain during a pose, Abaci says.

4. Pilates

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Pilates can do more than just strengthen the mind and body. In one recent study, Italian researchers found improved core strength and stability, posture and balance, and fewer pain symptoms in people with lower back pain who took pilates classes three times a week for 14 weeks.

In an earlier 2015 study, the same researchers found that engaging in pilates reduced back pain more than other interventions using minimal physical exercise. But just like yoga, pilates generally requires instruction, so be sure to seek an experienced teacher to guide you.

“For people with spinal injuries, pilates is a great choice that places strong emphasis on core stabilization and breathing, while using your brain to engage in learning new movements,” says Abaci.

5. Strength Training

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If you think lifting weights is only for meatheads at the gym, you may want to think twice.  Muscle strengthening exercises and resistance training can help you control chronic pain by strengthening the muscles around the joints, which takes some of the stress off the joint when in use.

Strength training doesn’t always have to involve lifting heavy weights — just using your own body as weights can be very beneficial. Be sure to heed the advice of a physical therapist or personal trainer experienced in dealing with people suffering from chronic pain before starting any strength training regimen.

Before Getting Started on an Exercise Plan

Before you jump in and start exercising, talk to your medical team about your plans to exercise, suggests Abaci. Let your doctor know what you have in mind and get his or her input on where to start. You may need a fitness assessment to see where you should focus your efforts first, or a visit to a physical therapist to guide you through exercises or get you past an old injury.

Go at your own pace and don’t get discouraged, Abaci says. “One size fits all doesn’t apply with one form of exercise. It doesn’t matter if you start with a personal trainer, occupational therapist, a group yoga class or pilates teacher… just find somebody who really gets the big picture [of your pain].”

Article originally published March 31, 2016.

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