Benefits of Exercise in Chronic Pain
We all know that exercise is good for us and the research into this field is massive! A quick google scholar search (google scholar is the equivalent of a scientific nerds google- so it searches for academic articles rather than the whole internet) on the “benefits of exercise”, brings up 3 670 000 articles! And of those 1 700 were published in 2024 (what makes that impressive is that its not even the end of January 2024)!
So we all agree that exercise is good, but should exercise be done while experiencing chronic pain? The straight to the point answer: YES! But if that doesn’t convince you (and lets be honest, that was never going to be a satisfactory or compelling answer), read on…
Take a moment to think of all the benefits you already know, and tick them off this list:
improves cardiovascular function (lowers BP, reduces risk of heart disease, stroke, type 2 diabetes)
improves muscle strength and endurance
increases bone density and strength
controls weight
promotes sleep
boosts energy
reduces joint stiffness
increases aerobic capacity/fitness
protective against some forms of cancer
And now to some, slightly less obvious benefits… benefits to your brain health! Exercise results in changes in your brains anatomy (the way that it looks) and the physiology (the way that it works)! This is incredible news for all of us who thought that we were stuck with the brain (and all cognitive illnesses and declines) that we thought we were genetically given. No, the science does not show that you won’t get Alzheimer’s, Parkinson’s etc. if you exercise, but it does show that exercise is a great protector against these. So exercise now can act as an insurance plan for the future! Incredible! In addition exercise has been shown to help manage a host of mental illnesses including anxiety, depression and high stress. How does exercise do all this?
Exercise increases the levels of neurotransmitters (the little molecules that allow nerves to communicate with each other), such as dopamine, serotonin, and noradrenaline. An increase in these neurotransmitters results in effects you can feel immediately and last for up to 2 hours after exercise (improved mood, reaction time and attention to name a few). And if exercise is kept up, changes to your brain anatomy and physiology occur!
This all sounds wonderful and so positive, but our natural (and normal) response when our bodies alarm system (pain=our alarm system, see previous blog posts to learn more) goes off, is to reduce movement and therefore avoid exercise and activity. This reduction in movement is vitally important for healing after an acute injury, but in circumstances where pain persists past tissue healing and becomes chronic, this long reduction in activity means less movement which means we set ourselves up for the negative effects on all the areas we just listed above as benefits to movement.
In essence by not moving we set up a negative downward spiral, where now not only the pain promotes reduced movement, but reduced muscle strength, increased weight gain, poor sleep, increased stiffness, reduced energy levels, reduced aerobic fitness, increased anxiety and depression all also contribute to reduced movement, and that again means decreased muscle strength etc., etc., etc., and so the cycle continues. So the benefit introducing movement and exercise into the chronic pain picture starts with it breaking this downward negative “habit”.
And as you move, and as you feel less fatigued and stronger, your function will improve, meaning you can do more, become more social and re-engage with other live roles. This in turn has a domino effect on your confidence… you realise that you CAN do it, and eventually that movement does not need to be feared.
Here is another great benefit of exercise in chronic pain: regular exercise produces a natural anti- inflammatory response in your body. Great news for everyone who has an inflammatory component to their pain picture. How do you know if your picture includes inflammation? Here are two clues:
Any condition with the suffix “-itis”, as in oesteoathritis, rheumatoidathritis, etc., means that there is an element of inflammation
If you have been prescribed any anti- inflammatory medication, so anything like Voltarane, Nurofen, Celebrex, Naprosyn, Disprin, etc., etc.
And lastly (yes, I have saved my personal best benefit for last!), is that exercise helps retrain your brain (it’s my favorite because it blows my mind… pun intended!) Our brains are adaptive and change depending on what we give it. Give it worry, anxiety and pain, and it becomes good at worrying, producing pain and being evermore fearful. Give it exercise that is safe and graded, and it can restore confidence and slowly reassure the brain that its safe to move. Pacing a return to activity here is vital! If prevents the boom/bust scenarios that are so common in people living with chronic pain. Diving into a hectic kickboxing/5km run/hardcore exercise class will do the opposite (increase pain and thoughts of “exercise is dangerous and should be avoided). So, the trick is pacing and slowly training the brain.
This is by no means an exhaustive list of the benefits of exercise or how exercise has all these marvelous effects, but if this blog post has sparked your curiosity and eagerness to give exercise a try, find yourself someone who can act as your “coach” to help you along the way- a physio who is clued up and knowledgeable about pain is an excellent candidate for this!
