Chronic pain affects about 50 million Americans according to the American Pain Foundation. Chronic pain includes osteoarthritis, back pain, migraines, nerve damage, fibromyalgia, shingles, and more. If you suffer from pain, there is a temptation to skip exercising. Regular exercise can help reduce pain and improve a pain-sufferer’s quality of life.
What activities do doctors and physical therapists recommend that can help pain sufferers ease in and hurt less? When developing a wellness routine, it is important to understand the difference between pain and injury.
“Pain in the joints can be the result of anything from bursitis to tendonitis to arthritis,” says Dr. Charles Pelitera, Assistant Professor of Kinesiology at Canisius College and owner of Pelitera’s Fitness Consultants. “In many cases, the goal is to decrease the inflammation initially before attempting an exercise program. As the inflammation subsides, then the goal of an exercise program is to strengthen the muscles that surround that affected joint. The exercises should be performed with light weights and include as much range of motion as possible without causing additional pain.”
Can virtually every person, no matter how much pain they are suffering from, engage in physical exercise? Dr. John Stavrakos, who specializes in physical medicine and is a rehab physician (physiatrist) at Texas Health Arlington Memorial Hospital, says that “practically every patient can benefit from therapy in some form but if pain is too severe, we may need to intercede in some manner first to get the pain to a manageable level before starting therapy.”
“I have designed exercise programs for people with limited mobility,” says Dr. Pelitera. “I have developed work-outs for people missing limbs, wheel-chair bound and those who have had joint fusions. I have found that people who have the most debilitating affliction can be the most dedicated to their workouts as they look at the workout as a way to improve their quality of life.”
“The paradigm of having people with certain health issues become invalids for ‘their own good’ has thankfully changed,” says Dr. Stavrakos. “By way of example, during the 1940’s, my grandfather suffered a heart attack while in his early ‘50s. The medical thinking at that time was that complete rest and no physical exertion was the best way to recover. Predictably, he died not long after as a consequence of complications from inactivity. We know have a much better understanding of the beneficial effects of regular exercise on nearly every condition, from heart disease to rheumatoid arthritis and even chronic neck and back pain.”
“Before beginning on any exercise regime, it is wise to check in with your family physician,” says Dr. Pelitera. “Since most check-ups are covered by insurance, getting a baseline for all pertinent health issues is vital.”
The next step is to find a qualified physical therapist. “Look for a physical therapist who has at least 10,000 hours of manual therapy experience,” says Richard Sedillo, Certified Orthopedic Manual Therapist at the Arizona Manual Therapy Centers. “This invaluable expertise enables the practitioner to accurately evaluate and diagnosis the cause of the chronic problem. The assessment includes an evaluation of the patient’s range of motion, flexibility, and limitations.”
“People with chronic pain should focus on stretching problem areas as flexibility is key to muscle function,” adds Sedillo. “Chronic pain sufferers should stay within the middle range of their available range of motion and focus mainly on non-weight baring activities such as the bike and the upper body arm bike. Until the pain is identified and addressed, most chronic pain sufferers should avoid the treadmill and elliptical.”
“Water types of exercise are excellent for the obese, wheel-chair bound and for pregnant women,” says Dr. Pelitera. “Some rheumatoid arthritis, osteo-arthritis and even fibromyalgia patients see reduced pain from water related exercises.”
Whatever the exercise chosen, it is important to rotate activities. “With any form of cardiovascular exercise, the biggest concern is overtraining that can result in overuse injuries. The key to not getting injured is to always allow the body to recover from its previous bout of activities,” says Dr. Pelitera.
Dr. Stavrakos’ suggested exercises for chronic pain sufferers include:
1. Biking: either a stationary bike or road bike: “It’s a non-impact form of exercise that’s good for the lower body, good cardiovascular training, you set the pace and difficulty, and its fun to do,” says Dr. Stavrakos. “This is typically a good exercise for people who suffer with most forms of chronic back pain.”
2. Stretching: “Nearly every condition involving pain and/or stiffness benefits from regular, daily stretching,” says Dr. Stavrakos. “You can keep it simple (e.g. neck and hip circles), do the ‘fencer’s lunge’ for the calves and hip flexors, even wrap a towel or therapy band around the ball of the foot and pull up on an extended leg to stretch the calves and hamstrings. Stretching is essential to keeping pain down and being healthy.”
3. Tai Chi: “The number of Tai Chi forms are too numerous to count, but many styles don’t involve deep knee or hip flexion, making them possible to do at almost any age,” says Dr. Stavrakos. “Tai Chi incorporates slow, steady, precise continual movements that work to warm up the body to get it moving, provide strength and (very important as we get older) the constantly changing of weight distribution keeps the balance centers in your body (eyes, inner ears and proprioceptive fibers in the toes, ankles, knees and hips) constantly challenged – as a result many studies show a benefit to Tai Chi in decreasing the risk of falls among senior citizens.”