7 Tips for Exercising When You Have Chronic Pain

A ballerina tells her story how exercise helped her overcome a ballet injury

Too much of the wrong activity can make pain worse. If running or jogging are out of the question, you may be able to manage and enjoy cycling, which is easier on painful knees and hips. Aquatic therapy, including aerobics performed in warm water, help to alleviate inflammation; the buoyancy of the water protects the body from the stress of gravity and from jerky or jarring movements that might otherwise cause pain. No matter which type of exercise you choose, use caution not to move too quickly, stretch or twist too far, or do so much that you pain becomes worse.

As you become more comfortable, you may decide to enroll in an exercise class or pursue personal training; inform you instructor or fitness professional of your condition, so he can demonstrate how to move safely and get the most out of your workout.

Exercise improves a person’s sleep patterns. Sleep problems often plague individuals who have chronic pain. Worry, depression, or the pain itself diminishes the quantity and quality of your sleep. Some medications also encourage insomnia. Sleeping aids can help, but practicing relaxation and behavioral therapy techniques can help you get more normal sleep without side effects. When restorative sleep patterns improve, pain symptoms usually do too.3 Physically active individuals sleep longer and more deeply that those who are sedentary. Exercise also helps to alleviate sleep apnea, a common disruptive sleep disorder that abruptly stops the breath.

7 Tips for Exercising When You Have Chronic Pain

  1. Talk to you doctor before you begin an exercise program.
  2. Start slowly and gradually increase your efforts as you gain strength, flexibility, and confidence.
  3. Move at your own pace. Never try to keep up with a class or a group if doing so is painful.
  4. Exercise every day, if possible.
  5. Strive for a balanced routine of cardiovascular, strengthening, and stretching exercise.
  6. Accept that you will be able to do more on some days than others.
  7. Be patient with your progress. Overexertion makes pain worse and can strain muscles.

Cynthia's Story

My pain began in 1982 from a ballet injury. It took nearly 14 years before I was diagnosed with complex regional pain syndrome, known then as reflex sympathetic dystrophy. Since then, I’ve developed fibromyalgia, chronic fatigue syndrome, irritable bowel syndrome, and osteoarthritis. On a scale of 0 to 10, with 10 being the highest pain imaginable, my pain was almost always a 10. I was bedridden for a decade because of it, unable to speak for five of those years, and rarely got much sleep.

ballerina adjusting her shoe

I began to improve when I finally switched to a pain-management specialist. Part of my multidisciplinary treatment was getting back to exercise. It’s the first thing I do every morning (except Sunday, my day off). I swim nearly a mile three mornings a week, whether or not I have slept or am in pain. If my right arm, which was broke a year ago and is often as painful as my CRPS, gives me too much pain, I kick the laps I can’t finish or I swim one-armed laps. On the other three mornings, I do an intense 45-minutes ballet-and-Pilates workout, followed by 15 to 20 minutes of Feldenkrais.

My morning exercise wakes me up and gets my body and mind ready for a productive day. I feel better when I move. Fifteen years ago after my pain started, I began seeing a pain psychologist, who taught me to use relaxation and biofeedback. My pain level tapered to between a 5 and a 7, and my body became more relaxed every week. In 2009, I achieved partial CRPS remission. Rarely, my pain now spikes to a 9, but it is generally between levels 2 and 4.

This article is an excerpt from Confronting Chronic Pain, A Pain Doctor's Guide to Relief, by Steven H. Richeimer, MD with Kathy Steligo. Reprinted by permission of Johns Hopkins University Press. Dr. Richeimer is a Professor in the Departments of Anesthesiology and Psychiatry and Chief of the Division of Pain Medicine at the University of Southern California.

Click here for more information about the book. For orders placed with the publisher, use code HNAF for 30% discount.

Updated on: 09/09/17
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