Exercise has come to be a prescribed part of some doctors' treatment regimes for patients with pain. Because there is a known link between many types of chronic pain and tense, weak muscles, exercise-even light to moderate exercise such as walking or swimming-can contribute to an overall sense of well-being by improving blood and oxygen flow to muscles. Just as we know that stress contributes to pain, we also know that exercise, sleep, and relaxation can all help reduce stress, thereby helping to alleviate pain. Exercise has been proven to help many people with low back pain. It is important, however, that patients carefully follow the routine laid out by their physicians.

Exercise and Chronic Pain

Exercise helps to manage symptoms. Illnesses such as chronic pain syndrome have symptoms of prolonged fatigue, pain, and other symptoms that impair the ability to do daily activities. Being inactive can increase your level of fatigue and pain, lead to deconditioning of the body, make you more prone to injury, and put you at risk for other more severe health problems. A cycle develops:

Daily exercise can end that vicious circle and replace it with an upward, positive cycle. When a person exercises, a new cycle develops.

Recent research studies with chronic pain have reported that moderate exercise decreases pain, fatigue, distress, improves health perceptions, physical functions and aerobic fitness. Studies have shown that low-intensity exercise like walking and pool exercises improved symptoms and the ability to do daily activities. People often report decreased joint and muscle pain from low intensity exercise.

People with chronic pain are in a “pain cycle” in which they often move differently, or adopt a different posture to avoid pain. They often move in a distorted way, and have poor posture and unbalanced motion. This creates more pain and possibly recurring injury. Breaking the pain cycle can be difficult, especially if the body has been in the cycle for a long time. Sometimes people feel like their attempts at exercise have been met with pain flare ups and maladies, so they don't exercise. Wrong! Even if there is more discomfort in the beginning, re-training your body and remaining active will help long-term. Aerobic exercise can be the first step in breaking the pain cycle.

Benefits of Regular Exercise

• Less pain
• Decreased fatigue
• Fewer tender points (joint and muscle pain)
• Decreased blood pressure
• Lower resting heart rate
• Lower risk for heart disease or stroke
• Improved sleep
• Decreased anxiety and depression
• Increased heart efficiency
• Increased control of muscle strength and aerobic fitness
• Increased energy
• Improved cholesterol profile
• Enhanced feeling of well-being
• Enhanced performance of work and recreational activities

Get Started Exercising

To begin an exercise program, start gradually and then increase your daily activity. Things you can do include:

▪ Taking the stairs whenever you can
▪ Walk more
▪ Do more tasks around your home
▪ Limit your television and compute game use.

Ask your doctor about your exercise readiness. Exercise must be started slowly and increased gradually. Some fatigue and soreness is normal when starting an exercise program. You should avoid any level of activity that you find increases your fatigue or any of your other symptoms to a level that is unusual.

Exercise Programs

Walking, swimming, riding a stationary bike, water aerobics, or a rowing machine are all good aerobic exercise sources. Stretching exercises, yoga, and breathing exercises are good additions to the aerobic exercises because they increase blood supply and nutrients to the joints, decrease risk of injury, increase coordination, improve balance, and reduce stress in muscles.

Start by exercising one to two days per week. Initially, the daily duration could be as little as five minutes. Gradually build up to three to four times a week. Then gradually increase the length of time of the exercise routine. Go from 5 minutes the first couple of weeks, to 10 minutes the next couple of weeks, to 15 minutes the next. Keep increasing the amount of time you exercise until you reach a goal of 30 straight minutes of aerobic activity three or more days per week.

The intensity of the exercise should only be increased after you have achieved your goal of 30 straight minutes of aerobic activity on most days of the week. After you have achieved the 30 minutes, you should consult your doctor or physical therapist about starting some light strength training.

Exercise can improve your overall health and improve symptoms such as fatigue and pain. It is never too late to begin an exercise program or experience the many benefits of exercise- take the next steps to get started today! If you have any questions about exercise programs, you can ask your doctor, physical therapist, a fitness trainer, or any professional that is experienced in dealing with people with chronic pain and/or fatigue.

1. Department of Veterans Affairs
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