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People with chronic pain often hide their condition; perhaps they are embarrassed by their suffering, or they are just tired of people saying to them “but, you look fine”. I have been very open with my struggles because I want people to understand that the face of chronic pain is very different from the stereotypes. Chronic pain sufferers are not all drug addicts, or lying helpless in bed, or unemployed, or look like shit. And, another thing, chronic pain and exercise are not mutually exclusive. In fact, exercise helps chronic pain.
People ask me all the time if I am able to run. They are generally surprised that the answer “yes”; it is almost always “yes”. I have been able to run with remarkable consistency despite the years of chronic pain. I rarely need days off, with the longest breaks in my training reliably coinciding with surgery. I track my runs and walks diligently on Strava; it has become a long standing joke that I will post a short walk around my neighborhood.
My Strava entries serve as an important reminder of the ebbs and flows of speed and mileage and runs vs. walks and how I’ve recovered from the various surgeries. It is also my way of staying connected as an athlete whose goals and challenges are different from those of years past. Most importantly, it is a reminder of how much I am able to do when conventional wisdom indicates otherwise.
The exercise effect
Here’s the thing with chronic pain, movement helps. It really does. Some chronic pain patients have figured this out. Others are still struggling with the idea that taking their battered body out to do something physical isn’t heresy and will make them feel better not worse.
I am a scientist, so I like to test hypotheses, and I have no problem using myself as a Guinea pig. I have explored many ways of resting and training to determine what works best for me in terms of pain control, positive mental health, and maintaining social ties. I know that complete rest is terrible, as it actually causes more pain does nothing for my mental health. In terms of “training”, well, that changes on a daily basis. It turns out, that I can still muster up a stellar run session now and again. I cannot always predict when that will happen, so I always give myself the opportunity.
I have learned to read the signs of when I can push through the pain and when to go home. And, that is the thing with chronic pain; the sufferer needs to come to an understanding with their body to determine what kind of movement helps (or hinders) and develop an exercise program that matches their capability.
The benefits of exercise
My experience with exercise alleviating some of the discomfort of chronic pain is not unique. The medical and scientific community have studied the relationship between exercise and chronic pain and have overwhelmingly found a positive association, meaning, in almost all of the studies, exercise helped with the symptoms of chronic pain.
“As part of a healthy lifestyle, exercise can also reduce general and specific risk factors for neuropathic pain, such as inactivity and diabetes, and may therefore reduce the global burden of neuropathic pain.”1 Why? There are the general benefits that exercise bestows, such as decreased risk for cardiovascular disease, lower blood pressure and blood glucose levels, reduced risk for certain cancers, and enhanced blood flow. Specifically, exercise promotes and preserves the function of peripheral nerves in those who have peripheral neuropathy.2 Additionally, exercise has positive effects on maintaining sensation, improves balance, enhances functional mobility, decreases fatigue, and reduces pain levels.3,4,5
Obesity and chronic pain co-exist.6 While many pain syndromes are not caused by obesity, increases in Body Mass Index (BMI) can contribute to higher levels of pain through extra stress on joints and greater peripheral inflammation.7 Long term studies have shown that weight reduction reduced pain levels.8 Since exercise can help reduce obesity, it can be viewed as another weapon in the fight against chronic pain.
There are NO pills or potions or voodoo magic that can make as many positive claims as can exercise for making improvements in chronic pain. That is why, no matter what, I find my way out the door to run. Or walk. Because, not doing so is bad for my pain, my health, and my well-being.
1Bonin, R. P. (2015). Running from pain: mechanisms of exercise-mediated prevention of neuropathic pain. Pain, 156(9), 1585-1586.
2Dobson, J. L., McMillan, J., & Li, L. (2014). Benefits of exercise intervention in reducing neuropathic pain. Frontiers in cellular neuroscience, 8, 102.
4Almeida, C., DeMaman, A., Kusuda, R., Cadetti, F., Ravanelli, M. I., Queiroz, A. L., … & Lucas, G. (2015). Exercise therapy normalizes BDNF upregulation and glial hyperactivity in a mouse model of neuropathic pain. Pain, 156(3), 504-513.
5Ericsson, A., Palstam, A., Larsson, A., Löfgren, M., Bileviciute-Ljungar, I., Bjersing, J., … & Mannerkorpi, K. (2016). Resistance exercise improves physical fatigue in women with fibromyalgia: a randomized controlled trial. Arthritis research & therapy, 18(1), 176.
6Okifuji, A., & Hare, B. D. (2015). The association between chronic pain and obesity. Journal of pain research, 8, 399.