Gentle exercise, for example stretching, swimming, walking, yoga etc., is now recommended as part of a plan for managing chronic pain. People we talked to recommended exercise for the mental as well as physical benefits, since it can be a great distraction from the pain.
Several people told us that they had found it difficult to start exercising. Some had never really exercised and didn’t know where to start, while others had taken part in very vigorous exercise before their pain started and knew they couldn’t go back to their old routines.
People were sometimes frightened of moving, or protected the painful part of their body and found the prospect of exercising terrifying. A few were concerned about exercising when taking medication in case they unknowingly injured themselves, although some had been taught that these concerns are unfounded (see also ‘What is chronic pain?‘).
Had been frightened of exercise and even movement but had been told by professionals and support…
Had been frightened that she might re injure her arm so protected it but now knows that exercise…
Was told at pain management that exercise is not going to make you worse because chronic pain is…
Often people were introduced to exercise by a physiotherapist, who gave them an individual programme. Some attended a special physiotherapy exercise class or learnt how to exercise safely on a Pain Management Programme (see also ‘Physical therapies’; ‘NHS pain management programmes‘).
Others had found useful books or videos on exercises for people with chronic pain (see Resources‘ section).
In the past, some people, particularly those with back pain, had been told to take bed rest until their pain eased. One woman said that she was not told when to start moving again and so ended up spending months resting, during which time she became very stiff. Another person who was advised to rest said he found lying down uncomfortable and started to walk and do stretching exercises instead, which helped.
Was advised to take bed rest but found it made the pain worse and that gentle exercise helped.
We now know that prolonged periods of rest lead to muscle wastage and stiffening of joints and tendons, which can actually make the pain worse.
One man, who was a nurse, said he was aware that medical understanding changes from time to time so understood why he had been advised to rest. Medical professionals and therapists now agree that rest combined with gentle activity, for example gentle pottering, is the best course of action for a flare-up of pain (see also ‘Coping with flare-up’).
Recognises that medical understanding has moved on and that prolonged bed rest is no longer…
Several people found that exercise relieved their pain through the release of endorphins, natural pain-relieving chemicals. Others did not experience noticeable pain relief but felt that they were physically fitter, had more strength and had reduced their weight by being more active.
Different types of exercise suited different people. The important thing with all types of exercise is to set yourself goals and build up to them gradually staying within your limitations (see also ‘Pain management: pacing and goal setting’). It was pointed out that it is important to remember that you are not training to run a marathon or to be an Olympic athlete.
Gained weight when he became less active but set himself walking targets and slowly worked up to…
Several people attended hydrotherapy with a physiotherapist and were shown exercises in a special heated pool. Hydrotherapy is usually only available for a limited number of sessions, but several people had continued to exercise at a public swimming baths. Swimming was seen as an excellent exercise because the joints are supported by the water.
Several people said that gentle Aquafit exercise or even walking in water was beneficial. Public baths could be busy, although many have adult only and women only sessions. A man suggested going during the day to avoid the children and a woman had attended a special session reserved for people with disabilities.
Learnt some exercises from a book and has also been swimming to a special session for people with…
Yoga, tai chi, qigong, pilates or exercises that focus on core stability muscles were popular. Classes vary considerably and some warned that it is important to find a teacher who understands your limitations.
Some people had joined a gym. They recognised that others might think that this was impossible and stressed that they stayed within their limits and didn’t use equipment that made their pain worse. One woman who had joined a local council gym said that it made her feel part of society again.
Joined a gym which made her feel part of society again.
Some gyms had specially qualified staff who could help people with chronic pain to develop a programme of exercise. One woman had been referred to a local fitness centre on a scheme funded by primary healthcare.
Was referred to a health centre on a new scheme set up between primary care and leisure services.
Exercise didn’t suit everyone, some thought it made them feel worse and others found it difficult to do and preferred to include exercise in their everyday routine. It was emphasised that any movement is beneficial.
Everyday physical activity included playing with children, gardening, working in the garage, cycling, doing general housework, walking the dog, walking up stairs, getting off the bus a stop earlier or walking to a friend’s house.
One woman recommended buying a pair of trainers and had been pleasantly surprised to find that she gained ‘a real spring in your step’. A woman who had been having her groceries delivered started to use the supermarket again – even loading and unloading a shallow shopping trolley could help with mobility.
Trying to maintain as normal a life as possible by continuing with activities and social contact can help to regulate peoples’ mood and stop them feeling isolated and depressed and this in turn can help with how people experience levels of pain.