24 Jul Pain, Movement and How Exercise Physiologists Can Help
This article was contributed and written by Accredited Exercise Physiologist, Amy Hondros.
UNDERSTANDING CHRONIC PAIN
July 22-28 is National Pain Week 2024 in Australia! So, what is chronic pain and how does exercise impact it?
Chronic pain is characterised as pain that persists beyond the expected healing time of an injury or longer than 3-6 months, depending on the condition. It is an unpleasant sensory and emotional experience that occurs in response to actual or perceived tissue damage. Chronic pain often presents in the back, neck, shoulders, joints or in conditions like endometriosis or persisting migraines.
Since pain is a unique experience, it is often quantified based on personal descriptions. For example, using the verbal numerical rating scale (VNRS) with 10/10 being the worst pain imaginable and 0/10 being no pain. Additionally, the character of chronic pain can be described as sharp, dull, aching, or burning.
HOW DOES THE BRAIN RESPOND TO CHRONIC PAIN?
When we feel the sudden onset of pain, or acute pain, our nerve cells responsible for detecting damage (called nociceptors) are triggered. They then send signals from the area of damage to the spinal cord and into the brain.
The information is then processed by cells called neurons and glial cells. From there, the information is carried as electrical impulses. The signals travel from the spinal cord to the prefrontal cortex in the brain and the brain decides what to do with the painful stimulus and how to respond.
As pain can have significant consequences, we have a network of interconnected cells called our salience network, which helps us decide what we need to pay attention to. Now that we have the stimulus and the attention of our brain, it will then respond accordingly, for example, by activating your motor pathways to off-load your leg after you sprain your ankle.
However, we also have modulators to help us cope with painful experiences, and the modulation network will secrete chemicals such as endorphins to dampen the sensation in acute painful settings. Therefore, all these processes work together to deliver your experience of pain, the intensity at which you feel pain, and the actions that follow.
EVERYONE’S CHRONIC PAIN EXPERIENCE IS DIFFERENT
These systems involved in pain have large levels of variance from person to person, which is why one pain experience could be different from another, even if two individuals have the exact same injury or genetics.
This is also why some people cope better with pain than others. It also explains why some individuals may experience acute pain as a protective and beneficial mechanism to assist with healing an injury, while others may go on to experience chronic pain that hinders normal functioning and quality of life.
This variability is why chronic pain can be difficult to treat, as there are a multitude of factors that may increase or decrease our sensitivity to pain. Currently, there is no way to pre-determine who will positively respond to more movement-based therapies such as weight training, yoga, hydrotherapy, or Pilates. But as we know, exercise and movement can have profound and positive secondary benefits in addition to pain management.
EXERCISE FOR CHRONIC PAIN
Exercise and movement are essential ingredients in the management of persistent pain. Many pain researchers and health professionals recognise that increasing physical activity levels can improve pain, function, and wellbeing across a range of persistent pain conditions including osteoarthritis, back and neck pain, shoulder pain, fibromyalgia, and post-surgery pain. Find out more about the benefits of exercise for pain.
Pilates for Chronic Pain
Pilates is a commonly used exercise methodology for managing chronic pain. It focuses on controlled movements, improving strength, flexibility, and posture.
By emphasising precise, controlled movements, it helps with improving neuromuscular pathways, helping the brain and body communicate more effectively. This retrains the nervous system, assisting with the reduction in pain sensitivity and improving movement efficiency.
Regular practice can improve mood, increase strength, flexibility, and balance, and assist with the management of pain. Additionally, Pilates enhances body awareness, helping individuals to move more freely, building confidence with movement variability.
Yoga for Chronic Pain
Yoga is another valuable practice for managing chronic pain. It also focuses on the connection between mind and body, promoting a state of relaxation. Yoga techniques engage the parasympathetic nervous system, encouraging the body to enter the “rest and digest” state where breathing is slower, the heart rate is slower, and chemical changes in the brain encourage relaxation.
Regular yoga practice can help address movement-related aspects of chronic pain, such as touch sensitivity, tissue tolerance, and the feeling of tightness and stiffness. It also helps improve mood, autonomy, and self-efficacy in managing chronic pain.
Exercise for Pain and Disability
Chronic pain and disability can significantly impact your quality of life. An Accredited Exercise Physiologist (AEP) can play a crucial role in managing various conditions through personalised exercise programs.
AEPs work with a range of different health conditions, injuries and disabilities including chronic and debilitating pain. AEPs will start with a comprehensive assessment to understand the individual, limitations and goals. From there, they will tailor a unique and effective exercise intervention.
Working with an AEP will help improve strength, flexibility, balance, fitness and mobility, to enhance daily function. Regular monitoring and adjustments ensure the exercise program remains effective as your condition evolves, helping you achieve lasting improvements.
With the support of an AEP, those living with pain or disability can focus on regaining independence, improving quality of life, and managing chronic pain more effectively.
THE KEY TAKEAWAY
The important takeaway message from this is that pain is complex and involves multiple systems and processes that are significantly different from person to person, meaning that everyone’s pain experience is unique depending on past experiences, levels of understanding, contextual factors, and an individual’s physiology.
Although this can make chronic pain multi-faceted and complex, it also means that interventions can be broad and varied and will depend on the individual. Working with an accredited exercise professional to incorporate effective exercise into your routine can be a life-changing step to living pain-free.
Connect with your local Accredited Exercise Physiologist today.
Written by Amy Hondros, Accredited Exercise Scientist (AES) and Accredited Exercise Physiologist (AEP).
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