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Pain Management

Don't let chronic pain keep you from living an active, robust life. Find out why it hurts and when to get help.

Expert Advice

Provided by: Johns Hopkins University
Howard Levy, M.D.

Got Pain? Exercise It Away By - Posted Tue, Nov 06, 2007, 1:48 pm PST

By Howard Levy, M.D.
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For people with chronic pain, just getting out of bed and walking to the bathroom can be challenging. So the idea that exercising can be an effective way to control your pain may seem absurd, if not impossible.

However, there are several good reasons why exercise should be part of a long-term pain-management regimen. Here are some of the benefits you can expect:

  • Increased blood flow. This brings more oxygen to your muscles and clears away carbon dioxide and other toxins that can cause or worsen pain.
  • Improved cardiovascular fitness. When your heart pumps more efficiently, you won't get tired as quickly.
  • Improved muscle tone. You'll be less likely to get painful muscle spasms.
  • Weight control. You'll burn more calories when you exercise, which helps to control your weight. Being overweight worsens many painful conditions.
  • Endorphin production in the brain. Endorphins are natural painkillers and mood elevators.
  • Better sleep. You'll fall asleep more easily and feel more refreshed upon waking. Poor sleep can worsen both your pain and your mood.

Which exercises are best for your chronic pain depends mostly on the type of pain you have, its location, and what you enjoy or don't enjoy doing.

In general, very low resistance exercises help to build muscle tone and improve overall conditioning. By limiting the weight or resistance, most people can tolerate at least a few minutes of such exercise without making the pain much worse. Good examples include walking, bicycling, elliptical training, swimming, and water exercises.

You can even lie in bed on your back and do slow bicycle motions with your arms and legs. If one or a few joints are particularly bothersome, try simply moving them through their normal range of motion for several minutes. For example, you might bend and straighten your knee, squeeze and release a rubber ball in your hand, or trace the alphabet with your feet and toes. 

Be realistic, and only do as much exercise initially as you can tolerate without making your pain a lot worse. Over time (at least several months, sometimes years), you'll gradually be able to do more repetitions or continue for longer periods of time, and will hopefully notice that the pain has gotten a little less severe. 

If you're having a problem with weakness, then consider working toward heavier weights (increased resistance) to try to increase your strength. These types of exercise have a greater risk of causing injury or worsening your pain, however, so be sure to get help from a physical therapist. A trainer will make sure you're doing the routines correctly and not adding too much weight or resistance too fast.

Use your physical therapist as a guide, but be sure to tell him or her what is working well and what isn't working so well. You also need to continue exercising regularly after formal physical therapy ends. Remember, the goal is to manage and control your pain, not cure it. If you stop exercising, the pain will probably get worse.

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