Break the Cycle of Chronic Pain

From a lecture series by Professor Barbara K. Bruce, Ph.D., L.P.

Pain affects more Americans than diabetes, heart disease, and cancer combined. So, if your life or the life of someone you love has been hijacked by pain, triggered by arthritis, chronic fatigue syndrome, disc problems, fibromyalgia, headaches, sciatica, or other causes, you should read these tips to successfully manage chronic pain.

Image of man with chronic pain in knee

A New Approach to Pain Management

There was a time, not so long ago, when people who had chronic pain were told to avoid exercise and exertion. Practitioners thought that their patients might do themselves more harm than good by aggravating injured joints and muscles.

Now we know the opposite is true. Study after study, case after case, shows how exercise not only improves people’s overall health, but also actually reduces pain symptoms and improves their quality of life.

Exercise produces many health benefits. It releases endorphins and enkephalins—the body’s natural painkillers and feel-good hormones. 

Exercise releases endorphins and enkephalins—the body’s natural painkillers and feel-good hormones.

It improves blood flow to the brain, and it reduces fatigue. It improves the quality of your sleep. It may even reduce the risk of Alzheimer’s disease and certain forms of cancer. And new research demonstrates how exercise can help you build emotional resilience as well as physical strength.

Break Out Of  The All-Or-Nothing Exercise Trap

The secret to making exercise help, rather than hurt, is moderation. That’s a struggle for a lot of us.  We usually gear ourselves up to concur that work-out and push ourselves to do it all. Yet the result is a rapid crash and burn and a worsening of your pain symptoms. But exercise doesn’t have to be that way.  The best strategy is to break out of that all-or-nothing, push-it-to-the-limit mindset and learn ways to make exercise actually work for you.

The secret to making exercise help, rather than hurt, is moderation, and the best place to begin is by building strength, endurance, and confidence. Here are three steps to help you succeed:

  1. Guidance: any exercise/well-being steps you choose to implement should be customized to your particular needs with the help of your doctor, as well as a professional physical therapist or trainer.
  2. Moderation: Start by going for a 10-minute walk 3 times a week. If that wipes you out take a different approach – walk two or three minutes a day, every day—less exercise, more frequently so that you can very gradually increase your strength and endurance, but not get into trouble with your pain.
  3. Goal: as you concur the two minutes a day – set a new goal and move up to four, then to six, then eight, and so on—every two weeks. Continually raising the bar as each new goal is met. Gradually, working your way to your ultimate goal – maybe being 30 minutes of walking every day. With this structure you’ll become strong enough to endure the physical demands of walking and become confident in your ability to do it.

Types Of Guidance

There are three different types of trainers that might be helpful to you, depending on your specific needs.

  1. A physical therapist is trained in the use of exercise to achieve physical fitness or rehabilitation from injury.
  2. An occupational therapist will help you learn how to safely perform everyday activities without aggravating your injury or pain—activities such as lifting, reaching, and even getting dressed.
  3. A certified exercise therapist, much like a physical therapist, is trained in helping you achieve general physical fitness. But these therapists work outside the clinical setting, usually in gyms and health clubs. A certified exercise therapist is different from a simple personal trainer and has more expertise in dealing with injured individuals.

Addressing Maladaptive Behaviors

When people live with pain, especially chronic pain, they tend to become inactive.

This inactivity may not be causing the chronic pain, but it can feed into the chronic pain in several different ways. It can lead to poor endurance, to weakness, to overall fatigue, and to what are called maladaptive behaviors.

Maladaptive behaviors are behaviors that help you cope with one problem, but in doing so, they cause another problem. So imagine that you have an injury in your left knee. You might be bearing too much weight on your right leg to compensate, and soon, you’ll have pain in both knees. That’s a maladaptive behavior.

So you need to address your inactivity, your poor endurance, and any maladaptive behaviors you’ve developed to manage your pain. Create a program that not only deals with the site of pain and any adaptations you’ve gotten used to, but that promotes general physical fitness and well-being. The goal is to be strong enough to live your life—to be able to bring the groceries in from the car, walk up the stairs—pick up your pots and pans to cook dinner.

Image of group of retirees working out to combat their chronic pain symptoms

Use SMART Goals For A Smart Exercise Routine

Perhaps you’ve heard of SMART goals before. They’re used by businesses, schools, organizations, and individuals of all kinds. They’re an absolutely wonderful tool.

SMART is an acronym. It stands for—Specific, Measurable, Attainable, Relevant, and Time-limited. When you design your goals, they should meet all five of these criteria. Here’s how it works.

  1. Is it specific? Know exactly what you want to achieve—to be healthy and mobile enough to _________.
  2. Is it measurable? For example: Walk for 30 minutes. Once a day.
  3. Is it attainable? If your initial goal is just too much and wears you out, break it down so that it becomes more attainable. As mentioned above the goal can became—to walk for 2 minutes a day, every day for 2 weeks and gradually work up to 30 minutes a day, without getting exhausted.
  4. Is it relevant? The purpose of a goal is to shift your focus from your pain to your life.  Make the focus your ability to walk for a pretty reasonable amount of time and to feel steady on her feet. That would enable you to do other things—go grocery shopping, go to a party, stand in line at the movies, lead a pretty ordinary life.
  5. Is it time-limited? A time-limited goal is one you need to complete it by a specific date. Set an original date that is achievable.  If you need to, move the deadline back a few months. Never eliminate the deadline altogether. That’s important. Deadlines motivate you. They give you a clear target to work toward.

So, make it specific, measurable, attainable, relevant, and time-limited. It’s a SMART goal. What is your goal?

A Note Of Caution

Have any of you ever bought an exercise video or book that opens with a disclaimer like: Talk to your doctor before starting any physical exercise program? That’s not just legalese.

Before you even meet with a therapist, you need to talk to your primary care provider. This is especially important if any of the following applies to you: if you have heart disease, if you have asthma or lung disease, if you have type 1 or type 2 diabetes, if you have kidney disease, if you have arthritis, if you’re being treated for cancer, or you’ve recently completed cancer treatment.

Basically, keep in mind is that if you have a personal health history that may impact your exercise plan—talk to your doctor first.

This is not meant to scare you off from physical activity—actually quite the opposite. The idea it to make sure that you’re taking part in the types and amounts of exercise that are best for you—make sure that it’s safe so that you’re getting every possible benefit you can out of your physical activity.

With that being said – there’s no better time than the present to start your new life of pain management and exercise!

From the Lecture Series The Mayo Clinic Guide to Pain Relief
Taught by Professor Barbara K. Bruce, Ph.D., L.P.

 

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