Are you Fearful of Working Out due to Chronic Pain?

Are you fearful of working out due to chronic pain? Chronic pain affects nearly 22% of women in the United States. This means, for at least the past 3 months, these ladies have experienced pain nearly every single day. But for some, it is much longer than 3 months. If you look around at women in your life, how many of them experience some form of pain? What about yourself?

Chronic pain, no matter what is causing this, can range from a daily annoyance to being completely debilitating. This is even worse when you have no idea why you are experiencing pain and when no one can seem to help you.

Over time, whether your pain is an annoyance or debilitating, you sort of (negatively) transform your life to the point where you do less and less physical activity in hopes that it does not aggravate your pain. But what if movement is actually the answer we have been looking for this whole time?

Causes of Chronic Pain

Understanding how exercise can help such a multifactorial condition, we look at all of the contributing factors to chronic pain.

Pain is normal, living in pain is not.

As we become older (especially during and after menopause) changes in our hormones, stress, nutrition, sleep, and many other lifestyle factors happen, and these changes all at once don’t play well together.¹

The result? Dysfunctions such as¹:

Fibromyalgia
Chronic fatigue syndrome
Anxiety and depression
Osteoporosis
Thyroid diseases

But a history of previous injuries, whether from trauma or overuse and repetitive injuries also play a role in the development of chronic pain. This is typically because the initial injury was not properly rehabilitated, leaving areas of continued weakness, tightness, or poor movement patterns.

These ongoing factors commonly create a highly sensitized nervous system which then alters how the brain processes information and perceived threats.² Your nerves and brain stay on high alert to incoming threats and dangers. This can progress to the point where an incident as simple as hitting your shin on the coffee table feels like a dagger is going through you, leaving you in higher amounts of pain for longer than expected. But in a normally functioning nervous system, hitting your shin the coffee table feels horrible, but quickly resolves.

So, we have the natural changes as we age combined with the possibility of previous injuries working against us on the road to potentially developing chronic pain. And who wants to work out when they are in pain? I know I sure didn’t want to at first.

Developing fear of exercise! Are you fearful of working out due to chronic pain?

Pain sucks, there is no better way to state that, it just plain ole’ sucks. And we want to do everything we can to avoid more pain. It is almost like we want to keep a reserve of energy and “pain free moments” in case we need to babysit grandkids, clean the house, or do overtime at work.

It is no wonder why we may develop a fear of exercising when in chronic pain. Our nervous system is literally becoming extra-sensitive and our brains have difficulty sorting out what is good versus bad stimuli.

When we re-enforce this behavior of avoiding exercise, the whole situation turns into a vicious cycle. Over time, we become even more weak, de-conditioned, and develop tightness and stiffness. We may start to gain weight, become more at risk for diabetes, cardiovascular diseases, and other metabolic lifestyle disorders. And the cycle of pain, inactivity, and poor health continues.

But exercise does not have to be scary, we have the power and ability to meet our bodies where they are at. Gradual exposure, small and progressive increments in activity level are both great ways to re-introduce activity to begin to work on improving chronic pain and fitness.³

Exercise, the miracle drug if you are fearful of working out due to chronic pain

Exercise, physical activity, movement, or whatever you want to call it, proves time and time again to have significant and abundant health benefits. This is especially true for females that are peri or postmenopausal.

Exercise prevents natural, age related loss of muscle mass and function, improves balance which then decreases risk of fall and other injuries, improves ranges of motion, decreases risk of diseases, improves cognitive function, and improves pain levels.⁴

Yes, exercise which may seem to bring on pain, can actually work in reverse and decrease your pain!

Examples of exercise that improve all of the above, plus improves overall quality of life includes:

Yoga
Pilates
Strength/ resistance training
High Intensity Interval training
Aerobics
Core and balance training
Tai Chi
Aquatic exercise

And the list can go on and on. Aerobic and resistance training are the most highly researched and supported forms of exercise used in improving chronic pain, severity of diseases, and improving overall quality of life.⁵

Although there is no consensus on the appropriate prescription or dosage of exercise (and maybe there should never be a consensus since pain can be so different for everyone) it seems that 2-3 sessions of moderate intensity exercise, for 30-45 minutes, is effective in reducing pain and improving overall quality of life.⁵

Whatever frequency and duration you decide to start at, it is important to note that over time, with increasing frequency, duration, and intensity of exercise, there is more and more association with less and less chronic pain. Within 1-3 sessions of at least 30 minutes per week at moderate intensity, chronic pain lowered by 10-12%. And in older groups of women, those who exercised had a 21-38% lower prevalence of chronic pain. The take home message? There is consistent, linear progressions between frequency, duration, and intensity of exercise and chronic pain.⁶ Start with a few 30 minutes sessions a week and progress as tolerated from there.

But where do you start?

The trick to getting into exercise to help with chronic pain, whether you have experienced chronic pain for 3 months or 3 decades, is to approach it in a safe, non-threatening manner to avoid negative, unhelpful associations between exercise and pain.⁷

Start with where you are at. Maybe this is a walk around the neighborhood, a quick yoga video, or performing some gentle body weight movements. Or maybe you are at the point of being able to go on a 3 mile hike, being able to lift weights and perform strength training, or maybe you can go on an hour bike ride.

It doesn’t matter where you are at, as long as you are doing your best. Exercise intensity is all subjective and relative to where you are at in your journey.

How on earth does exercise help pain?

Oh my goodness there are so many ways! From the release of happy, feel good hormones to retraining your brain and nervous system to not feel threatened! And from loosening up stiff joints and stretching out tight muscles. Think of it as clearing out the cob webs!

When was the last time you took a nice, deep, expansive breath of air? Felt your heart and blood pumping, and experienced that “high” from a work out? You can experience this if you are not fearful of working out.

All of these positive associations and benefits of exercise become front and center to your brain when you work out. They knock down fear and preconceived notion that activity or exercise will cause harm and pain to the body.

Think of it as your brain always on look out for a lion. If you constantly search for lions, something as small and friendly as a kitty may seem slightly scary.

One day you see the neighborhood kitty walking in your driveway and this instantly frightens you as you have been training yourself (your brain and your nerves) to be on high alert for lions.

Instead, if you went up to the kitty and interacted with it, your fear would decrease. Okay, so this example may be a shot in the dark, but the lion is your pain and the kitty is the exercise in this scenario.

Constantly thinking “movement is bad and causes increased pain”, your brain and nervous system “learns” that movement causes pain.

But, if you put down that guard and try out some movement, your brain and nervous system can see and realize that the pain did not increase, and in fact if felt sort of good to clean out the cob webs.

So, no matter what stage you are in life, where you are at in your chronic pain cycle, meet your body where it is at and try some exercise, just move your body around. Don’t be fearful of working out.

References