Dr. Shahnawaz Gazi
Chronic pain is any pain from an injury or condition lasting more than 12 weeks. Chronic nonspecificied neck pain and chronic nonspecified lower back pain are the most common sites at which people report experiencing chronic pain. Health and fitness professionals understand the benefits of exercise in the prevention and treatment of numerous health conditions and that exercise testing and prescription should be included as part of health care.
Expert recommendations from agencies such as the U.S. centres for Disease Control and Prevention (CDC), National Academies for Science, Engineering, and Medicine, and the Work Group on the prevention of Acute and Chronic Pain of the federal Pain Research Strategy have released guidance for medical, health, and Fitness professionals regarding nonopioid and nonpharmcologic treatments (including exercise, physical therapy, and coginitive-behavioral therapy) to address chronic pain. Another example of a professional orginazation dedicated to promoting safer alternatives to opioid prescription for addressing chronic pain is the American Physical Therapy Association (APTA). Their “choosePT” campain encourages health care professionals to discuss the risks related to the use of opioid medications and to promote physical therapy as the treatment for pain management.
Types of exercises that can help chronic pain.
Exercise has been frequently studied as an alternative to pharmacologic therapy in treating chronic pain. First, exercise is often part of weight management program. The achievement of a healthy body weight may reverse a chronic inflammatory stae, increased mechanical loading on the joints, and sleep disturbances associated with chronic pain disorders. Similarly, physical activity alone (without weight loss) can improve sleep and reduce chronic inflammation in the. In fact, avoiding movement, even in those dealing with chronic pain, may lead to loss of strength, range of motion, and independence body (Ambrose & Golighty, 2015).
- STRETCHING?SELF_MYOFACIAL RELEASE (SMR):-
Stretching is often looked at as the first line of defence so-to-speak when using exercise to treat chronic pain. In general, regular flexibility training can improve range of motion, increase circulation to the muscles, and activate the parasympathetic nervous system.
All these factors will allow for greater movement. Additionally, many chronic pain syndromes can be result of improper length-tension relationships of various muscles groups. For instance, shortening of the hamstrings can alter the range of motion in the hips, possibly leading to back pain (Gordon & Bloxam, 2016). Regular stretching combined with SMR or ”foam rolling” can help to restore appropriate length tension relationship thereby decreasing the potential for pain. - YOGA:- The practice includes components of balance/flexibility through various postures, control over breathing, and meditation. The breathing and relaxation techniques taught through yoga have been demonstrated to increase increase and help individuals with chronic pain syndromes deal with the emotional aspects of these conditions.
The balance/flexibility portion of yoga can help an individual with chronic improve range of motion and circulation to the muscles and reduce the potential for disability associated with chronic pain (Vallath,2010).
- RESISTANCE TRAINING:- This can help to reduce chronic pain in a few ways. First, strength training can be used as a tool for strengthening muscles that are relatively weak which could be a potential source of pain or as part of a constellation of muscle imbalances leading to painful movement. For example, patients with chronic low back pain may have a history of sitting for long periods of time.
This position shortens hip flexors, lengthens the gluteals and causes a persistent anterior pelvic tilt altering the position of the spine (Clark et al.,2014). A corrective exercise program that helps to inhibit/lengthen the hip flexors and activate/strengthen the gluteals and transverse abdominis (TVA) can help to relieve this pain.
- WATER AEROBICS:- Water aerobics can be an excellent choice of exercise modality for individuals who have conditions causing chronic pain. There are several reasons which this is the case. First, water provides buoyancy which helps to provide some ofloading of the stress on the joints while simultaneously providing resistance for exercise. Second the hydrostatic pressure experienced during a water aerobic session can help to increase the load on the respiratory system as fluids are driven towards the trunk in addition to providing additional supported allowing the patient to gain better postural control.
Last, hydrodynamic drag forces allow for resistance to increase as the participant increases their speed, yet, as soon as movement is stopped, the resistance is also stopped. This allows the participant complete control over how much resistance feels safe to them (Zamuner et al., 2019)
- BIKING ANG WALKING:-
Low intensity activities such as walking, and biking are generally very easy on the joints and are considered a very safe and effective exercise modality for those living with chronic pain. Likewise, cycling and biking are a good introduction to physical activity that can help chronic pain sufferers break the cycle of inactivity which leads to further pain and disability. It is also important to note that walking can be incorporated into other activities (i.e., yardwork, house cleaning, etc.) which will increase overall daily step counts.
There are many choices for exercise which are safe and beneficial for individuals struggling with chronic pain. A well-rounded exercise program which combines several of these exercise modalities can provide the most benefit as each addresses different aspects of conditions or movement imbalances leading to chronic pain.
(The author is Physiotherapist & Fitness Consultant in a Private Bank)