Response to exercise in chronic pain – Is your pain getting worse?

It is well known if you are suffering chronic pain, exercise is a very important part of management. Often advice is to do some form of cardiovascular exercise for example riding a bike, swimming or walking.

Sounds simple doesn’t it?

Many people with chronic pain try to do the right thing and follow the advice of their health practitioners to improve or keep exercising but really struggle with managing their pain and are left confused if they should be exercising.

The short answer is Yes, you should be exercising but your ability to exercise may be influenced by many factors. Reviewing all of these factors is beyond the scope of this blog, however, how your body’s nervous system responds to exercise may be quite important in your pain response.

A person’s usual response to exercise involves a phenomenon where decreased pain sensitivity occurs i.e. if you pricked with a sharp pin causing pain before exercise it would feel less severe after exercising.

Interestingly, in some people with chronic pain issues the opposite seems to occur i.e. their pain sensitivity increases during and after exercising increasing their pain. Ever been to an exercise class and it’s taken a week or two to settle back down?

If this sounds like you just pushing ahead with a particular exercise regime may not be for you at this point in time. The problem is you need to be physically active in some capacity or your pain and function tend to deteriorate further.

It is not completely clear currently what causes this phenomenon of increased pain sensitivity however it appears to be linked with heightened sensitivity and responsiveness of the nervous system. An example of this might be sensitivity to your clothes rubbing on your skin or sensitivity to cold temperatures. There are many factors that can influence pain sensitivity and many of these are modifiable in chronic pain sufferers.

A thorough assessment by a health practitioner experienced in chronic pain management will be able assess the dominant factors contributing to your pain and influencing your ability to exercise. Your pain sensitivity can be tested with some very simple clinical tests and your exercise regime can be guided appropriately.

If you have any questions please feel free to contact us at Quest Specialist Physiotherapy.