Exercising with Pain: 8 Tips for Safe Physical Activity

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Setting goals and choosing exercises you enjoy can help you be more physically active when you have chronic pain.

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When you’re living with chronic pain, a workout might be the last thing you want to do. Indeed, exercising with pain can be difficult, especially if you regularly experience discomfort.

Chronic pain is pain that lasts longer than three months. It can be constant or come and go, and it can happen anywhere in your body, according to the Cleveland Clinic. Common sources of chronic pain include:

  • Arthritis or joint pain
  • Back ache
  • Fibromyalgia
  • Headaches and migraines
  • Muscle pain
  • neck pain

If you suffer from chronic pain, know that you are not alone. More than 50 million American adults experience pain almost every day or every day, most often in the back, hips, knees and feet, according to a February 2022 study inPain.

Indeed, 20.4% of adults reported chronic pain and 7.4% of adults reported chronic pain that frequently limited their work and personal activities in the past three months (called chronic high-impact pain), according to the Centers for Disease Control and Prevention’s 2019 National Health Survey.

And because chronic pain can interfere with your normal functioning, exercise can sometimes feel like excessive exercise. But even small amounts of movement can help relieve or manage your discomfort.

Here, experts share their tips for exercising with chronic pain.

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“It’s never a bad idea to consult a doctor before beginning your exercise program,” says Stephen Lawrence Thorp, MD, pain medicine specialist at Northwell Phelps Hospital. “If you have a significant injury that is limiting you, it may be beneficial to do imaging and a thorough physical exam.” A doctor can also connect you with a physical therapist to help you incorporate more movement into your life, he says.

Should you exercise with chronic pain?

While it may be tempting to reduce your activity level in an effort to manage your chronic pain, it may actually be more beneficial to get moving.

Physical activity can help reduce your chronic pain in the following ways, according to Utah State University:

  • It builds muscle strength and flexibility
  • It reduces fatigue
  • It reduces sensitivity to pain
  • It reduces inflammation

Exercise can also help improve your chronic pain by rewiring the way you respond to pain.

“Exercise can change how the brain responds to pain by normalizing pain signaling and promoting the release of painkillers – [hormones and other compounds that act] as natural pain relievers – which turn off pain signals,” Joseph Lipsky, DPT, CSCS, physical therapist at Reload Physical Therapy & Fitness and certified strength and conditioning specialist, told LIVESTRONG.com.

Similarly, an April 2017 review in ​Cochrane Database of Systematic Reviewsconcluded that exercise may benefit adults with chronic pain by reducing pain intensity and improving physical function and quality of life.

The review also found that exercise, when done safely, poses little risk to people with chronic pain, especially those who fear that physical activity will increase their pain.

How to exercise with chronic pain

If you are able to be physically active and have received advice from a doctor or physical therapist, exercise can be a tool to help you lead a more fulfilling life when you suffer from chronic pain.

Follow these expert-recommended tips to help you get moving:

1. Start with low intensity exercises

It’s best not to dive straight into rigorous, high-intensity exercise because excessive physical activity can lead to increased pain, according to Utah State University. Instead, focus on low-intensity exercises that are good for your body.

For example, low-intensity activities like walking or light swimming for 30 minutes each day can help reduce your chronic pain and stress levels, according to the Cleveland Clinic.

You should also start small when trying to increase your activity level. “When pain becomes chronic, our body’s response to movement and activity can change,” says Dallas Reynolds, PT, DPT, director of operations support for ATI Physical Therapy. “Things that shouldn’t normally be painful can become painful.”

“What we want to encourage with chronic pain is to start creating a better relationship with movement, and we start with non-painful movements, no matter how small they may seem,” he says.

While you certainly don’t want to overwork yourself when training with pain, you do want to challenge yourself.

“Challenging doesn’t mean being exhausted or lifting tons of weights — it’s relative to the individual and what they’ve done,” Lipsky says. “When I have clients with chronic pain who are starting an exercise routine and haven’t exercised in years or months, walking 15 minutes is a challenge.”

Safely pushing your limits can help you get stronger, he says.

When trying to establish a fitness routine as someone with chronic pain, it helps to have clear goals in mind.

“One person’s goal may be to return to the field at a professional level, another may be to step onto the field with their grandchildren,” says Dr Thorp. “Once you’re clear on what you hope to accomplish, you can start designing the program to get there.”

4. Choose activities you enjoy

Another key to getting up and moving is prioritizing fun exercises, Lipsky says.

“For example, I have a client who used to run but has chronic pain. When we started exercising again, we used to run, but walking in our gym “, he says. “The power of not emphasizing the specific exercise and more on the fun has a higher chance of success.”

5. Take rest days and nourish your body

Rest days and exercise are complementary.

“Never forget that we break down our muscles and tissues during training, and it’s on our rest days that the muscles get stronger,” says Dr. Thorp. “You have to be as serious and disciplined on your rest days as you are on your training days.”

Factors like nutrition and sleep also matter. “Good nutrition, adequate hydration and optimal sleep will make a huge difference in your ability to recover from your workouts and reap the benefits,” he says.

Keeping stress under control, along with getting more physical activity, can also help improve your chronic pain.

“Making sure you’re also managing your stress is a big part of pain management because high stress will increase pain,” Reynolds says. “On your rest days, it is recommended that you work on stress management techniques like meditation. This will help you continue to work on your chronic pain even on your rest days.”

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New to meditation? Try these beginner-friendly tips for getting started with meditation, like starting small with five-minute sessions.

7. Modify the exercise to make it safe for you

According to Utah State University, even minimal movement may be better than no physical activity when you have chronic pain.

But you may need to take some precautions to make exercise safer, such as:

  • Modify to reduce the risk of falling
  • Ensure good posture
  • Use a range of motion that does not increase pain

8. Adapt your fitness routine to your type of pain

You want to make sure the types of exercises you do are appropriate for your specific type of chronic pain.

“For example, stretching and strengthening exercises are helpful for back pain and arthritis,” says Yili Huang DO, MBA, Certified and Licensed Pain Management Anesthetist and Director of the Pain Management Center of Northwell Phelps Hospital.

“Some forms of chronic headache can be caused by the neck, so stretching and strengthening the areas around the neck can help,” he says. “Alternatively, chronic headaches caused by stress or migraines may benefit from stretching and relaxation exercises.”

Warning

“If at any time you experience serious symptoms such as unrelenting pain, weakness in extremities, loss of balance, or any other symptom of concern, you should always seek medical attention,” says Dr. Thorp.

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