Importance of physical exercise in pain

Research by Cochrane Library point out that the physical activity makes up a fundamental part of the treatment of chronic pain . However, when we feel any form of pain, we avoid physical activity for fear that it will get worse. Thus, a dangerous and very harmful cycle begins: The patient does not do physical activity for fear of pain and becomes increasingly sedentary. sedentary lifestyle in turn increases the pain.

But after all, it is possible to practice physical activities in the treatment of chronic pain ?

Exercise and physical activity in general, no matter how difficult they may seem, should always be part of your chronic pain treatment plan. There are many benefits to exercising.

Concept of Physical Activity and Physical Exercise

According to World Health Organization , the physical activity is defined as " any body movement produced by skeletal muscles that promotes energy expenditure, including activities performed during work, play, performing household tasks, traveling and engaging in recreational activities " (WHO, 2015).

The WHO also states that " exercise is a subcategory of physical activity that is planned, structured, repetitive and aimed at improving or maintaining one or more components of physical fitness " (WHO, 2015).

Physical activity for health can take many different forms:

• Structured exercise (classes at the gym or program carried out at home);
• Small activities per day (activities of daily living)
• Vary in intensity, duration and type: aerobic (such as walking) or more focused on increasing flexibility, strength or balance.

Especially in chronic pain, physical activity should be performed as a form of regular exercise and guided by a professional.

Benefits of Physical Activity in the Treatment of Chronic Pain

Regular physical activity is a key approach to managing chronic pain and is as important as taking medications. Physical activity can also play an important role in preventing persistent pain.

Practicing physical activity regularly has a beneficial effect on several factors related to chronic pain:

• Reduces obesity
• Affects central pain modulatory processes.
• They increase muscle resistance.
• Relieve joint stiffness
• Affects the metabolism of muscle, bone, joint, tendons and intervertebral discs

According to research published in the Journal Pain a single exercise session increases the production of endogenous opioids (substances produced by the body itself similar to morphine), leading to transient antinociception (pain inhibition) in animals and humans. Repeated exercise produces long-lasting antinociception.

THE  aerobic exercise It is also strongly linked to weight loss, which in turn has implications for the management of chronic pain, as pressure on the joints is reduced. Muscular resistance exercises or other forms of strength training improve muscle tone.

THE resistance training Repetitive full-range exercise around the lumbar spine (in chronic low back pain) improves metabolism in the lumbar discs and aids in their repair. Training to improve balance and flexibility also has benefits, as it reduces the risk of falls and the potential for further pain or injury.

How to start practicing physical activities to treat chronic pain

It is important to start slowly when beginning an exercise program and gradually increase the intensity to avoid developing more severe pain.

To walk is the most common form of aerobic exercise recommended for people with chronic pain. However, if you have any physical limitations you can start with:

• Aquatic exercises
• Stationary bike
• Yoga
• Tai chi
• Pilates
• Muscular endurance using body weight

Additionally, progressing to exercises that increase muscle strength and endurance helps prevent many types of pain, including neck, shoulder, and back pain. Therefore, patients are encouraged to do resistance training to strengthen all muscle groups.

If you have chronic pain, it may be best to exercise in the mid-morning or early afternoon—or when any pain medications are most effective. Avoid exercising when your muscles are tense or at a time of fatigue.

While you sleep, your body temperature drops, leaving you stiff and inflexible in the morning. It may not be a good idea to do your workout first thing in the morning. However, everyone is different, so listen to your body and speak to your fitness professional for more advice.

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