How to manage chronic pain? New research indicates that movement can help

Researchers found that participants who reported moving more regularly had higher pain tolerance than sedentary participants. The more active the person was, the higher their tolerance.

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The two questions raised by these results are: why does physical activity have this effect? And could the pain-reducing effects of a “hand in ice” study be generalized to other conditions?

The why ?

The study’s lead author, Anders Årnes from the University Hospital of Northern Norway, explains that there are many possible reasons why exercise may affect our experience of pain.

“Engaging in activity releases substances in our nervous system that trigger pain-inhibiting pathways,” he says. “In fact, these are the same pain-inhibiting pathways that opioids and cannabinoids use, and so in some ways the effect of physical activity is the ‘little brother’ of these substances.”

Professor James McAuley, principal investigator at Neuroscience Research Australia and the UNSW School of Health Sciences, adds that activating the brain’s endogenous opioid pathways, via exercise, may protect people from part suffering from pain, so they might still feel pain but are not in as much pain.

Physical activity also influences markers of inflammation in the body, which can sensitize us to pain.

Then there are the psychological effects that can influence how the brain processes pain. Physical activity can regulate stress and anxiety, help us focus our attention, and reduce the risk of catastrophic pain.

Being active can also improve our confidence, says McAuley: “If you can increase someone’s confidence, it improves their pain and their disability.

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Although he says it’s a “great paper” with a great set of data, he adds that there may be other explanations for the relationship between physical activity and blood tolerance. pain. People who choose to do more physical activity may naturally have more pain-tolerant personalities or may have adapted to the experience of pain by pushing themselves and feeling sore muscles from exercise. .

“It would be great to find out,” McCauley says, explaining that what’s not clear is whether prescribing exercise to people who aren’t already active will reduce their pain or make them more tolerant.

Can physical activity improve chronic pain?

Arnes acknowledges that chronic pain is “a pretty different beast” than the pain of sticking your hand in freezing water.

“We don’t fully understand what causes pain to persist in this way. However, some theories point to this individual ability to process pain signals as a possible contributing reason,” he says. also be a useful tool for preventing and treating chronic pain, we are trying to determine if this effect on pain sensitivity might have something to do with it.”

Professor Manuela Ferreira of Sydney Musculoskeletal Health and the University of Sydney says exercise is ‘the way to go’ in preventing and treating chronic back pain.

“Our spine was made for movement,” she says.

Maintaining physical activity during the acute phase of pain (the first six weeks), although at a reduced level, and having a physiotherapist or exercise physiologist design an exercise program if the pain becomes chronic (more than 12 weeks), this can help in a multitude of ways.

Exercise increases blood flow and nutrients to the soft tissues of the back, improving the healing process and reducing the stiffness that can lead to back pain. It also strengthens the muscles around our spine.

“It provides stability to our internal organs and trunk,” she explains.

Yet the first thing many people do when their back hurts is to stop moving, says Ferreira: “It’s actually going to trigger other problems with the muscles and joints…putting more load on structures that can’t really support that load More load on small joints instead of muscles.

And not moving lowers a person’s confidence in their ability to move freely, she adds.

It’s still unclear how much and what type of physical activity works best, but Ferreira, who was the lead author of the paper predicting a rise in back pain by 2050, thinks we can. prevent and treat it.

“Most of it [estimate] is driven by an aging population and population growth… we cannot change that,” she says. “But we haven’t invested in preventative strategies and we haven’t made sure people know it’s okay to move. Exercise and physical activity are safe. We need to change people’s opinions and knowledge about back pain. If we do that, we can reduce the numbers.

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