Health

Pain: A Little to Get Rid of a Lot

January 17, 2017

Being in pain, especially chronic pain is just no fun.  All of us have had some pain at some time in our life.  Sometimes it can be just a bump, bruise or minor burn, but sometimes, it can be chronic lower back pain, arthritis or other causes of severe pain that just doesn’t seem to go away.  Many times, pain killers of various types and strengths can help, but other times, only the strongest pain killers with the side-effects that come with them and their addictive properties can make a dent.  And one of the things that many people in pain stay away from is activity and exercise.  The question is does exercise help or hinder people in pain.  Obviously, each case has to be examined on its own merit, but in fact, different types of exercise tend to help people with chronic pain.

About a year ago, Moshe Chaim, a Yeshiva Bochur aged 19 came to see me and enrolled in our 10 Week weight loss program.  He was not only overweight, but at this young age had high cholesterol and very elevated triglycerides.  His eating was not healthy and there was a lot of overconsumption. What complicated this particular case was that Moshe Chaim also suffered from Psoriatic Arthritis.  Psoriatic arthritis is an inflammatory arthritis that is seen in association with skin psoriasis. It causes joint pain and swelling that can lead to damage of the joint if the inflammation is not controlled. (Joint damage can be prevented or controlled with the appropriate medications).  This complicated our program because Moshe Chaim could usually only walk 10-15 minutes before pain would kick in.  Sometimes, even less.  Naturally, his response was to avoid walking. 

Recently, Rivka Sarah came into our program and although she would like to lose some weight, her main goal was to gain energy and function.  Rivka Sarah has osteoarthritis. Osteoarthritis is the most common form of arthritis, affecting millions of people worldwide. It occurs when the protective cartilage on the ends of your bones wears down over time.  Rivka Sarah used to love walking, but because of pain in her knees and ankles as a result of the arthritis, she was also limiting herself and using public transportation and taxis almost all the time.

Pain can be a terrible thing and the effects of pain go well beyond just what hurts.  It can be very physically difficult to get out of bed in the morning and sleeping can become a major issue which just exacerbates the pain.  People with chronic pain feel unproductive and can fall into depression and even major depressive disorder.  Focusing on any particular tasks—whether at work or at school can become difficult and almost impossible for some.  For some, just doing regular every-day chores can be challenging and can cause you to become very fatigued.  General demoralization is also very common when pain goes on for a long time.  And also devastating to one’s health is the weakening of the immune system as a result of long-term pain.

People in pain try many types of remedies.  That can include standard over the counter drugs like ibuprofen, aspirin, or Acamol, or prescribed medication which tends to be stronger.  Some try either acupuncture or manipulation such as osteopathy or chiropractic. Nerve blocking using local anesthetic or trigger point injections are often used by pain doctors at specialized pain clinics.   Bioelectric treatment and surgery are also used successfully to treat pain. 

But what about exercise to treat pain?  Most of the aches and pains we experience are caused by old injuries, repetitive motions in our workplace or doing sport, posture problems, osteoarthritis, aging, and general inactivity.  According to the Harvard School for Public Medicine, ignoring the pain won’t make it go away. Nor will avoiding all motions that spark discomfort. In fact, limiting your movements can weaken muscles, compounding joint trouble, and affect your posture, setting off a cascade of further problems. And while pain relievers and cold or hot packs may offer quick relief, fixes like these are merely temporary.

By contrast, the right set of exercises can be a long-lasting way to tame ankle, knee, hip, or shoulder pain. Practiced regularly, joint pain relief workouts might permit you to postpone — or even avoid — surgery on a problem joint that has been worsening for years by strengthening key supportive muscles and restoring flexibility. Over time, you may find limitations you’ve learned to work around will begin to ease. Tasks and opportunities that might have seemed impossible may become doable again.

Using exercise to help alleviate pain is one of the cases where it is advised to see a personal trainer who has expertise in this area or an exercise-knowledgeable physical therapist.  Trying to do this on your own might bring the opposite effect.  Start by having a postural assessment so the possible cause of your pain can be spotted and then dealt with. I have found very often that minor corrections in exercise or walking form, or obtaining an good, functional orthotic to correct your biomechanics will more often than not help to relieve knee, hip, ankle and lower back pain.  Many times, it is only a centimeter or two in your feet that is off and the cause of pain.  WEARING PROPER FITTING AND GOOD QUALITY SHOES IS ESSENTIAL.

Aside from staying active and walking, the exercise that might be the most helpful for joint and muscle pains is stretching.  This aspect of exercise is too often overlooked but is so important to both prevents pain and to help relieve it.

Moshe Chaim was a very successful client.  In our 10 weeks together, all the issues that we expected to resolve with his new good health habits did indeed resolve.  His cholesterol and very high triglycerides fell to perfectly normal levels.  He lost 12 kilograms.  But the biggest surprise was that he now became far more functional.  He was now walking up to 45 minutes without pain and had less discomfort in general.  He was walking and stretching every day with some muscle building exercises 3 times per week. 

Rivka Sarah is still amazed every time she comes into the office.  Simply by pushing herself to do more, she is doing more.  Her walks are now 35 minutes at least.  She also is also stretching and like Moshe Chaim, she has also made certain dietary changes.  Her husband keeps saying “You’re walking again, you’re walking again”. Her entire demeanor and mood have changed.  And the pain has been greatly reduced.

There are times where certain types of injuries do require a period of rest, but laying around in bed day after day usually caused more problems than it helps.  Always listen to your body when exercising so you don’t overdo it either. We need to move and be active for our overall health and certainly to help our pains heal.  Some aches here and there may be inevitable, but many if not most of the daily pains we experience can be reduced or eliminated with the right kind of movement and exercise.  Taking the necessary steps to keep yourself pain-free can “add hours to their days, days to their years, and years to their lives.”