What’s an ordinary person to do who is experiencing pain but also needs to exercise? It’s no secret that there are many benefits to exercise – and there are many forms of exercise that offer uniquely different benefits, deciding on what is right for you is the challenge.
Let’s start with the condition that plagues me (and possibly many of you) Osteo-Arthritis. Mayo Clinic writers (see reference below) remind us that exercise is necessary, even when it hurts, to:
- Strengthen muscles around joints.
- Help maintain bone strength.
- Increase energy.
- Make it easier to sleep well.
- Help control weight.
- Improve balance.
- Improve mood.
Given all the many ways in which exercise can benefit our body/mind, it is easy to understand that most health professionals would advise us to keep moving. But then there’s this issue of pain…
There’s plenty of advice out there about exercise and pain. Pain can get in your way, it can be the thing that stops you in your tracks, makes you lay your dumb-bells aside or tuck your running shoes back into the closet. It seems to signal danger, so we are inclined to avoid anything that reminds us that it’s there – lurking, waiting to injure us in some way.
- Your yoga instructor will likely advise you not to push through pain, but to learn the difference between a stretch your body doesn’t enjoy and the signal it sends when you really shouldn’t ask more of a muscle group.
- Your trainer in the gym may offer the adage, “no pain, no gain” – and yes, muscles do often tear in order to heal and grow (increase in size) when one is actively in body-building mode. For the rest of us, this wisdom doesn’t apply!
But for chronic pain sufferers, (those with pain lasting beyond normal tissue healing time, generally 10-12 weeks), a recent meta-analysis of studies reports that while physical activity doesn’t generally cause harm it also may not change pain perception or elf-reported pain intensity (Geneen, et al, 2017). So, an exercise program is not the magic bullet for those of us seeking relief from persistent aches and pains.
Some researchers have proposed that pain-related fear amplifies the experience of pain; and suggest that there is strong evidence that pain is experienced more strongly when there is a greater focus of attention on it (Smith, et al, 2019). So, if exercise is recommended for someone in pain, that exercise (or the fear of engaging in it) may make the pain seem worse.
Yet, since research reminds us that exercise isn’t likely to be dangerous, it is probably wise to incorporate some thoughtful periods of movement into our lives rather than simply hope the pain and stiffness (from any chronic condition) will just go away on its own – it probably won’t! And, without sufficient movement, muscles can atrophy, joints can stiffen, making movement of any sort even more miserable – it’s a vicious cycle that’s unwise to ignore!
Why bring all this up now? Well, there’s also a body of literature that reminds us how life experiences and trauma can leave us with “unexplained symptoms” – like physical pain. And, while it has no easy explanation, that pain is a somatic expression of the events we carry with us (Roenneberg, et al). It can show up as a chronic illness (that offers a medical diagnosis, like arthritis) or as an enigma that stumps your medical provider, who can’t explain WHY you hurt, but is willing to accept THAT you hurt.
Caregiving is one of those life events that can lead to somatic symptoms from real conditions that emerge from our human predispositions (genetics) or self-neglect (too much sitting) or even our forays into self-harm (smoking, substance-misuse, etc.). It isn’t polite to admit, but LOTS of caregivers are in pain.
The public health crisis that is the tsunami of opioid addiction in our country is a vivid expression of this sort of pain. Pain that defies explanation and persists long after any easily-identified injury should have healed can lead some to make very poor, even dangerous, decisions about their health and wellbeing.
What’s a caregiver to do? You’ve got constraints on your time, energy and resources. You may only attend to your own wellbeing after you’ve managed everything on your “to-do” list related to caring for your loved-one. You’re busy, your tired, you’re overwhelmed. Maybe you’re not attending well to normal, preventive care (health screening, dental check-ups, etc.) and in a cumulative sense, that’s self-neglect!
Caregivers can fall into patterns that just aren’t healthy, giving so much to others, that there is little left for oneself. If that’s you, you need to chart a course out of that territory and into a healthier set of choices. Self-care isn’t selfish, it is genuinely self-preservation!
If you’re in pain, take steps to understand what’s driving that pain. Get appropriate care for an injury. Follow-through with rehabilitation and strengthening advice. If your pain comes from a chronic condition, take a look at what you’re doing to manage that condition vs. exacerbate that condition. Recognize too, that when pain interferes with your sleep it will mess with every part of your life. If your pain is a somatic symptom of the stress you’re under as a caregiver, acknowledge that, and find help!
As always, let me know if I can help. Self-care is crucial for bringing your best to your caregiver role!