Chronic pain can have a devastating effect on every aspect of your life. It’s not just the pain itself, which in some cases can be almost unendurable, but there’s the fatigue, headaches, a general feeling of being unwell, and very often depression and feelings of despair. It feels as if all the joy has been sucked out of you, and you exist from day to day rather than living your life as you would wish. Added to the physical and mental symptoms of chronic pain, you may also suffer from side effects due to medication such as strong painkillers, anti-depressants, and muscle relaxants. Very often, the last thing you feel like doing is exercising, but it can be one of the best ways to help with the self-care of chronic pain.
What is chronic pain?
The causes may be varied, but the common characteristic that defines chronic pain is that it is no longer (and in some cases never has been) serving a useful function, or that the feeling of being in pain outlasts the damage that caused it in the first place. Pain serves an essential role in the body because it alerts you to illness and injury, making you take action to prevent further harm to yourself. If you break a bone, it will be agonizing to start with; then as healing begins, the pain will reduce to a more manageable level. Once the bone is healed, the pain should disappear. In some people, for reasons that still aren’t entirely clear, the pain signals continue to transmit to the brain despite the fact they are not performing a useful function anymore.
What causes chronic pain?
It can arise from a variety of conditions, sometimes following injuries, especially those involving nerve damage, or illnesses that are acutely painful. Neuropathic pain develops when nerve endings grow pain receptors instead of ordinary sensors, resulting in hypersensitivity and the perception that stimulus that would normally not cause pain, such as a light touch, is intensely uncomfortable. In conditions such as fibromyalgia, the entire body can be hypersensitive, and the feeling of pain is constantly present to varying degrees. The root cause can’t be isolated to any one factor, or at least research has yet to find any common denominator for chronic pain. Theories that show promise include the role of inflammation, a natural response that helps heal damaged tissue, but that can persist after the repair has been affected. Research is ongoing, but for now, there is no simple cure for chronic pain.
When you first visit your doctor with chronic pain, they may well send you for tests and scans to see if there is any identifiable cause for the pain. If nothing can be found, but the pain persists, then one of the first steps is often the prescription of painkillers. Strong opioids that have similar effects to morphine used to be prescribed quite regularly, but in recent years, it’s been shown that the risk of addiction and abuse of these drugs is very high. It’s now becoming much harder to get a prescription for opioids, but in some respects, this has advanced the efforts to find alternative treatments rather than just disguising the pain without addressing the underlying cause.
The importance of moving and exercising
When you are struggling with chronic pain and its related symptoms, it can be very hard to motivate yourself to take actions that could help. If your back pain is making you miserable, then the idea of attempting yoga poses seems ludicrous and probably impossible without making the pain much worse. It seems counter-intuitive to make your body work when the pain is usually a signal that you should rest, but with chronic pain, the opposite is true. The pain is real, and just as unpleasant as if you were in an acute state of illness or injury, but those signals being sent to your brain are meaningless. You won’t suffer any harm or damage yourself further in any way by moving as freely and normally as possible. In fact, if you remain in a protective posture, or avoid movement and activity, your pain will worsen as other muscles start to feel the strain. Learning to relax your muscles and maintain as normal and correct a posture and gait as you can are the first steps in learning how to live with chronic pain.
Potential treatments for chronic pain
As research gathers data and evidence is found, a better understanding of how chronic pain manifests itself is developing. This has, in turn, led to far more options for treating pain, rather than depending on painkillers, physiotherapy, and rest. Some of the treatments that have shown good results include:
- Prolotherapy: this involves injecting painful ligaments and tendons with natural compounds such as Xylocaine and Sodium Morrhuate, which increase the production of prostaglandin in the affected tissue. As prostaglandin is a healing substance produced in the body, it works to rebuild tissues much as a scab would cover a skin wound.
- PRP (Platelet Rich Plasma): platelets and white blood cells are used by the body to start the healing process following tissue damage. A PRP device extracts these healing substances from the patient’s blood and concentrates them into an injectable form. This is then directed into the painful areas, stimulating the release of tissue growth factors that accelerate and enhance healing.
- Spinal cord stimulator: a device that is implanted into the patient, where it interacts directly with the nervous system. The stimulator sends electrical pulses along the spinal column and works by interfering with the transmission of pain signals and how your brain receives them. Practitioners have had good results, particularly with chronic back pain.
- Stem cell transplant therapy: Stem cells have been hailed as something of a miracle, as they have the ability to transform into any specific cells the body requires. It means they have the potential to regrow body parts that have been damaged or are diseased, although this application is still being studied. For chronic pain treatment, stem cells can be extracted from the patient’s own bone marrow or fatty tissues and concentrated in a centrifuge before being injected into the painful area. This stimulates repair and new tissue growth, and thus reduces pain.
Risks and side effects
Like any other medical procedure or treatment, there is a degree of risk involved with undertaking these therapies. However, they have been shown to be very safe when carried out by experienced therapists who are qualified in carrying out the procedure. Occasionally there may be side effects to treatments, so you should always make sure you’re fully informed and discuss any possible problems such as spinal cord stimulator side effects with your doctor.
Dealing with depression and low mood
Coping with the pain is only half the battle; suffering from depression can be just as hard, if not harder, than dealing with the physical pain. Trying to find the motivation and energy to exercise or undertake any physical activity can often seem impossible when you are low, but again, the act of taking exercise will help with your mental wellbeing in the long run. If you are finding it difficult to cope because of your mood, see if you can get some help from a therapist, and talk to your doctor to find out if anti-depressant medication would be helpful for you.
What kinds of exercise can you do?
You may not feel like a vigorous bout of cross training when you are in the grip of chronic pain, but there are plenty of other ways to keep yourself supple and fit. Yoga, Pilates, and Tai Chi are all excellent ways to stretch your muscles and loosen joints, while at the same time relaxing and de-stressing. Don’t be put off by thinking you have to contort yourself into bizarre positions like an expert; there are plenty of easy poses, and they can all be adapted to take account of any particular difficulties you may have. Running and other high impact activities may well be too uncomfortable, the concussion alone would make a person living with fibromyalgia weep, but you may find an exercise bike or treadmill that you can set to a gentle pace will keep you toned without overdoing it. Toning tables are another great way to stretch and exercise your body without putting undue strain on it. Perhaps the favorite activity for many chronic pain sufferers is swimming. Just being in the water can relieve the worst of your pain, and swimming is one of the best all-round forms of exercise for anyone.
Chronic pain is not something that can be shrugged off, and there’s no easy way to treat it as yet. If you are unfortunate enough to be living with some form of chronic pain, remember that exercising is one of the primary ways of helping your body to stay strong and cope with your condition, so be good to yourself and find the activity that gets you moving and helps you beat the pain.