“Pain is a subjective experience, it’s personal to each and every individual,” states Dr Ashley Gluchowski, Clinical Exercise Physiologist. “It reflects on an actual or potential for tissue damage. Pain is our bodies’ alarm system. But pain is complex. Pain can be present without tissue damage. But the opposite is also true. Tissue damage can be present without pain.”
Dr Ashley explains that the function of pain is to alert us to protect a particular body part. For example if we have back pain we automatically say that must mean tissue damage so we protect our backs. “That’s the association we make and in the short term its usually a helpful response,” she says. “Another example is if we put our hand on the stove top we pull away immediately because we feel pain. This is an example of pain as a helpful alarm system in the short term. It’s acute pain because the pain should subside.”
She points out that over time, if pain becomes chronic, this response is no longer serving a purpose. “Any pain lasting longer than 3 months is chronic pain. This pain starts to interfere with our daily lives. Chronic pain no longer serves a purpose for us over time because it engulfs our thoughts and feelings. It’s all we can think about and even the lightest touch can bring on pain. This is called sensitisation.”
According to Dr Ashley managing chronic pain is possible and it usually requires a combination of treatments. “Studies have shown that the best improvements come with a combination of these things:
- Education – to understand what pain is and what it isn’t. When it’s beneficial and when it’s harmful.
- Regular exercise – we need to retrain the body to disassociate pain and movement.
- Cognitive Behavioural Therapy – known as CBT – this will help us to identify and overcome our harmful perceptions about pain and movement.”
The research shows that all kinds of exercise can be beneficial. What exercise does, says Dr Ashley, is
- It increases our bodies natural opioid production – endorphins – to increase the inhibition of pain.
- It retrains our brain, to tell our brain that movement is safe, therefore decreasing our fear of movement.
- It improves one’s physical functioning which means that we can get on with our daily activities easier.
- It increases our quality of life and it will improve our muscle mass and our muscle strength. Which will protect us from deconditioning, frailty and falls.
“Most people found that they didn’t have any adverse effects with exercise,” continues Dr Ashley, “if you do exercise its safe and free from adverse effects. To make sure it’s safe start with a low intensity and progress slowly. You can start in a pain free range of motion and increase to a tolerable amount of pain.”
It’s true that most people who have pain completely stop being physically active. “By staying inactive you perpetuate the pain and you add more consequences of being inactive such as weight gain, increased pain, increased risk of muscle loss, osteoporosis, metabolic diseases like diabetes and increased risk of falls,” observes Dr Ashley of this scenario.
She maintains that doing exercise and persevering at it will actually decrease pain and increase quality of life. “People can start with any exercise they enjoy, perhaps something they enjoyed before pain. So not something you don’t find enjoyable. It’s more about actually getting up and doing it.”
It is important to note that everybody is different and will see decreases in pain at a different rate when starting an exercise routine. “The most important part is consistency,” encourages Dr Ashley, “you’ll see some improvements right away and the pain will subside. It all depends on your consistency and perseverance. It’s an individual thing, people respond at different rates. Some people have a harder time than others. The pain is personal so it’s hard to tell.”
She advises that if it’s hurting too much – then lower the intensity of your exercising. You should expect to experience some pain until your body adapts and retrains. “If it’s unbearable then dial back the intensity,” she underlines.
And Dr Ashley is very focussed on improving outcomes for people with chronic pain. “For people in chronic pain exercise is one of the ways you will learn to manage the pain and decrease its severity.” Almost every research study and set of expert guidelines for chronic pain include exercise as a way to manage that pain. She points out that the NICE (National Institute for Health and Care Excellence) guidelines state that exercise should be ‘a core treatment irrespective of pain severity.’
But she does also observe that when you start a new exercise routine, you should also expect some muscle soreness. “However this will subside quickly as you are consistent with the new exercise routine. This is our body adapting to exercise. With muscle soreness your body adapts and becomes more fit.”
More proof that exercise really is for everyone – and Goldster can facilitate that.