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How exercise and movement reduce pain

It remains the single most common medical complaint by patients. It is sensory, emotional and perceptual — seemingly all at the same time. The way we experience it varies greatly. No two patients experience it the same, yet it is one of the body’s most important communication tools. Because the experience is so individualized, it can be challenging for the physician treating it.At the least, it is unpleasant. At its worst, it is intolerable. It is called pain, and what is known as acute pain is nature’s warning signal that something is wrong and should be attended to.

Recently, I mentioned the long-standing concept of the “magic pill,” a pill that is part of this imaginary vision of how medical treatment should be expected to function — quick, simple and effective. The “pain pill” is certainly a version of that.

Millions of Americans live with acute or chronic pain. Many rely on prescription drugs to improve their ability to function and maintain their quality of life. As we have learned, the drugs of choice, prescription opioids, have high abuse potential and can lead to life-threatening events when taken in excess or in combination with other drugs.

According to the National Institute on Drug Abuse, opioids are now responsible for over 100 deaths a day in the U.S.

As noted in a recent NPR report, for people who live with chronic pain, getting up and moving can seem daunting. Some fear that physical activity will make their pain worse. People with pain can be caught in a vicious cycle of inactivity, and this can result in lost muscle strength and further pain problems.

Recent findings show that physical activity does not make pain worse. In fact, researchers are finding the opposite to be true. The right kind of exercise can help reduce pain. They believe they may have hit upon a way to unleash natural opioids in the body that are thought to bind to the same receptors in the brain as opioid painkillers. According to these researchers, it is possible to produce enough of these natural opioids to create a sense of euphoria — what is known as a runner’s high.

The prescription for this treatment may surprise you. To ease pain, exercise in the form of taking brisk walks. It is recommended to start slow. Gentle physical activity, gradually increased with a health care provider’s tailored guidance, is a safe and comfortable way for sufferers to reduce pain. It starts by thinking of the exercise as a form of treatment.

“Movement is essential for nutrition of the cartilage,” Dr. Virginia Byers Kraus, a professor at Duke University’s Molecular Physiology Institute, tells NPR. Kraus goes on to explain that building up surrounding muscles helps stabilize the hurting joint and also increases lubrication of the cartilage.

Adds neuroscientist Benedict Kolber of Duquesne University in Pittsburgh, exercise may also cause changes in the brain that can make a big difference in damping down pain. Exercise engages our bodies to make opioids. If the goal is to walk to ease your pain, don’t do it just once or twice and then stop, Kolber advises. Shoot for getting out at least five times a week.

According to exercise physiologist Kirsten Ambrose, program manager for the Osteoarthritis Action Alliance at the University of North Carolina, exercise can “simply boost somebody’s self-efficacy, or their belief in their ability to be physically active.” That increased self-confidence can also help ease pain. She suggests making walking “a habit for life.” For further information, Ambrose suggests people consult Walk With Ease, a walking program sponsored by the Arthritis Foundation.

According to the National Institutes of Health, back pain is one of the most common medical problems in the United States. The National Institute of Neurological Disorders and Stroke lists back pain as the third most burdensome condition plaguing Americans.

If you are suffering from acute back pain, you might be considering surgery or other intervention for treatment. According to the folks at Harvard Health, most cases of back pain caused by normal wear and tear do not require you to stop your life and wait to heal. Move your body instead. In many instances, your best prescription is good old-fashioned movement and exercise.

According to Dr. James Rainville, assistant professor of physical medicine and rehabilitation at Harvard Medical School, the difficulties of back pain treatment are likely due to a neurological healing process, not a physical one. Relief does not seem linked to healing because the pain is usually unrelated to an injury.

As the theory goes, when a problem occurs and triggers pain, it is your nervous system that actually adapts to the pain, and that is what makes discomfort go away. Exercise and movement may help your nervous system make this adjustment more rapidly.

According to a Harvard Health report, many doctors are encouraging a return to the past when it comes to managing back pain, with less emphasis on intervention and more on encouraging movement.

“People who get moving — back to the gym, back to cleaning the house — do the best,” says Rainville. Movement always seems to help people.

Write to Chuck Norris ([email protected]) with your questions about health and fitness.

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