Exercising while living with pain

Pain falls into two categories: chronic and acute. Acute pain is temporary, it usually has a clear cause and can be treated with pain relief such as paracetamol or ibuprofen. It may cause short-term mobility issues, especially if it is due to a muscle sprain, but it is usually resolved within a few weeks.¹

Chronic pain, however, is more severe. Up to one-third of all adults in the UK are impacted by chronic pain. It can occur in any part of your body, but for it to be considered chronic, it must have lasted longer than 3 months.¹

You may not be able to treat chronic pain with over-the-counter pain relief. 1 You should speak to your GP or pharmacist about it. While some stronger forms of pain relief may help you manage your symptoms, some can’t be taken long-term. Codeine, for example, is not recommended for chronic pain as it can have side effects and long-term use can result in addiction.

Although chronic pain is a health condition, it can also be a symptom of other conditions.¹

Chronic pain can also cause:

• Disturbed sleep and tiredness
• Low mood and overwhelm
• Light sensitivity
• Poor concentration and memory
• Lack of mobility. ¹

You may find that your mental health is impacted if you have a chronic pain condition. For example, you may experience:

• Anxiety and depression. Chronic pain can make you feel isolated, hopeless and anxious.
• Stress. Stress hormones like cortisol can make pain feel worse.
• Post-traumatic stress disorder (PTSD). If your pain condition is a result of a trauma, you may also develop PTSD.

It is not unusual for these mental health conditions to make pain feel worse, but your mental health may improve if you treat your physical pain.²

Gentle exercise can help reduce pain by blocking pain-related signals in your brain. It also helps strengthen and stretch stiff muscles, ligaments and joints.³

Exercise releases hormones called endorphins, which are your body’s natural pain relievers. It also releases serotonin, which is sometimes called your happy hormone. Serotonin helps you feel good after a workout. The combination of these two hormones can help you feel mentally stronger as well as reduce your pain.⁴

Regular physical activity can also make your muscles stronger and can support improved mobility. ³

There are things you need to consider before you start any new form of exercise. This includes:

• Deciding on your tolerance. If you live with pain, you will have an understanding of your tolerance levels. When you begin a new exercise routine, you may notice some pain, but you will have to decide whether you are over-exerting yourself or not. As you grow more used to your new movement patterns, you may notice less pain, but you shouldn’t ignore extreme pain when you begin a new activity.
• Thinking about how you monitor your commitment to change. Starting to add more physical activity to your life will help you to progress and reach new milestones. Doing exercise that you enjoy or that isn’t too strenuous can help you stick to your routine long-term. You don't have to start off with lots of sessions of physical activity. Go slow and add more to your routine when you feel ready.
• Deciding on where you will exercise. No matter whether you exercise at home, go outdoors or join a local gym, there are many ways to get moving. You are more likely to have fun when you feel comfortable and confident.⁴

Inactivity can make your pain worse. Building strength, flexibility and tone through regular activity can help in the long term by not only reducing pain but also improving your mental wellbeing.⁵

There are many different types of exercise you can try to minimise pain symptoms. It can help to pace yourself when starting a new exercise so that you don’t burn out too quickly.⁴

Some exercises that are suitable for beginners include:

• Yoga and Pilates
• Swimming or water exercise like aquarobics
• Tai chi
• Walking
• Chair stretches
• Group exercise classes.^4,6

NHS Better Help offers advice and resources on physical activity that can help you get started. You may also want to join classes in your local area. Better is a charitable organisation that can help you find leisure centres, pools and gyms near you.

If you have chronic pain or a pain-related condition, you may be able to access physiotherapy on the NHS. Your GP can either refer you or, in some areas, you may be able to self-refer. Your GP can tell you which route you can take. Your physiotherapist will assess your symptoms and can devise a suitable exercise plan that will help you manage your symptoms.⁷

During your appointment with a physiotherapist, they will ask you about your symptoms and any limitations you have due to your condition. They will assess your current level of activity and will help you understand why you may be experiencing pain. It’s a good idea to wear comfortable clothing during your appointment so that you can move freely during your assessment.

You will be given a pain management programme. It will outline recommended physical activities and how often they should be carried out.