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February, 2016

Want Less Pain? Move More!

by Larry

As my 93-years-young mom who leads several aerobics classes each week can attest, exercise lowers stress and heightens chemicals in the body that help us feel good. In addition, staying physically active allows us to heal faster, maintain balance better and so fall down less, remain mentally sharp longer, keep fit, and be more limber. It generally enhances our readiness in most all ways to have a quality experience of life. The old adage, use it or lose it, really applies in spades here.

Yet what about debilitating pain that seems so intense one cannot move much? Here too, even if one believes movement is excruciating at first, a little goes a long way toward increasing tolerance for further range of motion increases and strengthening of muscle, and these in turn help us heal, have good overall physical and mental function, plus a superior outlook.

Just as a cascade of negative results may occur as we defensively lower movement and shut down in reaction to pain, so increasing movement allows for a blossoming of benefits that only grows with greater strength and ranges of motion. Research is showing that, besides keeping closer to peak potential in the most directly affected muscles, regular exercise provides many side benefits. Our mental health is brightened. Lungs and heart work better. Our immune systems operate normally. Good circulation keeps impurities from being stored in our bodies. We have properly regular movement of digestive system waste. Infections and allergies affect us less. Inflammations are reduced. We are able to be more positively engaged with life overall.

However, often people who have chronic pain fear increased movement, anxious that it will instead increase their hurting and believing they are already at or close to their highest tolerable threshold for acute soreness. Reducing the fear is necessary before much augmentation of motility, which in turn can diminish their overall pain levels, becomes practical. Support group classes, participated in and taught by peers who have similar long-term pain histories, can be encouraging and help relieve the stress of trying levels of activity that at first are very much outside folks' comfort zones. No doubt their is a spectrum of pain tolerance vs. sensitivity, and folks fall at different points along it, but with practice it seems one can increase the tolerance and decrease the sensitivity, benefiting then from this change. I know when I have at times had quite painful foot, wrist, shoulder, and back conditions, it could feel as though very little movement was then possible. Yet, with encouragement from physical therapists, it did not take long to again greatly increase what I was able to be doing.

Group involvement is frequently helpful more generally as well. When enhanced physical activity can be matched up with things we enjoy, it is more likely to be maintained. So if one's fitness efforts are carried out in the context of a fun gathering of friends who boost one another socially as well as cheering the participants along for healthy workouts, what is not to like?

Others probably get at least equal benefit from engaging in active hobbies or play, for instance kayaking clubs, hiking groups, square dance classes, Iron Man competitions, long walks with the dog, gardening, fauna surveys, nature photography, horse-related activities, hunting, bicycling alone or with others, frisbee golf, soccer or other sports, walking on paths amid gorgeous scenery, or having free-for-all games with one's younger kids or nieces and nephews. Disciplines such as yoga and Thai Chi can be immensely helpful as well.

Brothers of mine typically give themselves challenging goals that involve getting into good shape over periods of several months, then mastering whatever the latest target is, like paddling down the Missouri and Mississippi rivers, hiking up Pike's Peak, walking some everyday, rain or shine (for example, a total of as many miles as the number of the current year), or working up to doing the Rim-to-Rim Grand Canyon trek.

Some like one-day-at-a-time goals, perhaps watching a "Dancin' to the Oldies" tape while following along with one's own dance, balance, and exercise regimen. I like to pair up exercise in my living room with watching fun or interesting movies, then also take our pooch, Peri, out for a daily constitutional. A dog may be man's best friend partly because he or she can help each of us get up off our duff!

There are a variety of modern gadgets that encourage us to move more too, such as pedometers to measure our steps (10,000 a day being the recommended minimum) as we go through our routines and extra walks, or software for our smart phones or smart watches, that show us maps of where we have gone, the total distance traveled, our MPH rates of progress, etc.

Physicians are quite familiar, of course, with this idea that greater movement equals less overall pain. Patients recovering from recent injuries or surgeries are thus invited to begin getting active again right away afterward. Failure to do so can involve all sorts of complications, including constipation, loss of bone mass, poor sleep, depression, blood clots, muscle atrophy, coordination difficulties, and so on.

In general, folks who undergo surgeries for their musculoskeletal difficulties are five years later no better off in terms of functionality and pain reduction than others who engage in occupational or physical therapies, avoid overeating, and are physically active.

One difficulty we have is that we make small changes day to day that appear to have very little long-term impact. What harm, we might think when tired and busy, if we take a break tonight from an intended exercise regimen? And indeed if it were just that one time out of many, no problem. I find it easy to give in to this sort of temptation. However, if we habitually make that "just this once" choice not to engage in much movement, before we know it we have lost muscle tone and mass, are less coordinated, will tend to fall more easily, and may have a tendency to put on extra weight. Speaking from experience, then it is that much harder to get back into and maintain a healthier long-term lifestyle.

The types of pain reduced by movement are varied. Being in better condition physically, then adding to this with regular movement pastimes or therapies, enhances our mental health as well. We then feel more upbeat overall, dwell less on regrets about things from the past, and obsess less about things we imagine might go wrong in the future. Pain is lessened as well for areas of the body right around specific injuries or degeneration, as is true too for more generalized discomfort. More movement equals less "need" for pain medication, which, in turn, means less chance of becoming overly dependent on artificial ways to control our perception of pain.

Many older adults have seen these dramatic differences: among their friends and relatives who engaged in little movement activity as they aged, the pain they have felt is greater and their mental health, physical capacity, and quality and length of life on average are significantly diminished. Among those who remain more active, employing extra movement as a regular part of their routines, pain tends to be diminished, their minds are sharper, they are able to do more physically, and they enjoy richer, more fulfilling, and longer lives.

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