When you’re dealing with a condition that causes chronic pain, exercise might be the last thing on your mind, but it’s actually one of the best things you can do to feel better.
“People will avoid movement when something hurts for fear they will make it worse, but movement can often help reduce pain over time,” says UNC Health physical medicine and rehabilitation and sports medicine physician Katie Bartolo, MD. “Not moving can make things worse.”
It’s important to note that chronic pain is distinct from injury, and injuries do require some rest. But for conditions such as arthritis, autoimmune disorders and cancer, finding a way to regularly exercise can help ease symptoms of pain and fatigue.
“In addition to increased strength, reduced stiffness, a greater range of motion, better quality sleep and increased blood circulation, movement actually affects how the nervous system processes pain,” Dr. Bartolo says. “Not moving can amplify how painful something feels.”
If you haven’t been regularly exercising due to chronic pain, here are some tips for getting started again.
Tip No. 1: Talk to your doctor.
Before getting started, it’s important to talk to your primary care provider or the doctor who has been helping you manage your chronic condition. They can provide guidance on what’s appropriate for you in terms of intensity and length of a workout session, as well as identify any forms of exercise that would be inappropriate for your condition.
They also can help you identify when pain during movement is a sign to stop.
“Some mild discomfort with a new activity is normal if you haven’t been active,” Dr. Bartolo says. “Your provider can help you distinguish between that mild pain and harmful pain. Sharp pain, swelling, something that’s not resolving after a day or two are the types of symptoms that indicate we should pause and reevaluate or modify.”
Your doctor can also determine if you’d benefit from physical therapy to regain strength or range of motion before more strenuous workouts. They can help with some of the anxiety you may have about causing flare-ups of pain with exercise.
“As physicians, it helps us if we know where the patient is coming from, so explain your fears and worries, and we can guide you through that,” Dr. Bartolo says.
Tip No. 2: Consider working with a physical therapist or personal trainer.
You may feel more comfortable resuming exercise if you have professional help by your side.
“If you don’t have a lot of experience with movement, a physical therapist or trainer can give you recommendations for where to start,” Dr. Bartolo says. “You can get a customized program and build confidence with the guidance of a professional.”
Your doctor may have recommendations of physical therapists or personal trainers with specific expertise with your condition; if not, ask a trainer or therapist what they know about it before working with them. They need to build a plan that is appropriate given your condition, fitness level and any mobility issues.
“When you are working with a physical therapist or personal trainer, they should be seeking feedback from you on how things are feeling,” Dr. Bartolo says. “You should be getting feedback on form and guidance on gradually building your activity.”
Tip No. 3: Start small and be consistent.
Before dealing with chronic pain, you may have been accustomed to workouts that lasted for 30 minutes or an hour. Don’t expect to return to that right away.
“Start small, start slow,” Dr. Bartolo says. “Even five to 10 minutes at a time can be beneficial, when it’s done consistently. You can gradually increase.”
And if you’re new to regular exercise, focus on finding types of movement that you enjoy, because that will help exercise feel like less of a chore.
“For many people, I recommend low-impact activities like walking, swimming and cycling as good entry points,” Dr. Bartolo says. “They don’t put much additional stress on the body, and they can be a good social activity, so you can find an accountability buddy to join you.”
In addition to cardio activity, make time for strength training and flexibility. For strength, Dr. Bartolo recommends working with resistance bands before trying dumbbells or weight machines, and for a stronger core and flexibility, she recommends Pilates.
Tip No. 4: Give it time.
You probably won’t notice the benefits of exercise right away. While regular movement does eventually help with symptoms like pain and fatigue, those symptoms might actually feel slightly more pronounced at first as your body gets used to moving again.
“You have to be patient,” Dr. Bartolo says. “In general, it will probably take four to six weeks to start to see some of those benefits. That’s why it’s so important to find something you enjoy and be consistent.”
If you’re struggling to stay motivated, try pairing your exercise with something you enjoy.
“With an accountability buddy, you’re more likely to move consistently because you have someone to do it with, who’s counting on you,” Dr. Bartolo says. “If there’s a reality television show that you like, bundle that with exercise. You’ll look forward to the movement because you get to watch the show.”
Continue to check in with your doctor about your progress, both physical and emotional.
“People can get frustrated because they want to go right back to their activity level before pain,” Dr. Bartolo says. “A gradual return is part of the process, so be kind to yourself.”
Before you start a new exercise program, talk to your doctor. If you need a doctor, find one near you.