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Understanding Chronic Pain & Exercise

A plain-language guide to persistent pain and getting moving again

Your alarm system

Pain is like your body's built-in alarm system.1 If you touch a hot stove, your alarm system gives you a sharp warning, so you pull your hand away. Pain is doing its job and keeping you safe.

Pain doesn't always mean damage

Sometimes, your pain alarm system has become very sensitive and is turning on (or being extra loud) even when your body is safe. To be clear, your pain is real, even if your body is not in danger.1

How you feel can also impact your pain: being stressed, feeling tired, or worrying about work and whānau can make your pain feel worse.2

Movement turns the alarm back down

When you are in pain, it makes sense that you want to stop moving and rest. But movement is important because it helps teach your pain alarm system that your body is safe.3

How to start moving again2

  1. Gradually start moving your body. Start with short periods of gentle movement and then rest. Slowly build up to longer or harder movement and activities.
  2. Breathe when you move. Often, when we are in pain, we can hold our breath, but this can make things worse. Practise taking easy breaths when you move.
  3. Do things that are meaningful to you.4 If you enjoy something, try to find ways to make the movement easier. For example, if your back gets sore during gardening, maybe you sit on a stool, try a kneeling pad, or you do short 3-minute stints of gardening before resting.
  4. Understand that flare-ups are normal. Some days or weeks will feel better than others. Just because your pain has increased, doesn't mean you have gone backwards in your recovery.

How a Clinical Exercise Physiologist (CEP) can help

A CEP can support you to start moving again, by listening to your story and your goals, and helping to find movement that will work for your body right now. They will use movement and exercise to slowly teach your alarm system that painful movements are actually safe, which will ultimately reduce your pain.1

References

  1. Moseley, G. L., & Butler, D. S. (2015). Fifteen years of explaining pain: The past, present, and future. The Journal of Pain, 16(9), 807–813. https://doi.org/10.1016/j.jpain.2015.05.005
  2. O’Sullivan, P. B., Caneiro, J. P., O’Keeffe, M., Smith, A., Dankaerts, W., Fersum, K., & O’Sullivan, K. (2018). Cognitive functional therapy: An integrated behavioral approach for the targeted management of disabling low back pain. Physical Therapy, 98(5), 408–423. https://doi.org/10.1093/ptj/pzy022
  3. De la Corte-Rodriguez, H., Roman-Belmonte, J. M., Resino-Luis, C., Madrid-Gonzalez, J., & Rodriguez-Merchan, E. C. (2024). The role of physical exercise in chronic musculoskeletal pain: Best medicine—A narrative review. Healthcare, 12(2), Article 242. https://doi.org/10.3390/healthcare12020242
  4. Liddiard, K. J., Brown, C. A., & Raynor, A. J. (2024). Positive association between patients’ perception of chronic pain rehabilitation as a personally meaningful experience and the flourishing aspect of well-being. Healthcare, 12(16), Article 1655. https://doi.org/10.3390/healthcare12161655

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