CHRONIC PAIN AND EXERCISE
In cases of chronic musculoskeletal pain (pain lasting > 3 months), secondary consequences of pain such as fear of movement, anxiety, pain catastrophizing and nervous system sensitisation become the primary drivers of pain and disability – more so than tissue damage.
There is an overwhelming amount of evidence concluding that exercise is the most effective intervention for chronic pain, however the mechanism of benefit is most likely different to what most people think.
Exercise-induced biopsychosocial changes such as reduced fear, reduced anxiety, increased pain self-efficacy and neural adaptations appear to influence pain more than physical adaptations to exercise. The fact that no single form of exercise has proven to be superior over another in treating chronic pain further supports this theory.
Proper education regarding pain and pathology for those suffering from chronic pain is crucial to the success of any intervention, and needs to be included to complement any exercise program.
Exercise can decrease pain, improve function and reduce disability in those with chronic pain, and should be prescribed on an individualised basis within a biopsychosocial framework (Booth et al., 2017).
Chris Bryceson
B. Health Sciences (Physio), APAM
CB Physiotherapy