When you’re in chronic, debilitating pain, it seems counter-intuitive to move. All you really want to do is be as still as possible and if you’re lucky, sleep. My pain went away when I slept. It was like 4-hour mini vacation from Pain Island.
So why do people want you to MOVE when you just want to be still? Here is my second item in my Pain Management Tool Box – Gentle Movement Every Day.
One reason it’s important to incorporate gentle movement if you’re suffering from chronic pain is our lymphatic system. Lymph is a fluid in our body that among other things carries garbage away from our muscles. But unlike blood, nothing pumps lymph through our body. We have to move it physically through hydration, gentle movement, like stretching, swimming and rhythmic movement, and massage.
When lymph builds up in an area, especially one you’re not moving because it hurts, it will create swelling. This buildup of toxins and swelling is called an edema and it’s a serious medical condition.
How many of us learned the RICE method in health class? Rest. Elevation. Ice. Compression. It’s still being used by many people today. But if you talk to some physicians and physical therapists, they will not recommend RICE for a variety of reasons, one of which is that they know it will prevent the lymph from moving in the affected area, which creates swelling. And swelling is inflammation which is pain.
In a 2004 systematic review of 49 different studies regarding mobilization vs immobilization of the limbs Nash et al concluded, “Mobilization increases blood flow and so reduces muscle atrophy, disuse osteoporosis, adhesions, and joint stiffness. Early mobilization seems to decrease pain, swelling, and stiffness, and patients generally prefer it to immobilization. It results in earlier return to work, a greater range of motion, and fewer complications and residual symptoms. This systematic review of all upper- and lower-limb injuries, including fractures, consistently found in favor of early mobilization over rest. The best evidence at hand suggests the medical profession generally errs too conservatively on the side of immobilization.”
From Nash C. Resting injured limbs delays recovery: a systematic review. The Journal of Family Practice. 2004;53(9). Retrieved online on 3/5/14 from http://www.jfponline.com/Pages.asp?AID=1772.
Many physicians are starting to recommend MEAT = Movement, Exercise, Analgesics and Treatment. As I think about the HOURS I spent icing myself down after my surgery to numb my pain and the subsequent nerve damage I developed AFTER my surgery, I have to wonder how much that ice really helped me. It numbed my post op pain but at what cost?
Another benefit of gentle movement is that when you move, your body releases endorphins. These are the feel good chemicals that will give you a “runner’s high.”
When you’re in chronic pain, you’re probably not going to be running but by moving through walking, you will still release endorphins. Endorphins act like analgesics. They decrease how we feel pain without the horrible side effects many people experience from taking prescription opioid based analgesics such as morphine.
So what are some good gentle movements for people in chronic pain?
Walking – Walk in the mall. Take the stairs if you’re able. Park a little farther away in the parking lot at the grocery store. I used to walk up and down my street with my neck brace on in my PJ’s. No wonder my neighbors think I’m crazy.
Yoga – I really recommend restorative yoga or if you can afford it, a private consultation with a yoga therapist or a physical therapist who’s also a yoga teacher. I know some amazing people if you’re looking for a referral.
Swimming – If you’re able to swim, being in water takes the pressure off your body. It supports you and allows you to move more. I am not the greatest swimmer so I use a kick boards to give me extra support.
If there are other activities you LOVE, talk to an instructor or expert or your physician about ways to modify it to accommodate your body. Many times they’re able to suggest alternative things you can do. I’ve seen women in their 8th month of pregnancy in Zumba classes. They just don’t do the jumps or a lot of the arm movements. Good instructors/trainers want you to be healthy and are always happy to work with you to do a particular activity.
Find ways to MOVE your body and get the lymph and endorphins flowing.