Exercise as an alternative for pain killers
Pain is a complicated clinical issue, mostly because pain is a complicated neuroscientific issue. When we get injured, the body sends signals to the brain to indicate that we are in pain. When we incur an injury, receptors on the skin called nociceptors send information (electrical signals) from the body, through the spinal cord, and up to the brain, where these electrical signals are translated into the feeling of pain. Generally, the body begins to heal and the pain sensation dissipates. However, in some instances even after the injury is visibly healed, the pain persists. This is a condition called chronic pain. Why the body and brain generate pain long after the injury subdues is unknown. Because of this, chronic pain can be difficult to treat. Chronic pain can be treated with psychological methods such as cognitive behavioral therapy, and/or pharmacological methods such as non-opioid medications like antidepressants. In some instances, opioid medications may be prescribed. Chronic pain affects an estimated 100 million Americans, more than diabetes, heart disease, and cancer combined. Considering this statistic, it is no wonder that America is in the middle of an opioid epidemic.
I am one of these 100 million Americans suffering from chronic pain. Every day is different, but on most days I wake up feeling sore and uncomfortable, a feeling that makes me depressed and often anxious. My best and sometimes pain free days are the days that I get to exercise, and I have chosen to manage my chronic pain with physical activity. I am fully aware that not all sufferers of chronic pain have the physical ability to exercise, and so I feel grateful that I can use this natural technique to manage my pain.
Research shows that just a single bout of exercise can be an effective way to decrease pain sensitivity in healthy adults as well as clinical populations such as those with low back pain, osteoarthritis, myofascial pain, chronic fatigue syndrome, and fibromyalgia. This phenomenon is called exercise-induced analgesia. Exercise increases levels of endogenous opioids and endocannabinoids in the periphery, spinal cord, and brain, and it is thought that increases in these neurochemicals underlie the pain relieving effects of exercise. In addition, animal studies have shown that long-term or chronic exercise causes significant changes in brain areas that regulate pain sensitivity.
Fibromyalgia is a chronic disease that is characterized by widespread pain and is often accompanied by problems with sleep, fatigue, cognitive issues, and stiffness. These symptoms lead to a decreased ability to perform activities of daily living and an overall decreased quality of life. Exercise adherence is low in patients with fibromyalgia, especially because exercise can lead to transient increases in pain levels in patients with this disease. Recently, a group of scientists conducted a study to examine whether exercise can be effective at reducing symptoms in patients with fibromyalgia (https://pubmed.ncbi.nlm.nih.gov/28322760/). A group of 83 women between the ages of 30 to 75 were randomly assigned to either exercise or continue their normal activities for 8 weeks. The exercise group engaged in 120 minutes of exergaming per week that focused on postural control and coordination of the upper and lower limbs, aerobic conditioning, strength, and mobility. Exergaming was used as it adds an element of fun and engagement rather than simply running on a treadmill or cycling on a stationary bicycle. Clinical symptoms were evaluated both before and after the intervention.
Compared to the sedentary group, the exercise group showed significant improvements in a variety of clinically relevant areas. In terms of physical ailments, exercise increased mobility and decreased pain, discomfort, and stiffness. In terms of psychological ailments, exercise decreased anxiety and depression and promoted feel-good sensations. In addition, exercise increased the self-reported ability to work. Another recent study revealed that exergaming increases mobility, speed, and balance and decreases the fear of falling in patients with fibromyalgia (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5401622/).
In conclusion, exercise can be helpful for decreasing pain levels. If you suffer from a chronic pain condition, consult your physician to see what types of exercise are recommended for your situation. A physical therapist or personal trainer may also be helpful at prescribing an exercise regimen. Additionally, research is showing that exergaming may be helpful to decrease your pain. If you don’t like traditional forms of exercise, this might be something to try. These games are available on many video game systems like the Wii, Xbox, or PlayStation and are now even becoming available through phone applications.
References:
Collado-Mateo, D., Dominguez-Muñoz, F. J., Adsuar, J. C., Merellano-Navarro, E., & Gusi, N. (2017). Exergames for women with fibromyalgia: a randomised controlled trial to evaluate the effects on mobility skills, balance and fear of falling. PeerJ, 5, e3211.
Collado-Mateo, D., Dominguez-Muñoz, F. J., Adsuar, J. C., Garcia-Gordillo, M. A., & Gusi, N. (2017). Effects of Exergames on Quality of Life, Pain, and Disease Effect in Women With Fibromyalgia: A Randomized Controlled Trial. Archives of Physical Medicine and Rehabilitation.
